scholarly journals Management of epistaxis during COVID-19 pandemic

2021 ◽  
Vol 11 (42) ◽  
pp. 50-52
Author(s):  
Rahul Mishra ◽  
Anjan Kumar Sahoo ◽  
Priyanka Gosain
Keyword(s):  
Emergency Department ◽  
Viral Load ◽  
High Risk ◽  
Healthcare Workers ◽  
Healthcare Providers ◽  
High Viral Load ◽  
Protective Equipment ◽  
Special Focus ◽  
Bleeding Control ◽  
Upper Airways

Abstract Epistaxis represents a commonly encountered manifestation in the ENT Emergency Department. Healthcare providers working in the ENT Emergency Department are at high risk of COVID-19 infection both because of the high viral load in the upper airways and because of the asymptomatic presentation of COVID-19 disease. Special focus is needed for managing the balance between appropriate patient care and ensuring the safety of healthcare workers. Adequate preparation and modification of the procedures for bleeding control to minimize risk of spread is necessary. While managing, attention should be kept on less invasive methods with avoidance of aerosol-generating activities. Nonetheless, proper use and disposal of personal protective equipment is of utmost importance in stopping the spread of COVID-19.

Innovative Draping Method to Mitigate Aerosolization During Coronavirus Pandemic

2020 ◽  
Vol 3 (2) ◽  
pp. 73-76
Author(s):  
Kripa Dongol ◽  
Yogesh Neupane ◽  
Dipesh Shakya
Keyword(s):  
Viral Load ◽  
High Risk ◽  
Operating Room ◽  
Healthcare Workers ◽  
Operative Procedure ◽  
High Viral Load ◽  
Upper Airways ◽  
Self Confidence ◽  
Additional Form

Otolaryngologists are at high risk of acquiring coronavirus because most of the procedures are aerosol generating and we have to deal with upper airways which contain high viral load. The objective of this study is to elaborate the draping technique which diminishes aerosol in the operating room. Use of a framework and a drape with customized hand insertion ports help to contain the aerosol generated during the operative procedure. The draping technique acts as an additional form of protection from aerosol along with an increase in self-confidence to the healthcare workers during this pandemic.

Accidental Organophosphate Insecticide Poisoning: a Fatal Child case with Hazards to Emergency Department Staff

2003 ◽  
Vol 10 (4) ◽  
pp. 248-252
Author(s):  
CL Lau ◽  
KL Chung ◽  
CW Kam
Keyword(s):  
Emergency Department ◽  
Healthcare Workers ◽  
Spontaneous Circulation ◽  
Organophosphate Poisoning ◽  
Protective Equipment ◽  
Organophosphate Insecticide ◽  
Secondary Poisoning ◽  
Initial Resuscitation ◽  
Emergency Department Staff ◽  
Department Staff

A 2-year-old boy was accidentally poisoned by one spoonful of organophosphate insecticide and presented in cardiac arrest. Spontaneous circulation was restored after initial resuscitation and antidote therapy (atropine and pralidoxime) but the boy finally succumbed with multiple complications. We reviewed the literature on the clinical features and management of acute organophosphate poisoning, and the appropriate protective equipment for preventing secondary poisoning of healthcare workers.

scholarly journals Evaluation of saliva sampling procedures for SARS-CoV-2 diagnostics reveals differential sensitivity and association with viral load

2020 ◽  
Author(s):  
Pieter Mestdagh ◽  
Michel Gillard ◽  
Marc Arbyn ◽  
Jean-Paul Pirnay ◽  
Jeroen Poels ◽  
...  
Keyword(s):  
Viral Load ◽  
High Risk ◽  
Health Professionals ◽  
High Viral Load ◽  
Sampling Procedure ◽  
Differential Sensitivity ◽  
Collection Method ◽  
Viral Loads ◽  
Saliva Collection ◽  
Sampling Procedures

AbstractNasopharyngeal sampling has been the preferential collection method for SARS-CoV-2 diagnostics. Alternative sampling procedures that are less invasive and do not require a healthcare professional would be more preferable for patients and health professionals. Saliva collection has been proposed as such a possible alternative sampling procedure. We evaluated the sensitivity of SARS-CoV-2 testing on two different saliva collection devices (spitting versus swabbing) compared to nasopharyngeal swabs in over 2500 individuals that were either symptomatic or had high-risk contacts with infected individuals. We observed an overall poor sensitivity in saliva for SARS-CoV-2 detection (30.8% and 22.4% for spitting and swabbing, respectively). However, when focusing on individuals with medium to high viral load, sensitivity increased substantially (97.0% and 76.7% for spitting and swabbing, respectively), irrespective of symptomatic status. Our results suggest that saliva cannot readily replace nasopharyngeal sampling for SARS-CoV-2 diagnostics but may enable identification of cases with medium to high viral loads.

scholarly journals Comparison of SARS-CoV-2 detection in nasopharyngeal swab and saliva

2020 ◽  
Author(s):  
Sumio Iwasaki ◽  
Shinichi Fujisawa ◽  
Sho Nakakubo ◽  
Keisuke Kamada ◽  
Yu Yamashita ◽  
...  
Keyword(s):  
Viral Load ◽  
Healthcare Workers ◽  
Virus Detection ◽  
Pcr Detection ◽  
Concordance Rate ◽  
Nasopharyngeal Swab ◽  
Protective Equipment ◽  
Convalescent Phase ◽  
Two Samples ◽  
The Face

We prospectively compared the efficacy of PCR detection of SARS-CoV-2 between paired nasopharyngeal and saliva samples in 76 patients including ten COVID-19 patients. The overall concordance rate of the virus detection between the two samples was 97.4% (95%CI, 90.8-99.7). Viral load was equivalent in COVID-19 patients, but the virus tended to disappear earlier in saliva at convalescent phase compared to nasopharyngeal samples. These results suggest that saliva is a reliable noninvasive alternative to nasopharyngeal swabs and facilitate widespread PCR testing in the face of shortages of swabs and protective equipment without posing a risk to healthcare workers.

scholarly journals Portable negative pressure environment to protect staff during aerosol-generating procedures in patients with COVID-19

2020 ◽  
Vol 7 (1) ◽  
pp. e000653
Author(s):  
James Nilson ◽  
Nikolay Bugaev ◽  
Pavan Sekhar ◽  
Haracio Hojman ◽  
Luis Gonzalez-Ciccarelli ◽  
...  
Keyword(s):  
Viral Load ◽  
Personal Protective Equipment ◽  
Negative Pressure ◽  
Healthcare Providers ◽  
Cost Effective ◽  
Therapeutic Interventions ◽  
Protective Equipment ◽  
Cost Effective Method

Patients with COVID-19 often need therapeutic interventions that are considered high aerosol-generating procedures. These are either being performed by healthcare providers with potentially inadequate personal protective equipment or the procedures are being delayed until patients clear their viral load. Both scenarios are suboptimal. We present a simple, cost-effective method of creating a portable negative pressure environment using equipment that is found in most hospitals to better protect healthcare providers and to facilitate more timely care for patients with COVID-19.

scholarly journals Distribution of cervical lesions in high-risk HPV (hr-HPV) positive women with ASC-US: a retrospective single-center study in China

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Zhiling Wang ◽  
Ying Gu ◽  
Hui Wang ◽  
Junyu Chen ◽  
Yawen Zheng ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Viral Load ◽  
High Risk ◽  
High Viral Load ◽  
Single Infection ◽  
Multiple Infections ◽  
Trend Test ◽  
Cervical Lesions ◽  
Increased Risk ◽  
High Risk Hpv

Abstract Background To investigate distributions of cervical lesions and factors associated with the severity of the cervical lesions in high-risk HPV (hr-HPV) positive women with atypical squamous cells of undetermined significance (ASC-US) cytology. Methods Clinical information of 250,000 women who underwent HPV and cytological test was collected from January 2012 to January 2019. The association between the severity of the cervical lesions and hr-HPV genotypes, hr-HPV viral load, and ages, were analyzed in hr-HPV-positive/ASC-US women. Results 3459 hr-HPV-positive/ASC-US women were enrolled in this study. Overall, 43.51% of women with ASC-US had normal histological results, 34.35% had high-grade squamous intraepithelial lesion (HSIL), and 1.30% had cervical cancer. The rate of HSIL or worse (HSIL+) in women with single HPV16 infection (63.09%) was the highest, followed by HPV33 (57.50%), HPV51 (36.11%), HPV58 (36.11%), HPV52 (28.28%), HPV18 (26.37%), HPV66 (19.35%), HPV39 (18.92%), HPV53 (15.00%), and HPV56 (8.51%). Detection rate of HSIL+ in low, intermediate and high viral-load groups were 15.87% (n = 30), 34.91% (n = 74) and 40.68% (n = 214) (Cochran-Armitage Trend test χ2 = 35.03, p < 0.0001). Compared with the 51–60-year-old group (21.65%), the women in ≤ 30 (40.52%), 31–40 (39.67%), and 41–50 (34.22%) year-old groups had significantly higher risk of HSIL+. The women in ≤ 51–60 (2.68%) and > 60 (3.41%) year-old groups were at increased risk for cervical cancer, compared with the ≤ 30-year-old group (0.61%). Conclusions ASC-US women with HPV 16/18/33/51/52/58 single infection and multiple infections, as well as high HPV viral loads, have high risk of HSIL+.

scholarly journals Significance of the Viral Load of High-risk Hpv in the Diagnosis and Prediction of Cervical Lesions: A Retrospective Study

2020 ◽  
Author(s):  
Yang Liu ◽  
Changjun Xu ◽  
Jing Pan ◽  
Chunyi Sun ◽  
Honglin Zhou
Keyword(s):  
Cervical Cancer ◽  
Viral Load ◽  
Retrospective Study ◽  
High Risk ◽  
High Viral Load ◽  
Control Group ◽  
Cervical Lesions ◽  
Hpv Dna ◽  
Cin Iii ◽  
Hpv Viral Load

Abstract Background: The significance of HPV viral load in the detection of cervical lesions is still controversial. This study analyzed the correlation between the high-risk (HR)-HPV viral load and different cervical lesion degrees.Methods: This was a retrospective study of the patients who first visited the hospital between January 2015 and June 2018. Patients with positive HR-HPV were screening for cervical cancer. The HR-HPV DNA load was measured by the second generation hybrid capture (HC2) technology. The patients grouped as normal, CIN I, CIN II, CIN III, and cervical cancer. Multivariable logistic regression was performed to explore the association between HR-HPV DNA load and cervical lesions.Results: Finally, 265 patients were grouped as normal (n=125), CIN I (n=51), CIN II (n=23), CIN III (n=46), and cervical cancer (n=20). Among them, 139 (52.5%) had a low viral load, 90 (34.0) had a moderate viral load, and 36 (13.4%) had a high viral load. Taking the normal control group as a reference, a high viral load was an independent factor for CIN I (CIN I: OR=3.959, 95%CI: 1.300-12.059, P=0.015) CIN II (OR=6.211, 95%CI: 1.641-23.513, P=0.007), CIN III (OR=7.002, 95%CI: 2.308-21.244, P=0.001), and cervical cancer (OR=9.439, 95%CI: 2.394-37.22, P=0.001).Conclusion: Cervical lesions are closely related to HR-HPV infection. Higher HR-HPV viral load in cervical lesions was associated with a higher risk of high-grade cervical lesions.

scholarly journals Association between personal protective equipment and SARS-CoV-2 infection risk in emergency department healthcare workers

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Danique Schmitz ◽  
Marieke Vos ◽  
Renate Stolmeijer ◽  
Heleen Lameijer ◽  
Titus Schönberger ◽  
...  
Keyword(s):  
Emergency Department ◽  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Infection Risk ◽  
Protective Equipment

scholarly journals Subcutaneous REGEN-COV Antibody Combination for Covid-19 Prevention

2021 ◽  
Author(s):  
Meagan P O'Brien ◽  
Eduardo Forleo Neto ◽  
Bret J Musser ◽  
Flonza Isa ◽  
Kuo-Chen Chan ◽  
...  
Keyword(s):  
Viral Load ◽  
High Risk ◽  
Risk Reduction ◽  
Infected Individual ◽  
High Viral Load ◽  
Primary Efficacy ◽  
Symptomatic Disease ◽  
Assessment Period ◽  
Efficacy Assessment ◽  
To Receive

Background: Casirivimab and imdevimab (REGEN-COV) markedly reduces risk of hospitalization or death in high-risk individuals with Covid-19. Here we explore the possibility that subcutaneous REGEN-COV prevents SARS-CoV-2 infection and subsequent Covid-19 in individuals at high risk of contracting SARS-CoV-2 by close exposure in a household with a documented SARS-CoV-2-infected individual. Methods: Individuals ≥12 years were enrolled within 96 hours of a household contact being diagnosed with SARS-CoV-2 and randomized 1:1 to receive 1200 mg REGEN-COV or placebo via subcutaneous injection. The primary efficacy endpoint was the proportion of participants without evidence of infection (SARS-CoV-2 RT-qPCR-negative) or prior immunity (seronegative) who subsequently developed symptomatic SARS-CoV-2 infection during a 28-day efficacy assessment period. Results: Subcutaneous REGEN-COV significantly prevented symptomatic SARS-CoV-2 infection compared with placebo (81.4% risk reduction; 11/753 [1.5%] vs. 59/752 [7.8%], respectively; P<0.0001), with 92.6% risk reduction after the first week (2/753 [0.3%] vs. 27/752 [3.6%], respectively). REGEN-COV also prevented overall infections, either symptomatic or asymptomatic (66.4% risk reduction). Among infected participants, the median time to resolution of symptoms was 2 weeks shorter with REGEN-COV vs. placebo (1.2 vs. 3.2 weeks, respectively), and the duration of time with high viral load (>10^4 copies/mL) was lower (0.4 vs. 1.3 weeks, respectively). REGEN-COV was generally well tolerated. Conclusions: Administration of subcutaneous REGEN-COV prevented symptomatic Covid-19 and asymptomatic SARS-CoV-2 infection in uninfected household contacts of infected individuals. Among individuals who became infected, REGEN-COV reduced the duration of symptomatic disease, decreased maximal viral load, and reduced the duration of detectable virus.

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