Hand disinfection in the combat against COVID-19

A preliminary analysis of hand disinfection use by travellers and their colonisation-risk with multi-resistant bacteria: A proof-of-concept study

BACKGROUND

International travellers have the potential to transmit multidrug-resistant bacteria. However, the role of hygiene measures during travel has yet to be investigated.

METHOD

Travellers were asked about their use of disinfectants and hygiene behaviour. Stool samples were analysed for Gram-negative multi-resistant bacteria (MDRO). These data were analysed, and a new MDRO risk map was developed and compared with data from existing literature.

RESULT

Of 214 travellers, 6 (2.8 %) tested positive for an MDRO before and 16 (7.5 %) after the trip, with travel in known high-risk MDRO areas. Most travellers, 174 (81.3 %), regularly used disinfectants; only 36 (16.8 %) did not. There was no statistically significant correlation between the use of a disinfectant and colonisation with MDRO. In our and comparable studies, a high-risk region on the risk map was associated with an increased number of MDRO or extended-spectrum beta-lactamase (ESBL) positive returns.

CONCLUSION

Travellers showed a high willingness to use disinfectants. This preliminary study highlights the need for larger, randomized studies to better assess the true impact of hand disinfectants on MDRO acquisition.

Asian American Vaccination, Testing, and Other Healthcare Knowledge & Behaviors during COVID-19, A Systematic Review

Novel COVID-19 variants continue to endanger global public health. Increasing COVID-19 vaccination, healthcare-related preventative behaviors, and general knowledge rates are all critical in halting COVID-19 spread. We evaluated Asian American COVID-19 healthcare-related behaviors and knowledge, due to the dearth of knowledge in this area and the unique social factor of COVID-19 related discrimination; discriminatory acts during the pandemic may play a role in COVID-19 related behavior adherence. Following PRISMA-P protocol, we conducted a systematic review. The search strategy combined synonyms of health-care behaviors and knowledge. Reviewers synthesized key themes across articles and assessed studies utilizing modified Newcastle-Ottawa criteria. Of the 2,518 articles, 32 were selected. Asian Americans reported greater COVID-19 vaccination willingness and decreased COVID-19 testing relative to other racial groups. Common COVID-19 vaccination concerns included vaccination side effects, long-term safety, and distrust of COVID-19 information sources. Asian Americans had high COVID-19 preventative behavior rates including mask-wearing, handwashing, and social isolation compared to other ethnic groups. Asian Americans, conversely, had lower COVID-19-related healthcare knowledge and telemedicine adoption levels relative to other participants. This systematic review informs public health officials and clinicians of COVID-19 related healthcare knowledge and behaviors in the Asian American population. Equipped with this knowledge, public health officials can better target messaging about vaccine safety concerns to the Asian American community and recognize the importance of tailoring COVID-19 educational materials to the heterogeneous Asian American subpopulations. This systematic review also provides insight into the unique telemedicine challenges physicians may face when engaging with Asian American patients.

The Keratinocyte as a Crucial Cell in the Predisposition, Onset, Progression, Therapy and Study of the Atopic Dermatitis

The keratinocyte (KC) is the main functional and structural component of the epidermis, the most external layer of the skin that is highly specialized in defense against external agents, prevention of leakage of body fluids and retention of internal water within the cells. Altered epidermal barrier and aberrant KC differentiation are involved in the pathophysiology of several skin diseases, such as atopic dermatitis (AD). AD is a chronic inflammatory disease characterized by cutaneous and systemic immune dysregulation and skin microbiota dysbiosis. Nevertheless, the pathological mechanisms of this complex disease remain largely unknown. In this review, we summarize current knowledge about the participation of the KC in different aspects of the AD. We provide an overview of the genetic predisposing and environmental factors, inflammatory molecules and signaling pathways of the KC that participate in the physiopathology of the AD. We also analyze the link among the KC, the microbiota and the inflammatory response underlying acute and chronic skin AD lesions.

Global impact on dermatology practice due to the COVID-19 pandemic

This contribution focuses on the effects of coronavirus disease 2019 (COVID-19) on dermatology practice. We discuss the impact on practice volume and procedures and on the considerable increase in teledermatology use. We also describe the important roles that dermatologists have played in enhancing infection prevention and on the frontline. During the crisis, dermatologists have faced the challenge of a shortage of resources, such as personal protective equipment, in the health care system. In addition, they have been involved in managing cutaneous manifestations related to COVID-19 and occupational disease caused by personal protective equipment. Dermatologists have made a diligent effort to identify melanoma and to ensure the treatment of high-risk skin cancers. Safety guidelines have been suggested to minimize the potential risks associated with the systemic use of immunosuppressant agents and immunomodulators in patients with severe inflammatory skin disease during the pandemic. Finally, social distancing necessitated that dermatology conferences take place virtually and teaching via e-learning increased.

Sexual attitudes of healthcare professionals during the COVID-19 outbreak

During the COVID-19 outbreak, which is effective worldwide, the psychological conditions of healthcare professionals deteriorate. The aim of this study was to examine health professionals’ changes in their sexual lives due to the COVID-19 outbreak in Istanbul, Turkey. This online survey was conducted between 2 and 26 May 2020 with 232 healthcare professionals working in a pandemic hospital. After obtaining informed consent, a questionnaire was sent online from the hospital database and health institutions social media accounts (Twitter®, Facebook®, Instagram®, WhatsApp® etc.) and e-mail addresses. The first section of the four-part questionnaire included demographic data, the second and third sections of pre-and post-COVID-19 attitudes, and the last section to assess sexual functions (International Index of Erecile Function for male and Female Sexual Function Index for female), anxiety and depression. Dependent sample t-test, Mc Nemar test, and multivariate analysis were used.The study was completed with 185 participants in total. Healthcare workers’ sexual desire (3.49 ± 1.12 vs. 3.22 ± 1.17; p = 0.003), weekly sexual intercourse/masturbation number (2.53 ± 1.12 vs. 1.32 ± 1.27; p < 0.001), foreplay time (16.38 ± 12.35 vs. 12.02 ± 12.14; p < 0.001), sexual intercourse time (24.65 ± 19.58 vs. 19.38 ± 18.85; p < 0.001) decreased compared to the Pre-COVID-19 outbreak. In addition, participants prefer less foreplay (p < 0.001), less oral sex (p < 0.001) and anal sex (p = 0.007) during COVID-19 and more non-face to face sexual intercourse positions (p < 0.001). When factors affecting sexual dysfunction were analyzed as univariate and multivariate, sexual dysfunction was shown to be significantly more common in males (OR = 0.053) and alcohol users (OR = 2.925). During the COVID-19 outbreak, healthcare workers’ sexual desires decreased, the number of sexual intercourses decreased, their foreplay times decreased, and their sexual intercourse positions changed to less face to face.

Analysis of dermatologic conditions in Turkey and Italy by using Google Trends analysis in the era of the COVID-19 pandemic

Many areas of life including patterns of dermatological diseases that patients attend to the hospital were tremendously affected by implementing stay-at-home orders during the COVID-19 pandemic. We aimed to identify the dermatologic interest of the public during the COVID-19 pandemic by using Google Trends. The terms "acne", "hair loss", "eczema", "genital warts", "molluscum contagiosum", "botox", "skin cancer", and "sunscreen" were analyzed on April 1, May 1, June1, 2020, and the corresponding period of the previous year in Turkey and Italy by using Google Trends. The searching spectrum was between March 31, 2019 and June 1, 2020. The relative change of search term "acne" was +10, +29, +13/-1, +17,+33, "hair loss" was +14, +40, +16/+3, +16, +15, and "eczema" was +2, +34, -4/ +3, +25, +18, on the other hand, the relative change of the "genital warts" was -15, -48, +10/-44, -30, +18 and "molluscum contagiosum" was -12, -2, -4/-4, -1, -12 while "botox" was, -10, -43, -8/-41, -31, +4, "skin cancer" was -27, -38, -38/-22,+33, -7 and sunscreen was -6, -25, -71/-13, 0, -45 in Turkey/Italy on April 1, May 1, and June 1, 2020, respectively. A statistically significant positive correlation was found between the number of COVID-19 cases in Turkey and search terms of the general dermatology group during the COVID-19 pandemic (P < 0.05). The search terms including "acne", "eczema", "hair loss" appears to be increasing while "molluscum contagiosum", "genital warts" "botox", "skin cancer", and "sunscreen" decreasing in the era of the COVID-19 pandemic. Understanding the trends and impacts of dermatologic diseases on public perceptions during the COVID-19 pandemic will allow for better preparation of dermatologists.

[Occupational health recommendations for lifeguards in aquatic emergencies in the Covid-19 era: prevention, rescue and resuscitation.]

Severe acute respiratory syndrome (SARS-CoV-2), which causes coronavirus disease 2019 (Covid-19), is highly contagious. Lifeguards are the first line of response in aquatic emergencies and they will suffer a strong exposure to risk this first summer of the Covid-19 era, so their occupational health must be rethought in their professional practice during the new normal. The main public health measure to prevent drowning is prevention, but when this fails and assistance or rescue is required, in most interventions, distancing will not be possible. The limitation of personal protective equipment (PPE) for rescue is a reality that must be known and that can affect the health of the lifeguard. A review of the current literature aimed at avoiding or minimizing the risk of contagion in the interventions carried out by rescuers in the Covid-19 era was performed. This article provides structured information on the prevention of contagion in lifeguards, the potential risks, the available PPE, and the recommendations for its proper use during rescue or prehospital care in aquatic settings.