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Face Masks and Hand Sanitizers
Published in Hanadi Talal Ahmedah, Muhammad Riaz, Sagheer Ahmed, Marius Alexandru Moga, The Covid-19 Pandemic, 2023
Shahzad Sharif, Mahnoor Zahid, Maham Saeed, Izaz Ahmad, M. Zia-Ul-Haq, Rizwan Ahmad
In case of N95 masks, which can provide tight fitting as they are unable to allow the passage of air side-ways but it can pass through the mask [24]. Before using the respirators, the users should test its fitting so that it can be ensured that there is not any kind of leakage [25]. A study was also done to know the number of persons who can pass the fit tests with N100 masks, N95 masks (Ref1860) and N95 masks (Ref9210). The efficiency of their pass rates was 70%, 69% and 55% respectively. The experiments with the user seal check showed about passing of 71 to 75%. But the Quantitative Fit Testing incorrectly passed the 18 to 31% of the user seal checks. It indicates that for the overall effectiveness of the respirator, it should be fitted and worn properly. To check the fitting of the respirator, “Quantitative Fit testing” is more preferable than the user seal check. When surgical masks were checked, they came out with very poor fit factor and the fit factor of 13.7 was observed while wearing five surgical masks together. The respirator covering the half-face came out to have as low as 100 fit factors [19]. Qualitative tests on the face masks fitting revealed that almost all the 100% masks were failed while breathing normally. In the case of aided and non-aided Quantitative fit testing, fit factors from 2.8 to 9.6 and 2.5 to 6.9 were obtained, respectively [26]. These face masks cannot replace respirators as they have been designed in such a way that the space remains between the face and mask and thus also show less fit factor even when used in a multiple number together.
Radiation oncology considerations
Published in Charles F. Levenback, Ate G.J. van der Zee, Robert L. Coleman, Clinical Lymphatic Mapping in Gynecologic Cancers, 2022
Gwendolyn Joyce McGinnis, Anuja Jhingran
A large retrospective review of patients who underwent sentinel node biopsy showed patients with low-volume lymph node disease frequently received adjuvant treatment and had improved oncologic outcomes compared to patients with macrometastatic lymph node disease.39 In this study, 844 patients were included, 44 of whom had low-volume metastatic lymph node disease (LVM; defined as ITCs or micrometastatic disease) and 47 had macrometastatic lymph node involvement (MM); 753 patients were lymph node negative. In terms of adjuvant therapy, 82% of patients with LVM, 89% of patients with MM, and 14% of patients without lymph node involvement received adjuvant therapy. Recurrence-free survival was 90% for N0, 86% for N0(i+), 86% for N1(mic), and 71% for N1+ patients.
Breast Surgery
Published in Tjun Tang, Elizabeth O'Riordan, Stewart Walsh, Cracking the Intercollegiate General Surgery FRCS Viva, 2020
Gaural Patel, Lucy Kate Satherley, Animesh JK Patel, Georgina SA Phillips
The aforementioned three genomic tests are currently recommended by NICE for guiding adjuvant chemotherapy decisions for patients with ER+, LN− (including micrometastes) and HER2− early breast cancer who are assessed as being at intermediate risk. The indications are currently widening to include N1 patients.
Masks in COVID-19: let’s unmask the evidence
Published in Expert Review of Respiratory Medicine, 2021
Arjuna P. De Silva, Madunil A. Niriella, H. Janaka de Silva
Currently, FFPs have become one of the most sought-after PPE in the world. There are three primary classifications based on which part of the world they are manufactured. N95 is the classification based on NIOSH in the United States [30]. The classification N, R, P is based on the resistance of the mask to oil. N being not resistant, R being partially resistant and P being totally resistant or oil proof. N95 means the masks prevent 95% of the particles crossing the mask. N100 will keep 99.9 of the particles out. So, according to this classification, the best mask would be a P100 mask. However, being oil proof will not help in the COVID-19 pandemic. Thus, N95 masks would be adequate. It is also important to remember that these masks filter out particles of about 0.3 microns. The size of the SARS-CoV-2 virion is smaller (about 0.150 microns).
Outcome of carotid and subclavian blowout syndrome in patients with pharynx- and larynx carcinoma passing a standardized multidisciplinary treatment
Published in Acta Oto-Laryngologica, 2018
Constanze Gahleitner, Benedikt Hofauer, Katharina Storck, Andreas Knopf
The mean age at primary cancer diagnosis was 62 ± 13 years in our patient cohort. Seventy-eight percent were male and 22% were female. The majority (45%) of our patients were diagnosed with oropharyngeal cancers, followed by hypopharyngeal (22%) and laryngeal (16%) cases. Four patients suffered from cancer of the oral cavity, while three and two had nasopharyngeal and sinonasal carcinomas, respectively (Table 1). Approximately two-thirds of patients in our cohort showed advanced T3/4-status at the time of diagnosis. Sixteen patients had T1/T2-tumours. Nearly half of the patients had suffered multiple ipsilateral (cN2b) or bilateral (cN2c) lymph node metastases (48%). Five patients were at Stage N3 cervical metastasis. Limited N-status (N1/N2a) occurred infrequently (i.e. only in five patients). Almost one-third (33%) of patients were lymph node-negative at initial tumour diagnosis (N0). Tumour staging revealed one patient with lung metastases, while the vast majority did not develop distant metastatic outgrowth. With respect to tumour grading, tumours were graded as intermediate (G2), high-grade (G3) and low-grade (G1) in 60, 32 and 4% of our patients, respectively (Table 1). The vast majority of our patients had a history of prior R(C)Tx; 57% had received primary R(C)Tx and 20% adjuvant R(C)Tx. Four percent of patients were treated only with surgery. Nineteen percent of patients were treatment-naïve; of these, 13% were patients demonstrating CBS as the primary symptom before diagnosis and 6% were those who underwent best supportive care due to incurable disease at the time of diagnosis (Table 1).
The effect of moisture content within multilayer protective clothing on protection from radiation and steam
Published in International Journal of Occupational Safety and Ergonomics, 2018
The effect of moisture content on the thermal protective performance was investigated under low-intensity radiation and low-pressure steam. The results demonstrated that the difference in thermal protective performance between the N1 and N2 fabric systems gradually increased with growing levels of moisture content in the fabric systems. The trend for predicted times to develop second-degree and third-degree burns exhibited marked differences in dry heat exposure over moisture content, but the predicted skin burn times both reached the minimum value when the moisture content within the fabric system was 8.0 g. However, the addition of moisture content increased the second-degree and third-degree burn times when the fabric system was subjected to wet heat exposure. This is in part due to moisture’s ability to act as a thermal conductor to enhance heat transfer in the fabric system, and to slow down heat transfer due to the higher thermal storage and evaporative heat loss properties of water. The positive or negative effects of moisture mainly depend on the exposure time, moisture content and test conditions. With regards to dry heat exposure, the addition of water to fabric systems had a complicated effect on the thermal protective performance. In contrast, the increasing moisture content in fabric systems increased the positive effect on the thermal protective performance in wet heat exposure, regardless of short-term or long-term heat exposure.