AMANDA CARDOSO MONTAL
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5
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PAHC, Hospital das Clínicas, Faculdade de Medicina - Médico
FMUSP, Hospital das Clínicas, Faculdade de Medicina - Médico
FMUSP, Hospital das Clínicas, Faculdade de Medicina - Médico
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- Setting up hospital care provision to patients with COVID-19: lessons learnt at a 2400-bed academic tertiary center in SAo Paulo, Brazil(2020) PERONDI, Beatriz; MIETHKE-MORAIS, Anna; MONTAL, Amanda C.; HARIMA, Leila; SEGURADO, Aluisio C.As of August 30, 2020, Brazil ranked second among countries with the highest number of COVID-19 cases, with the city of SAo Paulo as the national epidemic epicenter. Local public healthcare institutions were challenged to respond to a fast-growing hospital demand, reengineering care provision to optimize clinical outcomes and minimize intra-hospital coronavirus infection. In this paper we describe how the largest public hospital complex in Latin America faced this unprecedented burden, managing severe COVID-19 cases while sustaining specialized care to patients with other conditions. In our strategic plan a 900 bed hospital was exclusively designated for COVID-19 care and continuity of care to those not infected with coronavirus ensured in other inpatient facilities. After 152 days, 4241 patients with severe COVID-19 were hospitalized, 70% of whom have already been discharged, whereas the remaining Institutes of the complex successfully maintained high complexity inpatient and urgent/emergency care to non-COVID-19 patients. (C) 2020 Sociedade Brasileira de Infectologia.
- Decontamination and re-use of surgical masks and respirators during the COVID-19 pandemic(2021) CORTES, Marina Farrel; ESPINOZA, Evelyn Patricia Sanchez; NOGUERA, Saidy Liceth Vasconez; SILVA, Aline Alves; MEDEIROS, Marion Elke Sielfeld Araya de; BOAS, Lucy Santos Villas; FERREIRA, Noely Evangelista; TOZETTO-MENDOZA, Tania Regina; MORAIS, Fernando Goncalves; QUEIROZ, Rayana Santiago de; PROENCA, Adriana Coracini Tonacio de; GUIMARAES, Thais; GUEDES, Ana Rubia; LETAIF, Leila Suemi Harima; MONTAL, Amanda Cardoso; MENDES-CORREA, Maria Cassia; JOHN, Vanderley M.; LEVIN, Anna S.; COSTA, Silvia FigueiredoObjectives: The coronavirus disease 2019 pandemic increased global demand for personal protective equipment (PPE) and resulted in shortages. The study evaluated the re-use of surgical masks and respirators by analysing their performance and safety before and after reprocessing using the following methods: oven, thermal drying, autoclave, and hydrogen peroxide plasma vapour. Methods: In total, 45 surgical masks and 69 respirators were decontaminated. Visual integrity, air permeability, burst resistance, pressure differential and particulate filtration efficiency of new and decontaminated surgical masks and respirators were evaluated. In addition, 14 used respirators were analysed after work shifts before and after decontamination using reverse transcription polymerase chain reaction (RT-PCR) and viral culturing. Finally, reprocessed respirators were evaluated by users in terms of functionality and comfort. Results: Oven decontamination (75 degrees C for 45 min) was found to be the simplest decontamination method. Physical and filtration assays indicated that all reprocessing methods were safe after one cycle. Oven decontamination maintained the characteristics of surgical masks and respirators for at least five reprocessing cycles. Viral RNA was detected by RT-PCR in two of the 14 used respirators. Four respirators submitted to viral culture were PCR-negative and culture-negative. Reprocessed respirators used in work shifts were evaluated positively by users, even after three decontamination cycles. Conclusion: Oven decontamination is a safe method for reprocessing surgical masks and respirators for at least five cycles, and is feasible in the hospital setting. (C) 2020 Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.