Study: Construction Industry Respirator Masks Can Be Used by Health Care Workers

E.J. Mundell wrote . . . . . . . . .

As the coronavirus pandemic stresses the U.S. health care system, personal protective equipment — including high-tech masks — are in desperately short supply.

But a new study suggests an innovative solution: Reusable respirators typically used by construction or factory workers may be a viable alternative to disposable N95 respirators used by health care personnel.

The reusable masks are called elastomeric half-mask respirators (EHMRs), and they “provide the same level of respiratory protection [from infection] as N95 respirators,” explained a team led by Lisa Pompeii, professor of pediatrics-epidemiology at Baylor College of Medicine, in Houston.

One potential roadblock to nurses and other health care workers using EHMRs is the time needed to assure a safe fit, however.

“Training and fit testing health care providers on respirators can be time-consuming, and in an epidemic we want to train and fit test a large number of workers quickly,” Pompeii said in a Baylor news release.

So, her team compared the time it took to fit test and train health care workers to use either standard disposable respirators or the reusable EHMRs.

The result: Health care staff quickly got the hang of the reusable respirators, and it didn’t take more time to fit test them than to do so with a disposable respirator, Pompeii’s group reported. Their findings were published online in the Journal of the American Medical Association.

“Our study shows that training and fit testing workers on these reusable respirators does not represent a barrier for possible use by hospitals,” Pompeii said.

Another huge advantage of using reusable respirators “is that there is no need to stockpile them,” as must happen with disposable masks, she noted.

Further investigation is needed to determine how best to disinfect elastomeric respirators in health care facilities, something that’s also being studied by Pompeii and her colleagues, and others.

The repurposing of EHMRs isn’t the only way that health care workers are partnering with the building trades to help fight the COVID-19 pandemic.

In a joint statement issued, the nurses’ union National Nurses United and North America’s Building Trades Unions (NABTU) announced that protective equipment used in construction would be donated to health care workers.

“We commend the thousands of nurses, first-responders, and health care workers who are putting their lives on the line every day during this pandemic,” NABTU president Sean McGarvey said in the statement.

“Given the shortage of health supplies, we are asking our contractors and our own training centers to donate N95 respirators and other protective equipment like face shields and goggles as quickly as possible in their own communities,” he said. “Our men and women will continue doing all we can to support those in need during this critical time.”

Source: HealthDay

Herb and Honey Lamb Cutlets

Ingredients

4 double lamb cutlets, about 75 g each
2 cloves garlic
1/2 cup mint leaves
1/2 cup flat-leaf parsley leaves
1/2 cup coriander (cilantro) leaves
1/4 cup red wine vinegar
2 tablespoons honey
sea salt and cracked black pepper

Method

1. Trim the cutlets of excess fat and place in a non-metallic bowl.
2. Place the garlic, mint, parsley, coriander, vinegar, honey, salt and pepper in the bowl of a food processor and process until finely chopped.
3. Pour the marinade over the lamb and allow to stand for 10-15 minutes.
4. Heat a non-stick frying pan over high heat. Remove lamb from marinade and cook lamb for 1 minute each side or until well browned. Reduce heat to low, add the marinade to the pan and cook for 4-6 minutes or until lamb is cooked to your liking and the marinade has thickened to a sticky sauce.
5. Serve the lamb with steamed greens.

Makes 2 servings.

Source: Fast, Fresh, Simple

Nutrition Tips for 14 days at Home

Cynthia Weiss wrote . . . . . . . . .

Between social distancing and self-quarantining, grocery store shelves are stocked with limited supplies as many people try to stock up knowing they can’t leave the house for 14 days. Debra Silverman, a Mayo Clinic dietitian, says that shopping for 14 days at home doesn’t have to become stressful.

First and foremost, Silverman says, make a list.

“Now is the time to double-check the pantry, fridge and freezer, and make a list of what you need that will last. All of us at some point realize when we’re back in our car halfway home, ‘I should have bought some flour or I needed sugar,'” Silverman says.

Silverman also offers these tips:

Think about your family and a new routine.

“You may have kids eating lunch at home now, so you might want to have things like extra peanut butter and jelly for sandwiches. Or flour and sugar, for example, if you’re planning a baking project with your kids,” she says.

Consider alternative options.

While dairy and fresh produce are staples for many households, Silverman says don’t forget shelf-stable alternatives or frozen options. “You can buy egg whites in cartons if you can’t find eggs, for instance,” she says. “Shelf-stable items, such as powered milk, frozen fruits and vegetables, or canned (fruits and vegetables), are always good to have on hand,” she says.

Check expiration dates.

As you shop, Silverman says check expiration dates. And consider items that you can use in multiple ways. “Eggs, for instance, often have three weeks to a month of use. However, egg whites in a carton will give you a much longer time period, say six to eight weeks,” she says.

Don’t forget freezer bags.

Silverman reminds that certain food, especially if you won’t use it immediately, also can be stored in the freezer. “If you find ripe berries in the store, you can freeze those for later use. You can freeze bananas and you can use those for protein fruit smoothies later on.”

Protein, like beef and chicken, can last for about four months in the freezer. Fish, cheese and bread also freeze well, Silverman says.

“But remember, when it’s time to use it, you will want to defrost it safely,” she says, adding that you want to continue to clean and disinfect your food prep station to avoid contamination.

Most importantly, Silverman says, don’t over purchase and maintain your routine. “Just purchase things that you feel that you commonly use, that you know that you’re going to use within two weeks for you and your family.”

Source: Mayo Clinic

If You Think Before You Snack, It’s Not So Bad

To snack or not to snack? That is not the question, because we’re going to snack.

But it doesn’t have to mean cookies, chips and cola. As eating habits evolve, snacking can mean anything from a mini-meal to workout fuel to a healthy interlude to tide us over to lunch or dinner.

“Each person has a different eating personality, and there’s no right or wrong,” said Dr. Anne Thorndike, a general internist and assistant professor of medicine at Harvard Medical School in Boston. “It’s just really important to be conscious of what’s in your snacks, and not to just eat mindlessly.”

It’s hard to measure just how much of the American diet consists of snacks. A 2011 U.S. Department of Agriculture report concluded 90% of adults snacked at least once a day – up 30 percentage points in 30 years – and consumed about one-fourth of their total calories between meals.

A 2019 study in the Journal of the Academy of Nutrition and Dietetics indicated nearly one-fourth of working adults ate food at work bought from vending machines and company cafeterias or offered for free by employers or colleagues, adding an average of almost 1,300 calories to their weekly totals.

“The opportunity is certainly there more than it used to be,” said Robin Plotkin, a Dallas-based dietitian and nutrition consultant. “Food is available around every corner. What it boils down to is personal responsibility.”

Plotkin said many factors have changed the traditional definition of snacking – munching on something between meals or before bedtime. People in a hurry grab something to go, drive-thru windows are everywhere, families may not sit down for traditional meals like they used to, and some people prefer to “graze” during the day rather than load up at a single sitting.

“But from a dietitian’s point of view, the advice is the same,” she said. “You want to pair a complex carbohydrate with a lean protein and healthy fat. And you want to focus on fiber, because most Americans don’t get enough.”

Thorndike agreed. “When you do choose to snack, you should reach for foods that are healthy and lower in sugar and salt. Fruits and vegetables, low-fat cheeses or nuts or yogurt are great snacks to tide you over to the next meal.”

Reading labels and resisting temptation also are key. Food companies are working to provide healthier snacks, Plotkin said, but consumers need to look beyond terms like “healthy” or “natural” on the label. She cited some nutrition bars, yogurts and smoothies as prime examples.

“You think you’re eating something healthy when in reality some of them have more calories and sugar than you’d find in a candy bar.”

Another key is to remember many between-meal calories come in liquid form.

“I think a lot of people are getting the messages about the calories in soda and juice drinks,” Thorndike said. “But perhaps they don’t realize how many calories they’re getting in their coffee drinks.”

The best solution, both experts agreed, is to bring snacks from home.

“You know what’s in it and that it’s food you enjoy,” Plotkin said. “Maybe people don’t consider leftovers for a snack, but that’s also a great way to combat food waste.”

Thorndike advocates – and practices – a technique she calls “choice architecture.”

“Set up your environment so the default is a healthier choice,” she said. “If you don’t want to eat cookies at home, don’t buy them. If you don’t want a snack during the day at work, don’t walk by the desk that has candy on it or stuff a lot of granola bars in your drawer.”

That architecture can be deployed on a broader scale. At Massachusetts General Hospital in Boston, where Thorndike practices, cafeterias place items like fruit and water at eye level, making unhealthier options a little less convenient. “Traffic light labeling” on many foods indicates immediately whether your selection rates red, yellow or green.

For a 2019 study published in JAMA Network Open, Thorndike analyzed two years of sales figures and concluded the tactics encouraged people to make healthier choices.

“There’s an emotional reaction to the red label,” she said. “It really does make a difference. Because before you reach for that snack, it’s really good to stop and think why you’re reaching for it.”

Source: American Heart Association

Severe COVID-19 Might Injure the Heart

Amy Norton wrote . . . . . . . . .

The new coronavirus may be a respiratory bug, but it’s becoming clear that some severely ill patients sustain heart damage. And it may substantially raise their risk of death, doctors in China are reporting.

They found that among 416 patients hospitalized for severe COVID-19 infections, almost 20% developed damage to the heart muscle. More than half of those patients died.

Doctors in China have already warned that heart injuries appear common in COVID-19 patients, particularly those with existing heart disease or high blood pressure. A recent, smaller study found that 12% of hospitalized patients had the complication.

These latest findings, from a team led by Dr. Bo Yang of Renmin Hospital of Wuhan University, and published in JAMA Cardiology, add a concerning layer: Patients who develop heart damage may face an “unexpectedly” high risk of death.

Much remains to be learned. For one, the findings come from a single hospital in Wuhan, where the outbreak began. U.S. experts said it’s not known whether the grim outlook will hold true at other hospitals worldwide.

“We certainly hope not,” said Dr. Thomas Maddox, head of the Science and Quality Committee of the American College of Cardiology (ACC).

The ACC has already issued clinical guidance to cardiologists. Among other things, it highlights the extra risks to patients with heart disease, and tells cardiologists to be ready to jump in to assist other doctors caring for severely ill patients.

“We’re anticipating that patients with underlying cardiovascular disease will struggle,” Maddox said.

The novelty of the coronavirus means that it’s not fully clear how to best manage those hospitalized patients. Standard heart medications and devices to provide cardiac support are being used, according to Maddox.

“We are continuing to figure this out,” he said.

But the importance of prevention is more obvious than ever. Maddox said people with existing heart disease — such as a past heart attack — or a history of stroke should consider themselves at “high risk” and be vigilant about protecting themselves.

For those living in a community with a COVID-19 outbreak, that means staying home as much as possible, according to the U.S. Centers for Disease Control and Prevention. Meanwhile, all high-risk people should wash their hands often, disinfect surfaces they routinely touch, and be serious about “social distance” if they do go out.

Among the unknowns, though, is whether people with high blood pressure might also fall into the high-risk category.

“This is an important question, and one on many people’s minds,” said Dr. Elliott Antman, former president of the American Heart Association and a senior physician at Brigham and Women’s Hospital in Boston.

Of the 82 patients in this study who developed a heart injury, 60% had high blood pressure. About 30% had a previous diagnosis of coronary heart disease, while almost 15% had chronic heart failure.

Antman said it’s hard to tell whether high blood pressure alone — without other health issues — was a risk factor for heart injury. Plus, he said, there’s no information on whether patients’ high blood pressure was under control with medication or not.

Of patients who sustained heart damage, just over 51% died in the hospital, according to the study. That compared with 4.5% of those without heart injury.

It’s not certain, though, that the heart complication is actually what caused those deaths, Antman said. “This could all be a reflection of a very bad infection,” he explained.

Why does the coronavirus wreak havoc on some patients’ hearts?

Again, no one is sure, Maddox said. But he explained the leading theories.

One suspect is the immune system’s reaction to the coronavirus. If it veers out of control, in what’s called a “cytokine storm,” it can damage the body’s organs. A second possibility is that in people who already have heart disease, the overall stress of the infection harms the heart muscle.

Finally, it’s possible that the new coronavirus directly invades the heart, Maddox said. Researchers say the virus very effectively latches onto receptors on our body cells called ACE2. Those receptors are found not only in the lungs, but elsewhere in the body — including the heart and digestive tract, he explained.

There has been some speculation that common blood pressure drugs — ACE inhibitors and angiotensin receptor blockers — might make people more vulnerable to falling ill with COVID-19. But that is based only on animal research suggesting that the drugs can boost the activity of ACE2 receptors.

Maddox and Antman stressed that no one should stop taking their prescriptions, since poorly controlled high blood pressure or heart disease would be dangerous — especially now.

Source: HealthDay

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