UNASSIGNED: To evaluate possible temporomandibular disorders (TMD) symptoms that may occur due to mask use in dentists during the coronavirus disease-2019 pandemic period and identify potentially effective factors.
UNASSIGNED: An online questionnaire consisting of three parts was sent to dentists and clinical dental students. The first part included questions regarding sociodemographic information. In the second part, questions were asked to evaluate stress levels, TMD symptoms, and treatment of TMD, if any, before (T0) and during the pandemic (T1). In the last part, professional mask choice, mask-related parafunctional movements, and breathing patterns while wearing a mask were evaluated.
UNASSIGNED: TMD symptoms and stress levels were significantly higher at T1. An increase in mouth breathing and mask-related parafunctional movements was reported during the use of N95 masks compared with daily life in dentists whose professional mask selection was an N95 respirator. The change in temporomandibular joints pain and muscle pain at rest between T0 and T1 was higher in those whose professional mask choice was N95 respirators than in those who chose to wear one surgical mask.
UNASSIGNED: The increase in mouth breathing and mask-related parafunctional movements during the use of N95 respirators may increase TMD.

BACKGROUND: In certain situations, masks are worn during sleep to prevent respiratory infections. However, the effects of mask wearing on cardiopulmonary function during sleep are unknown. This study aimed to determine whether wearing masks during sleep has an impact on cardiopulmonary function, including in patients with obstructive sleep apnea.
METHODS: This was a prospective, randomized crossover-controlled trial. The effects of wearing surgical masks or N95 respirators on cardiopulmonary function were measured in healthy subjects and patients with mild-moderate obstructive sleep apnea. Sleep breathing parameters were monitored during nocturnal sleep using a sleep monitor, and subjective feelings about mask wearing were assessed using a questionnaire.
RESULTS: Wearing masks during sleep at night did not significantly impact sleep breathing parameters. Furthermore, there were no significant differences in heart rate, blood oxygenation, and blood pressure before and after wearing masks. However, wearing masks wearing, especially the N95 mask, had an adverse impact on sleep quality, and masks were found to be subjectively uncomfortable.
CONCLUSIONS: Wearing masks during sleep at night does not adversely affect cardiopulmonary function but they can be uncomfortable, especially the N95 mask. Thus, in circumstances where wearing N95 masks during nocturnal sleep proves intolerable, we recommend the use of surgical masks as a more comfortable alternative.

OBJECTIVE: The aim of the study was to map the behavior of ophthalmologists regarding protective equipment during the COVID-19 pandemic (coronavirus disease 2019), both during the time of the mandatory restrictive measures and after their relaxation. Another aim was to evaluate the awareness of ophthalmologists in the Czech Republic about the possible impact of nose and mouth protective measures (masks, respirators) on the quality of eye examinations, especially on the results of standard automated perimetry (SAP) and intraocular pressure (IOP) measurement.
METHODS: As part of two professional ophthalmological events in the Czech Republic, which took place in 2022, we obtained and evaluated data from the ophthalmologists in attendance using a questionnaire. We evaluated demographic parameters, frequency of use and type of nose and mouth protective equipment and their influence on the quality of ophthalmological examination as well as the awareness of ophthalmologists about their possible influence on the outcome of SAP and IOP measurements.
RESULTS: We obtained data from a total of 212 respondents (148 women, 44 men, in 20 cases gender was not stated). In 91.5% of cases, ophthalmologists agreed that the use of respirators and masks makes ophthalmological examination more difficult. The most common problems were eyepiece fogging (85.8%), examination lens fogging (85.8%), and lens fogging when spectacles correction was prescribed (79.2%). The respondents most often combated these problems either by completely removing the respirator (24.1%) or at least by pulling it under the nose (39.2%). At the time when the measures were relaxed, significantly more men did not use any nose and mouth protection at all during ophthalmological examinations (15.8% of men vs. 4.2% of women; p = 0.032). An alarming finding was the fact that 35.6% of respondents did not know whatsoever whether the nurse was performing a perimetry examination on a patient with a respirator/mask or without protective equipment, i.e. they were not aware whatsoever of the possible formation of artifacts. Only 21.2% of respondents were aware of the possible difficulties of measuring IOP while wearing a respirator, while 59.9% of respondents were not aware of this risk (39.6% had never considered this problem, 20.3% of respondents were convinced that a respirator could not have an effect on the measurement of IOP).
CONCLUSIONS: The use of nose and mouth protective equipment clearly affects the ophthalmological examination and makes it more difficult. Although ophthalmologists belong to a group at high risk for the possible transmission of infection in the performance of their profession, they often removed nose and mouth protection in an effort to eliminate fogging of eyepieces and examination lenses. The awareness of ophthalmologists regarding the possible influence on the results of SAP and IOP measurement by wearing a respirator was low in our questionnaire survey. It is therefore advisable to discuss this issue more widely and warn doctors about these risks.

Mask use during the coronavirus disease 2019 (COVID-19) pandemic has been widely recommended and mandated worldwide. However, there is a lack of comprehensive research on the potential adverse health effects of mask usage. This study aimed to investigate and evaluate the negative effects of surgical mask use on scientifically proven cardiopulmonary functions in undergraduate and associate degree students, as well as its impact on coronaphobia. A total of 145 volunteer university students (49 males, 96 females, with a mean age of 20 years) were enrolled in the study, which consisted of two 120-minute sessions. Blood oxygen saturation, heart rate, and blood pressure were assessed before and immediately after each session. The Coronavirus-19 Phobia Scale was utilized to measure levels of COVID-19 phobia. While a time-dependent decrease in oxygen saturation level, blood pressure, and heart rate was measured when vital signs were evaluated at 1 and 120 minutes, none of the values fell outside the reference range. The study also investigated the effects of mask use on various symptoms including headaches, visual impairment, facial discomfort, earaches, shortness of breath, and anxiety. Significantly increased occurrences of all these symptoms were observed at the 60th and 120th minute compared with the baseline. The participants enrolled in the study demonstrated a moderate level of COVID-19 phobia based on the mean total score. Furthermore, high scores were recorded in the psychological and social sub-dimensions, while lower scores were recorded in the economic and psychosomatic sub-dimensions. In the post-COVID-19 normalization phase, the use of a surgical mask during a 120-minute course was found to have no significant impact on cardiopulmonary functions, but moderately affected coronaphobia scores.

There are very limited methods of relieving dyspnea that are independent of the causative disease. L-menthol olfactory stimulation is reported to be effective for dyspnea during exercise and inspiratory resistance. Therefore, we examined the effects of L-menthol olfactory stimulation on exertional dyspnea during the 6 min walking distance test (6MWT) in patients with chronic breathlessness syndrome. The subjects who consented to the study were divided into two groups. In Group A, the first 6MWT was performed as usual (placebo) while wearing a surgical mask, and the second 6MWT was performed under the L-menthol condition. In Group B, the first 6MWT was performed under the L-menthol condition, and the second 6MWT was performed as a placebo. A total of 16 subjects (70.8 ± 9.5 years) were included in the analysis. As for the effect of reducing dyspnea, a significant difference was observed in Group A patients who underwent the L-menthol condition in the second 6MWT (p = 0.034). In the comparison of the 6 min walking test under the L-menthol condition and the placebo, the modified Borg scale gain was significantly different between the L-menthol condition and the placebo (p = 0.007). Our results suggested that the L-menthol olfactory stimulation reduced dyspnea on exertion in patients with chronic breathlessness syndrome.

It is not clear whether or not high-flow nasal oxygenation used in patients with severe respiratory tract infection, or coughing, increases the risk of infection to the healthcare personnel, and whether or not applying a surgical mask to the patient\'s face or treating the patient in a negative-pressure room can reduce the risk.
In a randomized crossover design, we compared in 50 participants receiving high-flow nasal oxygenation, the aerosol counts measured at approximately 20 cm above the participant\'s mouth in 32 different circumstances (with or without coughing, with or without wearing a surgical mask, at four different flow rates of oxygenation, in a positive- or negative-pressure operating room).
In a positive-pressure room, a surgical mask significantly decreased the aerosol counts during coughing (P = 0.0005), or during no coughing (P = 0.009), under high-flow nasal oxygenation (at 60 l.min-1). In the negative-pressure room, the aerosol count was significantly lower than in the positive-pressure room, for all the circumstances (all P < 0.001), and a surgical mask significantly decreased the aerosol counts during coughing (P = 0.047) but not during no coughing (P = 0.60).
In conclusion, treating a patient in a negative-pressure room, or applying a surgical mask, during high-flow nasal oxygenation (with the flow rate of 60 l.min-1) would inhibit, but would not completely prevent, dispersion of aerosols by coughing.

Chest compression with rescue breathing improves outcomes in cardiac arrest. However, the efficacy of rescue breathing through surgical masks has not been investigated.
We aimed to compare the tidal volume generated by mouth-to-mouth ventilation (MMV) with that generated by surgical mask-to-mouth ventilation (SMV), mouth-to-surgical mask ventilation (MSV), and surgical mask-to-surgical mask ventilation (SSV) in a manikin.
A crossover randomized controlled trial was conducted in 42 medical personnel volunteers randomly assigned to perform four ventilation techniques: MMV (no protective equipment), SMV (participant wearing a mask), MSV (manikin wearing a mask), and SSV, (both participant and manikin wearing a mask). The average tidal volume and the proportion of adequate ventilation, evaluated using a manikin, were compared across different ventilation methods.
The average tidal volume of MMV (828 ± 278 ml) was significantly higher than those of the MSV (648 ± 250 ml, P < 0.001) and SSV (466 ± 301 ml, P < 0.001), but not SMV (744 ± 288 ml, P = 0.054). Adequate ventilation was achieved in 144/168 (85.7%) cases in the MMV group, a proportion significantly higher than in the SMV (77.4%, P = 0.02), MSV (66.7%, P < 0.001) and SSV (39.3%, P < 0.001) groups. The willingness to perform SMV was higher than that to perform MMV.
MMV resulted in a superior average tidal volume when compared to both MSV and SSV. However, SMV achieved a comparable average tidal volume to MMV.

BACKGROUND: The studies on cardiovascular alterations when using an N95 respirator or surgical mask-covered N95 during dental treatments are limited.
OBJECTIVE: To investigate and compare the cardiovascular responses of dentists treating paediatric patients while wearing an N95 respirator or a surgical mask-covered N95.
METHODS: This was a crossover clinical trial in 18 healthy dentists wearing an N95 respirator or surgical mask-covered N95 during the dental treatment of paediatric patients. Oxygen saturation (SpO2 ), heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) were monitored at baseline, intraoperation, and postoperation. The data were analyzed using the generalized estimating equation.
RESULTS: The mean SpO2 , HR, SBP, DBP, and MAP significantly changed from baseline up to the end of the procedures after wearing an N95 by 3.1%, 19.3%, 11.5%, 17.7%, and 13.8% and after wearing a surgical mask-covered N95 by 3.0%, 20.2%, 5.3%, 13.9%, and 8.8%, respectively (p < .05). No significant differences in these values were found between groups (p > .05).
CONCLUSIONS: N95 respirators and surgical mask-covered N95s significantly impact the cardiovascular responses of dentists treating paediatric patients with no differences between the two types of masks.

Reuse of personal protective equipment (PPE), masks more specifically, during the COVID-19 pandemic was common. The primary objective of this study was to compare pre-pandemic surgical site infection (SSI) rates prior to reuse of PPE, to pandemic SSI rates after reuse of PPE in trauma surgical patients.
A retrospective cohort analysis collected from the Michigan Trauma Quality Improvement Program database was performed. The pre-COVID cohort was from March 1, 2019 to December 31, 2019 and post-COVID cohort was March 1, 2020 to December 31,2020. Descriptive statistics were used to assess differences between variables in each cohort.
Nearly half (49.8%) of our cohort (n = 48,987) was in the post-COVID group. There was no significant difference in frequency of operative intervention between groups (p > .05). There was no significant increase (p > .05) between pre- and post-COVID cohorts for superficial, deep, or organ space SSI when reuse of masks was common.
Reuse of PPE did not lead to an increase in SSI in surgical patients. These findings are consistent with previous studies, but the first to be described in the trauma surgical patient population. Studies such as this may help inform further discussion regarding PPE usage as we continue to emerge from the current pandemic with the continuous threat of future pandemics.

Background The impact of COVID-19 on the world is rapidly spreading among countries. According to WHO, wearing face masks was recommended to prevent its spread. After regular use of face masks, some people have experienced common skin disorders such as facial acne, rash, and eczema. This paper aims to cite the prevalence and potential risk of wearing a face mask on the skin by exploring some of the rationales that have been established in the literature. Methodology A cross-sectional study was carried out in Jeddah, Saudi Arabia in November 2021. A self-administered online questionnaire was distributed among 389 participants from the adult public to find the correlation between face mask wearing and skin damage during the COVID-19 pandemic. Statistical analysis was conducted using the IBM SPSS statics for windows, version 25.0 (IBM Corp., Armonk, USA) to evaluate and test the hypothesis. Results The study included 389 participants; 63.8% of them were female and 36.2% were male. The main result of this study was that there was a statistically significant association between the duration and frequency of wearing a face mask and developing skin damage. 58.1% of the participants were using face masks for more than 4 hours. Furthermore, 22% and 59.1% of the male and female participants, respectively, said they noticed adverse skin reactions on their faces after using a face mask. Conclusion Our study revealed that 46% of the participants noticed adverse skin reactions on the face by wearing a face mask. Females had a significantly higher chance of developing skin irritation than males.