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Schirmer strips and conjunctival swabs are used in ophthalmology for the collection of tears and fluids. One of the biggest challenges during the COVID-19 pandemic has been accurate diagnosis and, in some cases, ocular manifestations are among the first symptoms. In this context, this study aimed to collect evidence to support the use of Schirmer strips and conjunctival swabs as a method of sample collection for viral analysis. A literature search was conducted following the Scoping Review protocol defined by The Joanna Briggs Institute. Studies were analyzed regarding virus research, collection methods, and sample analysis. The findings support that viruses can be detected on the ocular surface through analysis of Schirmer strips and conjunctival swabs. However, additional studies with larger samples and time data are necessary to confirm these conclusions.

Purpose Schirmer Strips and Conjunctival swabs are used in ophthalmology for tears and fluids collection. During the COVID-19 pandemic, one of the biggest challenges is accurate diagnosis, and it is known that, in some cases, ocular manifestations are one of the first symptoms. In this context, this study has the objective of raising scientific evidence that highlights the use of Schirmer strips and conjunctival swabs as a method of sample collection for viral analysis to support future research on this theme. Methods A literature search was conducted in the PubMed, Web of Science and BVS databases, following the Scoping Review protocol defined by Joanna Briggs Institute (JBI) after the guiding question “Is it possible to detect viruses on the ocular surface with Schirmer Test and/or conjunctival swab?”.Results A total of 418 studies were identified, and after discerning analysis, 36 English written studies were selected. Three researchers analyzed studies after virus research, collection methods, and sample analysis. Publications were mainly on adenovirus, herpes simplex virus and SARS-CoV-2, and there is also evidence of ocular detection of more viruses types. Conjuntival swab analyzed through Polymerase Chain Reaction (PCR) or Reverse Transcriptase-PCR (RT-PCR) were the most used methods.Conclusions Studies have generally been conducted to understand viral infection, to develop accurate diagnostic methods and to follow the patients’ response to treatment. Most studies were performed with a small number of patients and lacked clear definitions of collection time and viral persistence since the onset of diseases. Viruses can be detected on the ocular surface through the analysis of Schirmer strips and conjunctival swabs. However, additional studies with larger populations and time permanence are necessary to develop more assertive conclusions on the theme.

Submitted by Guilherme Lemeszenski (guilherme@nead.unesp.br) on 2013-08-22T19:07:06Z No. of bitstreams: 1 S0037-86822011000600020.pdf: 3038690 bytes, checksum: 35ccc2486bebedea060b6e3fb1146b75 (MD5) Made available in DSpace on 2013-08-22T19:07:06Z (GMT). No. of bitstreams: 1 S0037-86822011000600020.pdf: 3038690 bytes, checksum: 35ccc2486bebedea060b6e3fb1146b75 (MD5) Previous issue date: 2011-12-01 Made available in DSpace on 2013-09-30T18:23:19Z (GMT). No. of bitstreams: 2 S0037-86822011000600020.pdf: 3038690 bytes, checksum: 35ccc2486bebedea060b6e3fb1146b75 (MD5) S0037-86822011000600020.pdf.txt: 42373 bytes, checksum: 30711f7a26c3aef34bd96bcf04bbc6af (MD5) Previous issue date: 2011-12-01 Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-20T13:34:01Z No. of bitstreams: 2 S0037-86822011000600020.pdf: 3038690 bytes, checksum: 35ccc2486bebedea060b6e3fb1146b75 (MD5) S0037-86822011000600020.pdf.txt: 42373 bytes, checksum: 30711f7a26c3aef34bd96bcf04bbc6af (MD5) Made available in DSpace on 2014-05-20T13:34:01Z (GMT). No. of bitstreams: 2 S0037-86822011000600020.pdf: 3038690 bytes, checksum: 35ccc2486bebedea060b6e3fb1146b75 (MD5) S0037-86822011000600020.pdf.txt: 42373 bytes, checksum: 30711f7a26c3aef34bd96bcf04bbc6af (MD5) Previous issue date: 2011-12-01 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) INTRODUÇÃO: As abelhas africanizadas (AHBs) migraram do Brasil em 1956 para todo o continente Americano. Apesar de produtivas, são agressivas causando acidentes fatais. O objetivo foi avaliar pacientes atendidos no Hospital das Clínicas da Faculdade de Medicina de Botucatu (HC-FMB) e propor um roteiro de tratamento. MÉTODOS: Entre 2005 e 2006, foram analisados os aspectos clínicos e laboratoriais de 11 pacientes e anatomopatológicos de um que foi a óbito em 2003. RESULTADOS: A idade dos pacientes variou entre 5 e 87 com média de 42,5 anos. Sete eram do sexo masculino e quatro do feminino. O número de picadas variou entre 20 e 500. Nove deles receberam mais de 50 picadas. Os principais sinais e sintomas foram dor local, náuseas, taquicardia e vômitos. Os exames hematológicos mostraram leucocitose, neutrofilia, anemia e desvio à esquerda escalonado. Os exames bioquímicos revelaram níveis elevados de creatinofosfoquinase, desidrogenase lática e aspartato/alanina aminotransferase. O paciente que foi a óbito 24h após o atendimento tinha 11 anos, era do sexo masculino e foi atacado ao adentrar um edifício de dois andares recebendo mais de 1.000 picadas. O exame anatomopatológico mostrou lesões eritemato-purpúricas, além de necrose nos locais das picadas. Apresentou também rabdomiólise, necroses focais do miocárdio, degeneração hidrópica acompanhada de necrose tubular renal aguda, mioglobinúria e necrose centrolobular no fígado. CONCLUSÕES: Os pacientes acometidos por múltiplas picadas necessitam de tratamento imediato e por não dispormos de um soro específico desenvolvemos um roteiro que inclui os primeiros socorros, as drogas a serem empregadas e a retirada dos ferrões corretamente. INTRODUCTION: In 1956, Africanized honeybees (AHB) migrated from Brazil to other regions of the Western Hemisphere, including South, Central, and North America, except for Canada. Despite being productive, they are highly aggressive and cause fatal accidents. This study aimed to evaluate patients at the Clinical Hospital of Botucatu Medical School (HC-FMB) and to propose treatment guidelines. METHODS: From 2005 to 2006, the clinical and laboratorial aspects of 11 patients (7 male and 4 female) and the anatomopathological aspects of one patient who had died in 2003 were analyzed. RESULTS: The age of the surviving patients varied from 5 to 87 years, with a mean of 42.5 years. The majority of accidents occurred in the afternoon, and the number of stings ranged from 20 to 500. The principal signs and symptoms were pain and local inflammatory signs, nausea, tachycardia, and vomiting. Biochemical findings presented increased levels of creatine phosphokinase, lactate dehydrogenase, and aspartate/alanine aminotransferase. An 11-year-old male patient died upon entering the attic of a two-storey building where he was attacked by a swarm, receiving more than 1,000 stings. He was sent to HC-FMB where he was treated, but he died 24h later. Observed at the autopsy were erythematous-purpuric skin lesions besides necrosis at the sting locations, rhabdomyolysis, focal myocardial necrosis, tubular hydropic degeneration and focal tubular acute necrosis of the kidneys, myoglobinuria, and centrolobular necrosis in the liver. CONCLUSIONS: Accidents caused by multiple AHB stings always constitute a medical emergency. As there is no specific antivenom, we have developed guidelines, including first aid, drugs, and the proper removal of stingers. Universidade Estadual Paulista Faculdade de Medicina de Botucatu Departamento de Doenças Tropicais e Diagnóstico por Imagem Universidade Estadual Paulista Faculdade de Medicina de Botucatu Departamento de Dermatologia e Radioterapia Universidade Estadual Paulista Faculdade de Medicina de Botucatu Departamento de Pediatria Universidade Estadual Paulista Faculdade de Medicina de Botucatu Departamento de Patologia Universidade Estadual Paulista Centro de Estudos de Venenos e Animais Peçonhentos Universidade Estadual Paulista Faculdade de Medicina de Botucatu Departamento de Doenças Tropicais e Diagnóstico por Imagem Universidade Estadual Paulista Faculdade de Medicina de Botucatu Departamento de Dermatologia e Radioterapia Universidade Estadual Paulista Faculdade de Medicina de Botucatu Departamento de Pediatria Universidade Estadual Paulista Faculdade de Medicina de Botucatu Departamento de Patologia Universidade Estadual Paulista Centro de Estudos de Venenos e Animais Peçonhentos FAPESP: 2006/55545-8 FAPESP: 2007/05159-7

Methicillin-resistant Staphylococcus aureus (MRSA) is an important agent of colonization and infection in burn units. In order to identify risk factors for MRSA acquisition in a Brazilian burn unit, we performed two retrospective studies. In the first (“cohort” study), 175 patients who were not colonized with MRSA on admission were followed to assess risk factors for MRSA acquisition. In the second (“case–case–control” study), 143 individuals from the previous study who were negative for both MRSA and Methicillin-susceptible S. aureus (MSSA) on admission were followed. Case–control studies were performed to investigate risk factors for MRSA and MSSA acquisition. MRSA and MSSA were recovered from 75 and 23 patients, respectively. In the “cohort” study, only the number of wound excisions (Odds Ratio [OR] = 1.55, 95% Confidence Interval [CI] = 1.21–1.98, P = 0.001) was associated with MRSA acquisition. In the “case–case–control” study, burns involving head (OR = 3.43, 95%CI = 1.50–7.81, P = 0.003) and the number of wound excisions (OR = 1.83, 95%CI = 1.27–2.63, P = 0.001) were significant risk factors for MRSA. Burns involving perineum were negatively associated with MSSA acquisition (OR = 0.16, 95%CI = 0.03–0.75, P = 0.02). In conclusion, the acquisition of MRSA was related to the site of the burn and to the surgical manipulation of tissues, but not to the use of antimicrobials.