Distribution Of Quantitative Variables Research Articles

The symptoms and interval of Omicron SARS-CoV-2 reinfection among healthcare workers in a hospital of Southern China: a cross-sectional study

BackgroundThe prevalence and distinction between first Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and reinfection with the Omicron variant among healthcare workers (HCWs) remain unclear.MethodsA cross-sectional study was conducted at a hospital in Southern China. The study included 262 HCWs who were infected with SARS-CoV-2 between April and June 2023, with 101 cases of first infection and 161 ones of reinfection. Student’s t-test, Analysis of Variance (ANOVA), and Mann-Whitney U tests were used based on the distribution of quantitative variables. Pearson’s chi-square and Fisher’s exact tests were used based on the expected frequencies of categorical variables.ResultsThe reinfection rate among HCWs was 11.5% (161/1406). The majority of the infected HCWs were female (212/262, 80.9%, first infection vs. reinfection: 76.2% vs. 83.9%). The nursing staff, had the highest percentage of SARS-CoV-2 infection (42.0%), especially of its reinfection (47.8%). Out of the 262 infected individuals, 257 had received SARS-CoV-2 vaccination, primarily inactivated vaccines (243/257, 91.1%). The first infection group, which received four doses (24, 23.8%), was significantly higher than that in the reinfection group (6, 3.7%) (P < 0.001). The proportion of asymptomatic infections among HCWs in the two groups was 1.0% and 1.2%. The main symptoms during the first infection and reinfection were fever (83.2% and 50.9%) and sore throat (78.2% and 77.0%). There were significant differences in the prevalence of fever (83.2% vs. 50.9%), rhinorrhea (45.5% vs. 60.9%) and myalgia (56.4% vs. 37.9%) between the first infection and reinfection (P < 0.05). The average interval for SARS-CoV-2 reinfection was 149.9 (range: 114–182, SD = 11.9) days. Notably, physicians had the shortest average interval of 142.8 (8.8) days, while management and administrative staff had the longest average interval of 153.8 (13.5) days.ConclusionsAlthough the symptoms of HCWs during reinfection with SARS-CoV-2 were milder, the high reinfection rate and short interval between infections indicate the need to enhance monitoring and protective measures for HCWs during the epidemic.

Comparison of the Effect of two E-learning Methods, Problem Solving and Examination Question on Awareness; Attitude and Performance of Islamic Azad University –Maybod branch Nursing and Midwifery Students Regarding Hospital Infection Control in 2022

Introduction: Hospital infections are one of the most common health problems which can be controled by education. The purpose of this study was to compare the effect of two e-learning methods (problem solving and examination of question) on awareness; Attitude and performance of Islamic Azad University–Maybod branch nursing and midwifery students regarding hospital infection control in 2022.&#x0D; Methods: The current study was a semi experimental in which 36 Islamic Azad University–Maybod branch nursing and midwifery students were randomly Probability Proportional to Size assigned to intervention(problem solving, examination question) and control groups (N=12) based on the entry and exit criteria using probability proportional to size method. Education based on hospital infections booklet was assigned. Before and after the intervention, students’ knowledge, attitude and performance scores were evaluated using a standared questionnaire (alpha=0/82). The distribution of quantitative variables was done using the Kolmograph Smirnov test and parametric statistical tests (t_test/pair t_test/one way anova t test) considering the significance level of 0.05.&#x0D; Results: Comparing the scores of awareness (p=0.993), attitude (p=0.997) and performance (p=0.998) in the intervention groups; there is no significant difference and it means the same effect of two educational methods. Teaching two methods of problem solving – question and answer has no effect on improving students’ short-term attitude (p=0.172) and improving long-term performance scores (p=0.075). The effect of education in the two ways mentioned on improving awareness; Long-term attitude and short-term performance were significant (p&lt;0.05).&#x0D; Conclusion: e-learning in two ways of problem solving-examination question in increasing the average scores of knowledge; Attitude and performance have been equally effective.

Post-acute COVID-19 syndrome and its prolonged effects: An updated systematic review

ObjectiveThis systematic review aimed at estimating the prevalence of post-acute COVID-19 symptoms in view of published literature that studied prolonged clinical manifestations after recovery from acute COVID-19 infection. MethodsRelevant databases were searched for extraction of articles. For data synthesis, based on the distribution of quantitative variables, they were expressed as mean ± standard deviation (SD) or median and interquartile range (IQR). Qualitative variables were presented as frequency (n) and percentages (%). ResultsTwenty-one articles qualified for the final analysis. The most common persistent clinical manifestations were fatigue (54.11%), dyspnea (24.38%), alopecia (23.21%), hyperhidrosis (23.6%), insomnia (25.98%), anxiety (17.29%), and arthralgia (16.35%). In addition to these symptoms, new-onset hypertension, diabetes, neuropsychiatric disorders, and bladder incontinence were also reported. ConclusionClinical features of post-acute COVID-19 infection can manifest even after 60 days of initial infection. Multidisciplinary care along with regular follow-up must be provided to such patients.

Correlations between Transcranial Doppler Velocities and Laboratory Markers of SCA Severity

Introduction. Stroke is one of the main complications of Sickle Cell Anemia (SCA), occurring in about ten percent of the affected individuals before the age of twenty. Hydroxyurea (HU) currently used to treat SCA, although its exact mechanism of action remains not fully understood. The transcranial Doppler (TCD) is used to detect the risk of stroke in children with SCA, which measures the time-averaged mean of the maximum velocity (TAMMV) in the internal carotid artery and the middle cerebral arteries. TAMVV above 200 centimeters per second (cm/s) is associated with a high risk of stroke. In the present work, we evaluated the correlations between laboratory markers and TCD velocities and we also studied the influence of HU in different TCD groups. Material and methods. A cross-sectional study including 164 HbSS patients with average age 7.51±4.14 was conducted at the Pediatric Professor Hosannah de Oliveira Hospital (HUPES/UFBA) and in the Sickle Cell Disease Reference Center, hospitals located in Salvador and in Itabuna, both cities in northeastern Brazil. The risk of stroke was assessed by TCD, for three outcomes were considered: TCD1 for the normal group (TAMMV <170 cm/s), TCD2 for the conditional group (TAMMV 170-199 cm/s) and TCD3 for the high risk (TAMMV> 200 cm/s). The legal representatives signed the informed consent terms. The study was approved by the Research Ethics Committee and was conducted in accordance with the guidelines of the Declaration of Helsinki and its revisions. Hemoglobin profiles were confirmed by high-performance liquid chromatography (HPLC). Hematological analyses were carried out using an electronic cell counter. Biochemical and inflammatory analyses were performed by immunochemistry assays and immunoassays. Statistical analyses were performed on Graphpad prism 6.0. The distribution of quantitative variables was analyzed using the Shapiro-Wilk test. The median of quantitative variables between three or more groups was compared using One-way Anova/Kruskall-Wallis for nonparametric data. When comparing two groups, Mann-Whitney t-tests were performed. The correlation analyses were performed between variables using Spearman coefficient (r). Results. We observed negative correlations (with Spearman r< -0.2 and p<0.05) between left and right TAMMV and red blood cell (RBC) count, hemoglobin levels and hematocrit. There were positive correlations (Spearman r> 0.2 and p<0.05) with mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), Red Cell Distribution Width (RDW), white blood cell (WBC), lymphocytes, reticulocytes percentage, aspartate aminotransferase (AST) and total bilirubin. By comparing the three TCD groups, excluding the stroke group, nitric oxide (NO) levels (p=0.157) and mean platelet volumes (MPV) (p=0.0134) varied between groups, with the lower numbers observed for the TCD2 and TCD3 groups. WBC count is progressively increased in DTC groups (DTC3>2>1), but not significantly. The lymphocyte count (p=0.006) was increased in the TCD3 group, as compared to the other two groups. Ferritin median values were increased (p=0.005) in TCD2 and TCD3 groups. The MPV values were lower in TCD2 and TCD3 groups both for HU treated and untreated patients (p=0.032), with the lowest MPV values observed for TCD3. WBC count was significantly different among TCD groups of untreated patients (p=0.009) but not among TCD groups of patients treated with HU. Patients in use of HU showed decreased WBC counts in all TCD groups, but only in a significant way for TCD3 (p=0.002). In the same line, the lymphocyte counts were significantly decreased by HU in TCD 1 and TCD3, (p=0.04 and p=0.006) but not for TCD2.Conclusions. The current results show significant correlations between TCD-TAMMV and laboratory markers commonly used to monitor SCA pediatric patients. These laboratory parameters included reticulocyte percentage and white blood cell counts, which are known markers of SCA severity, but their correlations with TAMMV has never been shown before. We also show that hydroxyurea treatment had different impacts on laboratory parameters such as MPV, lymphocyte and leukocyte numbers in the different TCD groups evaluated here. We speculate that the association of these markers with TCD should be further studied and carefully analyzed along with TCD velocities. DisclosuresNo relevant conflicts of interest to declare.

THE RESULTS OF STEP-BY-STEP MYOCARDIAL REVASCULARIZATION IN PATIENTS WITH ACUTE CORONARY SYNDROME AND MULTIVESSEL CORONARY ARTERY DISEASE: EARLY PERFORMING CORONARY ARTERY BYPASS SURGERY AFTER STENTING USING BARE-METAL STENTS

Objective: To compare the long-term results of coronary artery bypass grafting performed in the early period after stenting for acute coronary syndrome by bare-metal stents with the results of coronary artery bypass grafting in patients with coronary heart disease.Material and Methods. The results of 24-month follow-up of step-by-step treatment of patients with acute coronary syndrome and multivessel lesion who received stenting of clinical-dependent artery with bare-metal stents as the first step and, then, underwent functional myocardial revascularization by aortocoronary bypass surgery within 90 days were analyzed. Results are presented as mean value and standard deviation (M±SD) in case of normal distribution and median with interquartile range in the form of 25 and 75 percentiles in case of non-normal distribution. The type of distribution of quantitative variables was assessed by the Lilliefors-corrected Kolmogorov–Smirnov test. Efficacy and safety assessments were carried out according to the criteria of non-inferiority in comparison with the literature data of myocardial revascularization by stenting. The differences were estimated using a two-way 95% confidence interval of the difference in adverse events based on the selected noninferiority design.Results. Surgical revascularization of the coronary bed in the early period after stenting of the clinically dependent artery using bare-metal stents in patients with acute coronary syndrome and multivessel lesion was equivalent to coronary artery bypass grafting, except for the rate of repeated revascularization.

Investigation of traffic behavior in driving accidents in Azarshahr city drivers

Background: Traffic accidents and losses caused by it are one of the current challenges of human societies that endanger the health of humans and impose a lot of economic costs on the economy of countries. One of the factors in driving accidents is human factors or driving behavior pattern. The pattern of driving behavior, like other human behavior, is influenced by a set of conscious and unconscious factors that are considered as the overall traffic behavior. The aim of this study was to investigate traffic behavior in driving accidents with Manchester driving behavior questionnaire among personal car drivers in Azarshahr city. Methods: This study is a research review. It is descriptive-analytic and the necessary information in this design through The Manchester driving behavior questionnaire was collected between 260 drivers. The research environment is the level of Azarshahr city and all the drivers. The data were analyzed by SPSS software version 16.To evaluate the normal distribution of quantitative variables, Kolmogorov-Smirnov test was used and considering that the distribution of variables was not normal for analyzing the difference, Mann-Whitney Test and Spearman test were used for correlation analysis. Results: In this study, the Manchester Driving behavior questionnaire, four factors of slippage, intentional violations, errors, and intentional driving violations were clearly differentiated among personal car drivers. In the first factor, the mean score of 1.5, second factor (intentional violations) of 1.85, Third factor (errors) 1.34, the fourth factor (unintentional violation) 1.51.In addition, there was a significant difference in demographic variables between men and women in terms of age, driving history, daily driving hours, and accident number (P < 0.001). Conclusion: The findings of this study confirmed that the results of intentional driving violations of the highest score and driving slippage are the second rank of driving behaviors among personal vehicles ' drivers in Azarshahr city.

PP053 A Case Study: Collective Individual Basis For The Judiciary Debate

INTRODUCTION:The volume of lawsuits for drugs has increased in Brazil. The scientific evidence basis consideration by the Brazilian judiciary system is being debated. In the State of São Paulo, the drug with the highest number of lawsuits is insulin glargine. Between January and August 2016, the São Paulo State Department of Health lost 264 insulin glargine lawsuits requiring supply for adult patients (&gt;18 years old). Insulin glargine has already been submitted and unfavorably assessed by the Health Ministry SUS Technology Incorporation National Commission (CONITEC), so is not available in the Brazilian public system.METHODS:Random analysis of 153 (58 percent) lawsuits were carried out on digital court records. Data collected from legal proceedings were: the type of diabetes (1, 2 or unspecified); age of the patient; origin of the order; specialty of the prescriber and the reason described for the request. Each record was structured with variables data within a matrix in Microsoft Excel© software. Analysis of frequencies, absolute and relative distribution of quantitative variables, as well as conceptual clusters in the qualitative textual analysis are presented.RESULTS:The mean age of the 153 patients was 49±17 years. The majority of patients requested insulin glargine to achieve glycemic control (n = 116; 76 percent): because -“diabetes is uncontrolled and the analogous insulin is essential to get it” (n = 106; 69 percent); or -“patient claims to have obtained glycemic control with insulin glargine but there are none of the mandatory laboratory tests results in lawsuits” (n = 7; 5 percent); or -“ask replacement of insulin detemir with glargine for glycemic control” (n = 3; 2 percent). Only 87 (57 percent) lawsuits reported the patients diabetes type: type 1 (n = 42; 28% percent or 2 (n = 45; 29 percent). Most of this judicialization came from private outpatient clinics (n = 116; 76 percent) and 99 (65 percent) were prescribed by endocrinologists.CONCLUSIONS:Judicial decisions are still insufficiently underpinned by scientific evidence (only the patients drug needs claim has been recorded to justify supply) and are incomplete regarding objective diagnostic variables. Also, the judges awareness of interdisciplinary measures to achieve diabetic patients glycemic control, besides complementary drugs, may improve the Brazilian judicialization burden.

Investigating the impact of body mass index on the outcomes of coronary artery bypass graft surgery: A single referral center experience

The aim of this study is to evaluate the relationship between Body Mass Index (BMI) and the outcomes of isolated CABG (Coronary Artery Bypass Graft) performed in Shahid Madani Hospital of Khorramabad, Iran. Data was retrospectively collected from the medical records retrieved from the hospital records office. All patients who had undergone isolated CABG under cardiopulmonary bypass in the Cardiothoracic Unit from 2007 till 2013 were identified and their demographic and clinical data were collected. Clinical data included BMI, ejection fraction (EF), history of COPD, MI, CVA, diabetes mellitus, hyperlipidemia, hypertension and the main outcomes included pulmonary complications, renal complications, transfusion, duration of ventilation, reoperation, intensive care unit stay, hospital stay and death. Patients were divided into six groups according to the BMI as follows: group 1: (BMI 0.05).There was no statistically significant difference between the groups in terms of the mean duration of mechanical ventilation, mean extubation time, drainage rate from the chest tube, and the amount of blood transfusion (PV > 0.05). Moreover, in 99.4% of the patients, broad-spectrum antibiotics, in 99.5% of the patients, inotropic drugs, and in 5.4% of the patients, IABP were used. Re-intubation was done in 3.1% of the patients. The average duration of hospitalization was 5.45 ± 1.48. There was no statistically significant difference between the groups in terms of hospitalization time (PV>0.05). In this study, 3.55% of the patients died. Smirnov and Kolmogorov tests showed that the distribution of quantitative variables is not normal in all the patients (PV<0.001). Therefore, to study the relationship between these quantitative variables, the Spearman correlation coefficient was used, which showed that none of the relationships were statistically significant. Therefore, considering these results, it can be suggested that if there is enough time before surgery, changes in the lifestyle of the individual be recommended so that he/she can attain a better health status. So, proper training and education can be very effective.

Nicorandil, Gastrointestinal Adverse Drug Reactions and Ulcerations: A Systematic Review.

Nicorandil is a popular anti-anginal drug in Europe and Japan. Apart from some common adverse drug reactions (ADR), its safety is satisfactory. Several reports have suggested a link between nicorandil, gastrointestinal (GI) ulceration and fistulas. The review aims to critically appraise, synthesize and present the available evidence of all known GI ADR per anatomical location. The study complied with the PRISMA statement. Literature and pharmacovigilance databases were used to provide rate and/or calculate parameters (median age, median dose, history of symptoms, length of therapy and healing time after withdrawal of the drug). Differences in distribution of quantitative variables were analyzed via Mann-Whitney test. Correlation between quantitative variables was assessed with a Spearman's correlation coefficient. A p value <0.05 was significant. Oral ulcerations occur in 0.2% of the subjects, anal ulcerations are present between 0.07% and 0.37% of patients. Oral and distal GI involvements are the most common ADR (28-29% and 27-31% of all GI ADR, respectively). The hepatobiliary system, the pancreas and salivary glands are not affected by nicorandil exposure. The time to develop oral ulcerations is 74weeks among people on <30mg/day compared to only 7.5weeks in individuals on higher regimens (p=0.47). There is a significant correlation between dose and ulcer healing time (Spearman's 0.525, p<0.001). Ulcerative disease is a very commonly reported GI ADR. A delayed ulcerative tendency supports the hypothesis of an ulcerogenic metabolite. Nicorandil seems to act as a cause of the ulcerations, but appears to also work in synergy with other promoting factors. Whether the action of the metabolites relies on a specific mechanism or a simple chemical ulceration is still to be established.

Measuring health-related quality of life in men with osteoporosis or osteoporotic fracture

BackgroundOsteoporosis is a serious health problem that worsens the quality of life and the survival rate of individuals with this disease on account the osteoporotic fractures. Studies have long focused on women, and its presence in men has been underestimated. While many studies conducted in different countries mainly assess health-related quality of life and identify fracture risks factors in women, few data are available on a Spanish male population.Methods/DesignObservational study.Study populationMen ≥ 40 years of age with/without diagnosed osteoporosis and with/without osteoporotic fracture included by their family doctor.MeasurementsThe relationship between customary clinical risk factors for osteoporotic fracture and health-related quality of life in a Spanish male population. A telephone questionnaire on health-related quality of life is made.Statistical analysisThe association between qualitative variables will be assessed by the Chi-square test. The distribution of quantitative variables by Student's t-test. If the conditions for using this test are not met, the non-parametric Mann-Whitney's U test will be used.The validation of the results obtained by the FRAX™ tool will be performed by way of the Hosmer-Lemeshow test and by calculating the area under the Receiver Operating Characteristic (ROC) curve (AUC). All tests will be performed with a confidence intervals set at 95%.DiscussionThe applicability and usefulness of Health-related quality of life (HRQOL) studies are well documented in many countries. These studies allow implementing cost-effective measures in cases of a given disease and reducing the costly consequences derived therefrom. This study attempts to provide objective data on how quality of life is affected by the clinical aspects involved in osteoporosis in a Spanish male population and can be useful as well in cost utility analyses conducted by health authorities.The sample selected is not based on a high fracture risk group. Rather, it is composed of men in the general population, and accordingly comparisons should not lead to erroneous interpretations.A possible bias correction will be ensured by checking reported fractures against healthcare reports and X-rays, or by consulting health care centers as applicable.