Normal Distribution Of Variables Research Articles

The Quadrangular Cartilage in Rhinoplasty: A Surgically Focused CT Dimensional Analysis of Black African and Caucasian Populations.

The apparent lack of quadrangular cartilage in Black African noses is commonly observed both from a radiological and clinical point of view. To the best of our knowledge, only a few research papers have been conducted on the facial proportions and structural anatomy of black people of Southern and Eastern Africa. The aim of this retrospective comparative study is a radiological assessment of the total amount of septal quadrangular cartilage by measuring its area in sagittal CT views, in two selected Black South African and Caucasian (CA) samples and the comparison with the literature in our hands. Statistical analysis was conducted, categorical variables are shown as frequencies and percentages, while continuous variables as means and standard deviations. Normal distribution of variables was verified using the Shapiro-Wilk test or by means of skewness and kurtosis values. Differences among unpaired groups were evaluated using the independent Student's t-test for normally distributed data (complemented by the Cohen's d to show the effect size with the following cutoff: d = 0.2, "small" effect size; d = 0.5, "medium" effect size; d = 0.8, "large" effect size) and Mann-Whitney U test in case of non-normal distribution. Statistical significance was defined as p < 0.05 setting the α-error probability at 5%. This study shows that, on average, there is 30% more cartilage available in CA compared with Black African noses and confirms the apparent lack of quadrangular cartilage and in Black African noses which is commonly observed in surgery. The need for an adequate amount of autologous septal cartilage makes cartilage availability a major concern before surgery and being able to preoperative accurately measure the amount of septal cartilage that is available to be harvested for other grafts in the surgery is essential.

Risk classification and door-to-antibiotic time in patients with suspected sepsis.

to evaluate the association between risk classification and door-to-antibiotic time in patients with suspected sepsis. retrospective cohort study, with a sample of 232 patients with suspected sepsis treated at the emergency department. They were divided into 2 groups: with and without risk classification. Once the door-to-antibiotic time was identified, one-way analysis of variance was performed with Bonferroni post hoc test or independent Student's t-test for continuous quantitative variables; Pearson correlation tests, point-biserial correlation or biserial correlation for association analyses; and bootstrap procedure when there was no normal distribution of variables. For data analysis, the Statistical Package for the Social Sciences software was used. the door-to-antibiotic time did not differ between the group that received risk classification compared to the one that was not classified. Door-to-antibiotic time was significantly shorter in the group that received a high priority risk classification. there was no association between door-to-antibiotic time and whether or not the risk classification was performed, nor with hospitalization in infirmaries and intensive care units, or with the length of hospital stay. It was observed that the higher the priority, the shorter the door-to-antibiotic time.

Classificação de risco e tempo porta-antibiótico no paciente com suspeita de sepse

Objective: to evaluate the association between risk classification and door-to-antibiotic time in patients with suspected sepsis. Method: retrospective cohort study, with a sample of 232 patients with suspected sepsis treated at the emergency department. They were divided into 2 groups: with and without risk classification. Once the door-to-antibiotic time was identified, one-way analysis of variance was performed with Bonferroni post hoc test or independent Student’s t-test for continuous quantitative variables; Pearson correlation tests, point-biserial correlation or biserial correlation for association analyses; and bootstrap procedure when there was no normal distribution of variables. For data analysis, the Statistical Package for the Social Sciences software was used. Results: the door-to-antibiotic time did not differ between the group that received risk classification compared to the one that was not classified. Door-to-antibiotic time was significantly shorter in the group that received a high priority risk classification. Conclusion: there was no association between door-to-antibiotic time and whether or not the risk classification was performed, nor with hospitalization in infirmaries and intensive care units, or with the length of hospital stay. It was observed that the higher the priority, the shorter the door-to-antibiotic time.

Does yoga training relate to health-promoting modifications of anthropometric indicators of overweight and quality of life in young women? Preliminary observations.

Background: Overweight and obesity are global civilization problems affecting all age groups, including in Poland. The prevalence of excessive body weight among young women in 2022, according to the Central Statistical Office (GUS), was 20%. Overweight leads to numerous complications and increases the risk of chronic diseases. There is also a confirmed link between obesity and low self-acceptance, leading to a decrease in quality of life, especially among women. Health-promoting modifications of lifestyle, including physical activity and diet, play a crucial role in the prevention and treatment of obesity. Regular physical activity like yoga is also associated with improved quality of life, particularly in the psychological domain. Aim of the study: The aim of this study was to assess the changes in anthropometric indicators of body weight (BMI, WC, WHR) and quality of life (SF-36) after 8 weeks of yoga training, conducted 3 times a week, with each session lasting 45 minutes.Material and methods: The study included 27 women with an average age of 31.48 years 10.98, who were not undergoing any medical therapy or engaging in other physical training, and were not pregnant. The participants did not make any changes to their diet during the study. The obtained results were subjected to statistical analysis using IBM SPSS Statistics 24. The normal distribution of variables was assessed using the Kolmogorov-Smirnov test, and the difference between variables was analyzed using either the Student's t-test or the Wilcoxon test. The relationships between variables were examined using the Spearman's rank correlation test.Results: The analysis of the obtained results showed that in the study group, the conducted yoga training led to a statistically significant increase in the level of quality of life in all domains (PCS, MCS, PF, RP, BP, GH, VT, SF, MH). There were no statistically significant changes observed in BMI, WC, and WHR before and after the training, which may be attributed to the small sample size and requires further research.Conclusion: Based on the preliminary results, it can be inferred that an 8-week yoga training may be recommended as a method to improve the quality of life in women.

Oxidative assessment of thawed donkey semen with seminal plasma, permeable and non-permeable cryoprotectants

During cryopreservation, donkey semen is exposed to oxidative and osmotic damage that alters the plasma membrane and causes alteration of sperm metabolism. In equids, the elimination of seminal plasma (SP) is a necessary process for the conservation of sperm in artificial conditions such as freezing, however, it is known that SP has an important role in physiological processes for sperm functions such as protection, transport, antioxidant defense, regulation of the inflammatory response in the uterus and interaction with the oocyte. The objective of this study was to evaluate total antioxidant capacity (TAC), reactive oxygen species (ROS) production and mitochondrial membrane potential of sperm, with different alternatives for donkey semen cryopreservation with permeable, non-permeable cryoprotectants and SP. Samples of semen were collected from ten Colombian Creole donkeys (Equus asinus), three ejaculates were collected from each donkey, for a total of 30 ejaculates. Eight treatments (T) were used with different combinations of 5% of dimethylformamide (DMF), 200 mM of sucrose (SUC), 1% of bovine serum albumin (BSA) and 10% of homologous seminal plasma (SP), as following: T1: DMF, T2: DMF/SP, T3: SAC/BSA, T4: SAC/BSA/SP, T5: DMF/SAC/BSA, T6: DMF/SAC/BSA/SP, T7: DMF/BSA, T8: DMF/BSA/SP. Besides the treatment, sperm was extended in EquiPlus® and 5% of clarified egg yolk, until a sperm concentration of 100 × 106 spermatozoa/mL. Posthawing, TAC was evaluated by the cationic radicalmethod (ABTS) and by the method of oxygen trapping capacity (ORAC) methodologies, total reactive oxygen species (ROS) production, superoxide anion (O2-) and hydroxyl radical (OH-) content were evaluated by spectrofluorimetry; sperm viability and mitochondrial membrane potential (ΔΨM) were measured by flow cytometry. For statistical analysis, a general linear model was fitted for each dependent variable. Normal distribution of variables was validated with the Kolmogorov–Smirnov test. Means were compared by the Tukey's test. Treatments T3 and T4 presented higher TAC (p<0.05) (ABTS and ORAC) compared to T1. For ΔψM, the lowest mean value was 9.1% for T4 (p<0.05), corresponding to one of the treatments without permeable cryoprotectant and SP. For sperm viability, the lowest values were found in both treatments with non-permeable cryoprotectant. Moreover, the treatments that were supplemented with SP showed higher production of ROS (p<0.05). In conclusion, supplementation of donkey semen with seminal plasma for cryopreservation does not alter the total antioxidant capacity; additionally, freezing semen with non-permeable cryoprotectants generates low sperm viability, low mitochondrial membrane potential and a high amount of reactive oxygen species and the composition of the freezing extender for donkey semen with seminal plasma influences the generation of total reactive oxygen species.

Association of Burnout with Socio-Educational Variables in a Sample of Chilean Dental Students

Objetive: Assess the association of burnout with socio-educational variables in a sample of Chilean dental students. Material and methods: A cross-sectional study was carried out on dental students in their 4th/5th years of the University of Concepción, Chile. The sample size was estimated at 170 students. The following variables were considered: sociodemographic (sex, age, with whom the student lives and commune of origin), educational (course, course failure, number of years behind and their cause, number of career options, funding, and secondary school type), and Burnout-MBI-SS (Maslach's Burnout Inventory for students). To evaluate the association between the variables, descriptive statistics for quantitative were made using mean and standard deviation for normal distribution variables, and median and interquartile range for non-normal distribution variables; for categorical variables, frequency, and percentage distribution was calculated. Shapiro-Wilk test was used to assess normality, as non-normal distribution was verified for MBI-SS, Mann-Whitney and Kruskal-Wallis was used to estimate statistical differences amongst categorical variables, and Spearman for correlations (p &amp;lt; 0.05). Results: Most students were in 4th year, female with a mean age of 23. For the majority, dental school was their first option, and were studying with a scholarship. Most of them lived with their nuclear family and 58% had at least failed one course. Statistical significant correlations were only found for Depersonalization with students’ age (rho= 0.2420) and reprobation years (rho= 0.1838). Conclusions: Dental students from the University of Concepción, which are female, attending their fifth year, and students who failed courses, especially clinical ones, exhibit higher levels of burnout.

Diagnostic value of novel hepatic fibrosis markers in assessing cirrhosis in patients with chronic hepatitis C

Objective: To investigate the efficacy of chitinase-3-like protein 1 (CHI3L1) and Golgi protein 73 (GP73) in the diagnosis of cirrhosis and the dynamic changes of CHI3L1 and GP73 after HCV clearance in patients with chronic hepatitis C (CHC) treated with direct-acting antiviral drugs (DAAs). The comparison of continuous variables of normal distribution were statistically analyzed by ANOVA and t-test. The comparison of continuous variables of non-normal distribution were statistically analyzed by rank sum test. The categorical variables were statistically analyzed by Fisher's exact test and χ(2) test. Correlation analysis was performed using Spearman correlation analysis. Methods: Data of 105 patients with CHC diagnosed from January 2017 to December 2019 were collected. The receiver operating characteristic curve (ROC curve) was plotted to study the efficacy of serum CHI3L1 and GP73 for the diagnosis of cirrhosis. Friedman test was used to compare CHI3L1 and GP73 change characteristics. Results: The areas under the ROC curve for CHI3L1 and GP73 in the diagnosis of cirrhosis at baseline were 0.939 and 0.839, respectively. Serum levels of CHI3L1 and GP73 in the DAAs group decreased significantly at the end of treatment compared with baseline [123.79 (60.25, 178.80) ng/ml vs. 118.20 (47.68, 151.36) ng/ml, P = 0.001; 105.73 (85.05, 130.69) ng/ml vs. 95.52 (69.52, 118.97) ng/ml, P = 0.001]. Serum CHI3L1 and GP73 in the pegylated interferon combined with ribavirin (PR) group were significantly lower at the end of 24 weeks of treatment than the baseline [89.15 (39.15, 149.74) ng/ml vs. 69.98 (20.52, 71.96) ng/ml, P < 0.05; 85.07 (60.07, 121) ng/ml vs. 54.17 (29.17, 78.65) ng/ml, P < 0.05]. Conclusion: CHI3L1 and GP73 are sensitive serological markers that can be used to monitor the fibrosis prognosis in CHC patients during treatment and after obtaining a sustained virological response. Serum CHI3L1 and GP73 levels in the DAAs group decreased earlier than those in the PR group, and the serum CHI3L1 levels in the untreated group increased compared with the baseline at about two years of follow-up.

Operating Performance Assessment Based on Semi-Supervised Cluster Generative Adversarial Networks for Gold Flotation Process

Operating performance assessment of gold flotation process plays an important role in improving the metallurgical performances and pursues the best comprehensive economic benefits. The appearance of froth is a good indicator of flotation performance; however, labeling the data is costly. To assess the operational performance of flotation process with a small amount of labeled data, this study proposes a semi-supervised cluster generative adversarial network (SSClusterGAN). First, latent variables are sampled from one-hot encoded variables and continuous normal distribution variables. While projecting all data into the latent variable space, the specific types of clustering in the latent space is realized by controlling the type of distribution of the learned latent codes, so that the training objectives of labeled data and unlabeled data are consistent. Then, by adapting the generative adversarial networks (GANs) framework, a pair of stacked discriminators are used to learn the conditional distribution of attributes for labeled and unlabeled data, respectively. In addition, using semi-supervised learning (SSL) as the basic learning technology, the high-confidence pseudo-labels obtained by training with unlabeled data are combined with the labeled training data to increase the training samples and effectively improve the accuracy of the model. Finally, the method was applied to the gold flotation process. The experimental results show that the method effectively utilizes unlabeled samples to expand the labeled dataset, combines the advantages of SSL and GAN, obtains accurate assessment results, and effectively improves the comprehensive economic benefits of the gold flotation process.

Coronavirus Disease 2019, a Popup Differential to the Postoperative Inflammatory State and its Impact on Outcomes after Cardiac Surgery – A Single-Center Experience

Introduction: Coronavirus disease 2019 (COVID-19) affected care among surgical patients. Considering the underlying comorbidities, physical status, and intricate perioperative course, the cardiac surgery patient represents a vulnerable cohort. This study describes baseline characteristics, laboratory findings, diagnosis, postoperative course, and their correlation with immediate outcomes in patients undergoing cardiac surgery. Methodology: Patients who underwent cardiac surgery at our institute for 1 year were screened for COVID-19 with the reverse transcription-polymerase chain reaction swab test and then were posted for surgery only after corroborating negative reports, except for emergency cases. Dedicated preoperative areas and COVID-appropriate measures were taken. Data from the electronic patient records of those diagnosed with COVID-19 in the immediate postoperative period were reviewed retrospectively. Continuous normal distributed variables are presented as mean ± standard deviation, alternatively as median ± interquartile range, and categorical variables as percentages. Results: A total of 22 patients were infected in the immediate postoperative period in spite of appropriate screening and had a high mortality of 36.36% (vs. non-COVID 6.27%,P&lt; 0.001). Days from index surgery to diagnosis were 6 (±3.75). The median stay in the intensive care unit and hospital stay was 6 (±2.75) and 10 (±3.2) days, respectively. The moderate and high-risk categories of the European System for Cardiac Operative Risk Evaluation II showed mortality of 33.3% (vs. 2.69% in non-COVID, odds ratio of 18.42) and 71.4% (vs. 11.2% in non-COVID, odds ratio of 19.65). Patients with C-reactive protein &gt;100 mg/lit, D dimer &gt;1000 ng/ml, and neutrophil/lymphocyte ratio &gt;3.5 showed very high mortality. Noninvasive and invasive ventilation in 27.27% and 31.8%, respectively. Two patients acquired acute kidney injury that required hemodialysis. Conclusions: Despite requisite measures, COVID infection still remains a momentous differential to postoperative complications affecting early outcomes. Therefore, more robust preoperative protocols, better strategies for the COVID-free environment, and early clinical suspicion and workup are required to mitigate its effect on this cohort.

CURAH HUJAN DAN SUHU UDARA TERHADAP KEJADIAN MALARIA DI KOTA BENGKULU

High and low incidence of malaria can be controlled by physical environmental conditions of the breeding of Anopheles mosquitoes. Data malaria cases in Bengkulu City for the last 8 years were 1.545, 934, 310, 144, 145, 25, 12 and 3 cases. The biggest factor affected mosquito breeding is climate. The purpose of study analyzed the effects of rainfall, temperature against the incidence of malaria in Bengkulu City. An ecological study using data from Dinkes and BMKG. The dependent variable is malaria incidence and independent variable was rainfall and temperature. Data analysis using univariate, bivariate and multivariate. The result of malaria incidence from 2012-2015 was 1,439 cases with rainfall 108-405 mm and temperature range between 25.57-26.740C. Normality test showed that the three normal distributed variables, Pearson correlation test between rainfall and malaria incidence there is a significant relationship, while the temperature and incidence of malaria there is no significant relationship. Multivariate analysis showed a weak relationship between rainfall and malaria incidence (r = - 0.173). The value of chi square coefficient (R2 = 0.3) means that the regression line equation describes 30% of the variation of malaria occurrence that is affected by rainfall. Suggestions for the results of this study can be to solve the strategy in combating malaria by anticipating if there is a sudden climate change that causes the high number of mosquito breeding and expected community participate in the prevention of malaria disease by maintaining the cleanliness of 3M environment especially in the rainy month.

OR19-6 Functional Hypothalamic Amenorrhea and Preclinical Cardiovascular Disease

Abstract Background Functional Hypothalamic Amenorrhea (FHA) is characterized by suppression of central GnRH drive with secondary anovulation and hypoestrogenemia, hypercortisolism, and low leptin that results from a combination of psychosocial stress and metabolic imbalance due to excess physical activity and/or weight loss. Cardiovascular disease (CVD) is the leading killer of women at all ages and CVD mortality rates are unchanged or increasing in young women aged 35-44 years. We investigated relations between FHA and preclinical CVD measured by endothelial dysfunction in premenopausal women with and without FHA, and recently menopausal women not on hormone therapy. Methods We studied 31 women with FHA, 29 eumenorrheic controls, and 30 recently menopausal women not on hormone therapy. FHA was defined as amenorrhea ≥3 consecutive months, estradiol &amp;lt;50 pg/mL, FSH &amp;lt;10 mIU/L, and LH &amp;lt;10 mIU/L, and exclusion of other etiologies including polycystic ovary syndrome, prolactinoma, thyroid dysfunction, and pregnancy. Eumenorrheic controls had self-reported monthly menstrual cycles, were not on hormones, with a day 22-24 progesterone level &amp;gt;3 ng/ml to confirm ovulation. Preclinical CVD testing for eumenorrheic controls took place days 3-5 of menses. Recently menopausal women had natural menopause within 3 years, FSH &amp;gt;30, and not on hormone therapy. Preclinical CVD was measured using Endo PAT 2000 (Itamar® Medical Ltd) to calculate reactive hyperemic index (RHI) stress to rest pulse amplitude. RHI ≤1.67 indicates endothelial dysfunction. Statistical analysis included analysis of variance for normal distributed variables and Kruskal Wallis test for non-parametric variables. Results The mean age, BMI and estradiol of FHA, no FHA and recent menopause was 26.4 ± 6.2 y, 30.3 ± 3.7 and 53.3 ± 2.6, respectively (p&amp;lt;0.0001); BMI 21.6 ± 6.2 kg/m2, 21.8 ± 2.0, and 23.5 ± 4.2 (p=0.06); and estradiol 29.7±18.2, 46.4 ± 15.7, and 10.9 ± 14.4 pg/ml (p&amp;lt;0.0001), respectively. The median months of FHA amenorrhea was 10.8 months. There were no differences in testosterone (p=0.48), however FHA women had lower leptin (p=0.012) and higher cortisol (p=0.0005) compared to both no FHA and recently menopausal women. Preclinical CVD measured by RHI was significantly lower in FHA compared to no FHA and recently menopausal women (1.8 + 0.5 vs 2.2 + 0.5 vs 2.2 +0.6;p=0.007, respectively). Further 35% of FHA women had RHI ≤1.67 indicating endothelial dysfunction. Conclusion Our results demonstrate endothelial dysfunction in young women with FHA women as compared to eumenorrheic women and older recently menopausal women not on hormone therapy. Our findings suggest that FHA may be an important contributor to CVD mortality in younger women and that preclinical CVD in FHA is not likely due to hypoestrogenemia alone. Future studies will focus on identifying potential treatment targets for CVD prevention. Presentation: Monday, June 13, 2022 12:15 p.m. - 12:30 p.m.

Effect of selenium on semen quality and fertility of rams

Objective: To evaluate the effect of different selenium (Se) doses on semen quality and fertility of rams. Design/Methodology/Approach: Se was administered subcutaneously each month to nine two-month-old rams (from April 2018 to February 2020). The treatments were: T1 = without Se, T2 = 0.1 mg Se kg-1, and T3 = 0.3 mg Se kg-1. Semen evaluations were carried out using an electroejaculator; a total of 180 ejaculations were analyzed. The rams with better semen quality (one per treatment) were subjected to a mating. The following variables were evaluated: volume (Vol), masal motility (MM), progressive motility (MP), sperm concentration per mL and ejaculation, acrosome integrity percentage, living spermatozoa, normal spermatozoa, and fertility percentage. The normal distribution variables were evaluated using an analysis of variance (ANOVA) and Tukey’s comparison test (Tukey, 0.05); the percentages were raised to the inverse sine in order to perform the appropriate ANOVA. Fertility was analyzed using a χ2 test. Results: There was no difference in semen quality and fertility percentage (p &gt; 0.05). The ejaculation volume showed differences between treatments (p ≤ 0.05). Study Limitations/Implications: A study including a higher number of rams and a previous fieldwork practice should be carried out, in order to evaluate semen parameters. These evaluations would help to accurately estimate semen quality and fertility, as well as to corroborate the results. Findings/Conclusions: Se did not improve semen quality and fertility of rams

EFFICACY AND SAFETY OF TERLIPRESSIN INFUSION VS BOLUS TREATMENT IN DIGESTIVE BLEEDING OF VARICEAL ORIGIN AT THE PUEBLA SPECIALTY HOSPITAL, PRELIMINARY RESULTS

Digestive bleeding of variceal origin represents an emergency medical event, with a mortality rate close to 20% and drug treatment is one of the pillars of management. In our environment and according to international recommendations, terlipressin administered in boluses is the treatment of choice for this entity, with a high percentage of adverse effects related to its use, so it is relevant to find other strategies in its use, but without reducing its use effectiveness. Some studies suggest that the use of terlipressin by continuous infusion could represent a more effective or comparable strategy for the control of bleeding, a lower rate of adverse effects and a lower risk of rebleeding, so the objective of this study is to compare the efficacy and safety of terlipressin in intermittent dose vs. infusion for acute bleeding of variceal origin in patients with portal hypertension. this is a randomized, open, comparative and prospective study that included adult patients with a diagnosis of portal hypertension of any origin, with manifest gastrointestinal bleeding, treated at the Puebla Specialty Hospital since March 1, 2021, who were randomly administered terlipressin by infusion and boluses. Study variables: treatment failure, adverse effects, days of hospital stay and transfusion requirement. The protocol was approved by the local committee and conbioethics 21-CEI-002-20180731, all patients participated with informed consent. Results were analyzed with frequency measures, Fisher's exact test was used to demonstrate hypotheses, and Student's t-test was used for unrelated normal distribution variables. Up to now, 10 patients have been admitted to the study, in which no significant differences have been obtained in the study variables; however, in the bolus terlipressin group, three of the five patients have presented adverse effects, unlike the infusion terlipressin group in which they have not been presented. At the moment, a total of 10 patients has demonstrated comparable effectiveness in both groups; however, in the bolus group, 60% of the patients have presented adverse effects that have led to the change of vasoactive drug, unlike the infusion group where there have been no adverse effects, however, no significant differences have been found between both groups, which is explained by the small number of patients at the moment. We consider that a larger number of patients is required to demonstrate our hypothesis. The authors declare that there is no conflict of interest.

Association of Electrolyte Changes and Inflammatory Markers with Renal Involvement in Children with Febrile UTI

Background: We need some simpler, cheaper, and less burdensome tools to investigate the severity of renal parenchymal involvement in children with clinical pyelonephritis. Objectives: The present study was designed to investigate the relationship between electrolyte changes with renal involvement as documented by dimercaptosuccinic acid (DMSA) scan in children with febrile urinary tract infection (UTI). Methods: This is a retrospective cohort study, involving 158 children aged two months to 14 years with febrile UTI admitted to Taleghani Hospital in Gorgan from 2018 to 2019. Their documents in hospital were analyzed. They were divided into two groups with positive or negative defects on DMSA scan. Clinical and laboratory data were studied. Statistical analysis was performed using SPSS version 18. Data were analyzed using independent t-test with normal distribution of variables, otherwise chi-square test was used. The statistical significance level of the study was considered 0.05. Results: Among the 158 children, 78 patients (49.4%) had normal DMSA scan results, and 80 patients (50.6%) had an abnormal result. The mean age in month was not different between the two groups. In patients with positive renal cortical defects on DMSA scan (group 2), ESR was significantly higher than the first group (P &lt; 0.05). The mean serum Na level in the second group was lower than in the first group; however, it was only slightly significant (P = 0.058). The two groups showed no difference with respect to serum potassium, urine specific gravity (SG), WBC count, and the duration of fever (P &gt; 0.05). The frequency distribution of proteinuria was not different between the two groups (P = 0.836). Conclusions: We suggest that increased ESR, positive CRP, and the presence of reflux can predict renal parenchymal involvement in children with febrile UTI as evidenced by a positive finding on DMSA scan, and the presence of hyponatremia has a little predictive value in this regard.

Comparative efficacy and predictive value of fixed combination of amlodipine and angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker in patients with coronary heart disease, post-infarction cardiosclerosis and hypertension

The aim of the work – to analyze the effectiveness of a fixed combination of amlodipine and angiotensin-converting enzyme (ACE) inhibitor (lisinopril) or angiotensin II receptor blocker (valsartan) in patients with coronary heart disease (CHD), post-infarction cardiosclerosis (PIC), arterial hypertension (AH) regarding the blood pressure (BP) control and impact on a composite endpoint. Materials and methods. General clinical examination of 108 patients with PIC and AH was done at the Cardiology Department of Shupyk National Healthcare University of Ukraine within 12 months. Patients were divided into two groups. The first group patients (n = 50) were assigned to receive a fixed combination of valsartan and amlodipine (160 mg and 5 mg, respectively), and the second group patients (n = 58) were treated with a fixed combination of lisinopril and amlodipine (10 mg and 5 mg, respectively). Patients were followed-up for 12 months, including general clinical examination, office BP measurements, 24-hour BP monitoring, echodopplerography, monitoring of the composite endpoint. Exclusion criteria were hemodynamically significant heart valve lesions, permanent or temporary cardiac pacing, acute heart failure and implanted cardioverter-defibrillator, permanent form of atrial fibrillation, acute cerebrovascular disorder, decompensation of severe somatic pathology. Statistical analysis of the data obtained was performed using Microsoft Excel, IBM SPSS Statistics v. 23. Descriptive data were presented as arithmetic mean ± standard deviation (M ± SD) in the case of normal distribution of variables, data with distribution other than normal were presented in Me format (Q25; Q75), where Me was the median, Q25, Q75 – lower and upper quartiles (Q25; Q75), or as a percentage for categorical values with Pearson’s Chi-square (χ2) calculation. Differences in mean values were considered statistically significant at a level of Р &lt; 0.05. Results. According to all statistical criteria, BP indicators did not differ in both patient groups. Systolic office BP in the first group was 133.00 (123.00; 140.25) mm Hg., in the second group – 130.00 (122.00; 140.00) mm Hg. In the first group, diastolic office BP was 81.00 (79.50; 81.00) mm Hg and in the second group – 80.00 (75.00; 86.00) mm Hg. No statistically significant differen­ces were found in the study groups when assessing mean BP levels during the 24-hour monitoring. In the assessment of index values, systolic BP load was higher than normal in 58 % of patients in the first group and in 56.9 % of patients in the second group (χ2 = 0.01; P = 0.53). The assessment of diastolic BP load indices revealed increased diastolic BP index in 72 % of patient in the first group and in 75.9 % – in the second group (χ2 = 0.2; P = 0.4). The number of patients with BP higher or less than 130/80 mm Hg was compared. Systolic BP was above and below 130 mm Hg in 56 % and 44 %, respectively, of the first group patients; the distribution was 37.9 % and 62.1 % in the second group. Therefore, the percentage of patients with target systolic BP was higher in the second group (χ2 = 3.52; P = 0.046). Analyzing the composite endpoint, a statistically significant difference in the Kaplan–Meier curves via the statistical criterion using a log-rank test (P = 0.007) was detected. Conclusions. No statistically significant differences were found in the analysis of office blood pressure and 24-hour blood pressure monitoring between amlodipine with lisinopril and amlodipine with valsartan groups. The detailed analysis revealed a greater percentage of patients with target blood pressure below 130/80 mm Hg among those under 65 years of age receiving amlodipine with lisinopril (χ2 = 3.52; P = 0.046). The better prognostic value of the fixed combination of amlodipine with lisinopril compared to the combination of amlodipine with valsartan (P = 0.007) was demonstrated by the endpoint analysis.

Acute kidney injury in COVID–19: A single–center experience in Nigeria

Background & objective: Despite available data from developed countries, suggesting a high incidence of acute kidney injury (AKI) in coronavirus disease 2019 (COVID–19), there is scarce data from African countries, including Nigeria. We conducted this study to determine and document the incidence, the associated factors and the outcome (in–hospital mortality) of AKI among COVID–19 patients managed in a center in Nigeria. Methodology: It was a retrospective review of confirmed COVID–19 cases managed at a center in Nigeria. AKI was defined using 2012 Kidney Disease: Improving Global Outcomes (KDIGO) creatinine criteria. We extracted relevant data from the electronic records of the COVID–19 patients admitted to our hospital and analyzed. Fischer's exact tests were used to test factors associated with AKI for discrete variables, Mann–Whitney U test was used for skewed continuous data, and T–test for continuous normal distribution variables. Results: This study involved 41 of the 56 confirmed COVID–19 cases. The mean age was 45 ± 17.94 y. A majority of the patients were males (33; 80.5%). AKI occurred in 6 (14.6%) of the patients. Of the 6 AKI; 4 (66.7%) and 2 (33.3%) were in stages 1 and 3 respectively. One patient (16.7%) had had hemodialysis. Of the 6 with AKI, 3 died with a mortality rate of 50.0%. Factors associated with AKI included age above 45 years, body weakness, severe and critical COVID, urea > 10 mmol/l, and serum creatinine > 1.5 mg/dl. Only severe and critical disease was predictive of AKI (adjusted odds ratio 1.777, 95% CI 1.028, 3.074). Conclusion: The results of our study show that AKI is common in severe and critical COVID–19 and is associated with a poor outcome. Key words: Acute kidney injury; AKI; COVID–19; Mortality Abbreviations: AKI – Acute kidney injury; KDIGO – Kidney Disease: Improving Global Outcomes 2012; eGFR – estimated glomerular filtration rate; MDRD – Modification of Diet in Renal Disease Ethical Review Committee Approval: MOH/ADM/SUB/1152/1/374 Citation: Ibrahim OR, Taofeek Oloyede T , Gbadamosi H , Musa Y , Aliu R , Bello SO , Alao MA , Suleiman MS , Adedoyin OT. Acute kidney injury in COVID–19: A single–center experience in Nigeria. Anaesth. pain intensive care 2021;25(4):470–477. DOI: 10.35975/apic.v25i4.1567

Changes of Ocular Surface Before and After Treatment of Blepharoptosis With Combined Fascial Sheath Suspension and Frontal Muscle Flap Suspension.

Objective:To explore the ocular surface changes after ptosis surgery in patients with severe congenital blepharoptosis.Methods:The patients were divided into group A and group B, Group A received conjoint fascial sheath suspension, and group B received frontal muscle flap suspension. The ocular surface changes were followed upon the 7th day and in the 1st and 3rd month after operation, which included Schirmer test (ST), break-up time (BUT), tear meniscus height (TMH). For normal distribution variables, t test was used before and after operation, and the Wilcoxon test was used for variables with abnormal distribution.Results:Compared to preoperative status, the ST and TMH were not significantly changed after surgery (P > 0.05), but BUT higher on the 7th day and in the 1st and 3rd month after operation (P < 0.05). The fluorescence staining (FL) score was higher in the 3rd month than that in the 1st month (P < 0.05), but was not significantly different between the 7th and in the 1st month after operation (P > 0.05). The ST, TMH, and BUT after surgery were not significantly different between groups of A and B (P > 0.05), but the FL score lower in the 3rd month than on the 7th day and in the 1st month after operation (P < 0.05).Conclusions:The ST, BUT, and TMH were not significantly changed after surgery between groups of A and B, but the FL score was lower in group A than that in group B in early postoperative time.

Neural Networks to Estimate Generalized Propensity Scores for Continuous Treatment Doses.

The generalized propensity score (GPS) addresses selection bias due to observed confounding variables and provides a means to demonstrate causality of continuous treatment doses with propensity score analyses. Estimating the GPS with parametric models obliges researchers to meet improbable conditions such as correct model specification, normal distribution of variables, and large sample sizes. The purpose of this Monte Carlo simulation study is to examine the performance of neural networks as compared to full factorial regression models to estimate GPS in the presence of Gaussian and skewed treatment doses and small to moderate sample sizes. A detailed conceptual introduction of neural networks is provided, as well as an illustration of selection of hyperparameters to estimate GPS. An example from public health and nutrition literature uses residential distance as a treatment variable to illustrate how neural networks can be used in a propensity score analysis to estimate a dose-response function of grocery spending behaviors. We found substantially higher correlations and lower mean squared error values after comparing true GPS with the scores estimated by neural networks. The implication is that more selection bias was removed using GPS estimated with neural networks than using GPS estimated with classical regression. This study proposes a new methodological procedure, neural networks, to estimate GPS. Neural networks are not sensitive to the assumptions of linear regression and other parametric models and have been shown to be a contender against parametric approaches to estimate propensity scores for continuous treatments.

116 Differences between 5- and 6-day progestogen-based oestrus induction protocol in Saanen and Toggenburg goats

Hormonal oestrus induction treatment is an important tool for the success of reproductive biotechniques in anoestrus goats. In the nonbreeding season, oestrus induction can be performed by the use of several protocols, including those varying in their duration. This study aimed to compare short-term (for either 5 or 6 days) progestogen-based oestrus synchronization protocols in dairy [Toggenburg (n=12) and Saanen (n=12)] goats during the nonbreeding season. This study was performed in Minas Gerais State, Brazil (21°35′S and 43°15′W), with 12 nulliparous (12–14 months old) and 12 pluriparous (2–4 years old in final third of lactation) goats, all with body condition scores (BCS) of 3.0 to 3.5. They were equally assigned to both treatments according to their order of parturition, BCS, and breed. On a random day (Day 0), 24 goats received an intravaginal device of 60mg of medroxyprogesterone acetate (Progespon®, Zoetis) which remained for 5 (G5; n=12) or 6 (G6; n=12) days. On Day 5, goats from both groups received 30µg of cloprostenol intramuscularly (IM) (Prolise®, ARSA S.R.L.) and 200IU of equine chorionic gonadotrophin (eCG) IM (Novormon®, Schering Plough Animal Health). Both groups received cloprostenol and eCG on the same day (regardless of device removal) to ensure they were administered at the same follicular wave. Both device insertion and removal were performed in the morning. Ultrasound evaluations were performed every 12h from device removal to ovulation detection. Ovulations were considered as the average interval between the last observation of follicles and the first exam in which it was no longer seen. The normal distribution of variables was determined by Shapiro-Wilk test and homocedasticity by Levene’s test. All variables were not normally distributed and thus analysed by Mann–Whitney U test, with P&amp;lt;0.05 considered significantly different. Values are presented in median±interquartile range. There was no difference between G5 and G6, respectively, in the interval to oestrus (48.0±0.0 vs. 48.0±12.0h), interval from oestrus onset to ovulation (18.0±9.0 vs. 18.0±12.0h), interval from device removal to ovulation (66.0±18.0 vs. 66.0±24.0h), number of ovulated follicles (2.0±2.0 vs. 2.5±2.0), or mean diameter of ovulated follicles (6.6±1.6 vs. 6.6±1.4mm). All ovulations were detected in the morning. In conclusion, our data demonstrate that short-term hormonal treatment for 5 or 6 days is similarly efficient to induce synchronous oestrus in Saanen and Toggenburg goats. This research was supported by EMBRAPA (Project 20.19.01.004.00.03.001) and CNPq (314952/2018-7).

P1822CLINICAL AND BIOCHEMICAL DIFFERENCES IN PATIENTS WITH CORTICODEPENDENT, CORTICORRESISTENT NEPHROTIC SYNDROME AND FRECUENT RECAIDS THAT DEVELOPED DISEASE CHRONIC RENAL DISEASE

Abstract Background and Aims Nephrotic syndrome not responding to steroids (corticodependent, corticorresistant, frequent relapses) in children is a disease with significant morbidity and mortality. The evolution to chronic kidney disease has a relationship with time to histopathological diagnosis, the treatment performed, its duration, the early identification of risk factors being of utmost importance. Method An observational-retrospective study was carried out with transverse temporality, the universe of study was patients with a diagnosis of nephrotic syndrome from 2007 to 2017 with outcome to chronic kidney disease, information was obtained from the clinical files and their subsequent Bivariate analysis of qualitative variables with linear Chi and quantitative variables of normal distribution with ANOVA and abnormal distribution with Kruskas Wails. Results The clinical and biochemical differences of 121 patients with a diagnosis of non-steroidal nephrotic syndrome were determined. The clinical presentation of corticorresistant was the most frequent in 89 (73.6%), corticodependents 16 (13.2%) and frequent relapses 16 (13.2%), being the association with the major histopathological type of corticorresistant with GEFS 60 (83.3% ), mesangial proliferation 13 (61.9%) and minimum changes 9 (60%) with a p 0.05. The sex that was determined most frequently were men 83 (68.6%), women 38 (31.4%) p 0.8. The age at diagnosis had a frequency of 60 (49.6%) between 2.1 to 10 years of age and 60 (49.6%) in those over 10.1 years of age p 0.7. The evolution to chronic kidney disease was determined in 27 (22.3%), being greater its relationship with GEFS 21 (29.2%), diffuse mesangial proliferation 2 (9.5%), minimum changes 1 (6.7%) p 0.05. The time of evolution to chronic kidney disease between 0 and 3 years was 20 (16.5%), between 4 and 7 years was 4 (3.3%), and greater than 7 years 3 (2.5%), finding a greater relationship with GEFS between the 0 to 3 years that were 15 (20.8%) p 0.1. It was determined that the type of treatment most commonly used were anticalcineurinics (Cyclosporine-Tacrolimus), cyclosporine in 51 (42.1%), tacrolimus in 54 (44.6%), mycophenolate 10 (8.3%), and without treatment 6 (5% ) with a higher GEFS ratio of the use of cyclosporine 32 (44.4%) and tacrolimus 32 (44.4%) p.0.017. The use of ACEI and ARA II as antiproteinurics determined only ACEI in 8 (6.6%), ARA II 9 (7.4%) and IECA + ARA II in 52 (43%), none in 52 (43%), with a ratio of use of ACEI + ARA II in patients with GEFS in 35 (48.6%) p 0.5. Conclusion In this study, similar results were found in frequency of age, sex, progression to chronic kidney disease, histopathological type, treatment with anticalcineurinics and use of antiproteinurics in patients with nephrotic syndrome not responding to steroids to those reported in the literature, being the first in Mexico should be the beginning of different cohorts (response, duration of treatment, complications of the disease) in this type of patients.