Tag: statistics

Mem Inst Oswaldo Cruz. 2021 Nov 8;116:e210203. doi: 10.1590/0074-02760210203. eCollection 2021.

ABSTRACT

BACKGROUND: Paracoccidioidomycosis (PCM) is a systemic mycosis endemic to Latin America. Etiological agents are Paracoccidioides species that diverge phylogenetically throughout South America.

OBJECTIVES: This study aimed to document the epidemiology of PCM in Venezuela.

METHODS: We have performed a retrospective cross-sectional descriptive study in 31,081 clinical records of patients from two reference centres during 65 years (1954-2019).

FINDINGS: PCM diagnosis was confirmed in 745 patients. Chronic PCM was the most prevalent form (90.06% cases); 80.67% were male and the most affected age range was 41-60. Farming and construction were the most prevalent occupation and Miranda State had a higher prevalence. Lung and skin were the most affected organs, followed by oral manifestations. Direct examination, culture and serology showed a high sensibility, and no statistical difference was observed among the diagnostic tools. Out of 17 Paracoccidioides isolates genotyped from Venezuela, one was typed as Paracoccidioides americana and 16 as Paracoccidioides venezuelensis.

MAIN CONCLUSIONS: Clinical manifestations observed, information about the epidemiology and molecular profile is essential not only for diagnosis but also for understanding therapeutic responses to mycotic drugs and prognosis. Therefore, it is necessary to sequence all positive isolated strains in order to confirm the dominance of P. venezuelensis in Venezuela.

PMID:34755819 | DOI:10.1590/0074-02760210203

Braz Dent J. 2021 May-Jun;32(3):56-64. doi: 10.1590/0103-6440202103961.

ABSTRACT

It aims on evaluate the effect of the test environment on static fatigue behavior of lithium disilicate-based (LD), and yttrium oxide-stabilized zirconia (YSZ) ceramics. Specimens of LD (IPS e.max CAD, Ivoclar Vivadent) and YSZ (IPS e.max ZirCAD MO, 3 mol% Y2O3, Ivoclar Vivadent) were randomly allocated into three groups: tested in air, inert (paraffin oil, Sigma Aldrich) or distilled water. The static fatigue test (n=15) was performed using a piston-on-three ball assembly, adapted from ISO 6872, as follows: starting load 100 N for LD and 300 N for YSZ; loading application time set to 1 hour for each loading step; step size of 50 N for LD and 100 N for YSZ, applied successively until fracture. Data from static fatigue strength (MPa) and time to fracture (hours) were recorded. Fractographic analysis was executed. Survival analysis corroborates absence of influence of environment on static fatigue outcomes (fatigue strength, time to fracture and survival rates) for YSZ. For LD, specimens tested in air presented statistically superior survival rate and static fatigue strength (p= 0.025). In regards of time to fracture, LD tested in air were superior than when tested in distilled water (p=0.019) or inert (p=0.017) environments. No statistical differences for Weibull modulus were observed. Failures started on the tensile stress surface. Thus, the test environment did not affect slow crack growth (SCG) mechanisms during static fatigue test of YSZ ceramics, but it plays a significant role for the static fatigue behavior of lithium disilicate-based glass ceramics, indicating a high susceptibility to SCG.

PMID:34755790 | DOI:10.1590/0103-6440202103961

Rev Lat Am Enfermagem. 2021 Nov 8;29:e3500. doi: 10.1590/1518-8345.5227.3500. eCollection 2021.

ABSTRACT

OBJECTIVE: to estimate the incidence of medical adhesive-related skin injury in the peripheral venous catheter fixation region in critical cancer patients, to identify risk factors, and to establish a risk prediction model for its development.

METHOD: a prospective cohort study with a sample of 100 adult and aged patients hospitalized in an intensive care unit. The data were analyzed using descriptive, bivariate and multivariate statistics with Cox regression.

RESULTS: the incidence of medical adhesive-related skin injury was 31.0% and the incidence density was 3.4 cases per 100 people-days. The risk factors were as follows: alcoholism, smoking habit, hospitalization due to deep vein thrombosis, acute respiratory failure, immediate postoperative period, heart disease, dyslipidemia, use of antiarrhythmics, blood transfusion, friction injury, pressure injury, turgor, edema, hematoma, petechiae, low values in the Braden scale, clinical severity of the patient, elasticity, moisture, texture and color. The predictive model consisted in the following: decreased skin turgor, presence of hematoma and edema.

CONCLUSION: medical adhesive-related skin injury at the peripheral venous catheter insertion site has a high incidence in critical cancer patients and is associated with decreased turgor, presence of hematoma and edema, evidence that can support the clinical practice.

PMID:34755780 | DOI:10.1590/1518-8345.5227.3500

Braz Dent J. 2021 May-Jun;32(3):105-115. doi: 10.1590/0103-6440202104138.

ABSTRACT

This clinical trial evaluated the effect of the coadministration of ibuprofen/caffeine on bleaching-induced tooth sensitivity (TS). A triple-blind, parallel-design, randomized clinical trial was conducted on 84 patients who received ibuprofen/caffeine or placebo capsules. The drugs were administered for 48 hours, starting 1 hour before the in-office bleaching. Two bleaching sessions were performed with 35% hydrogen peroxide gel with 1-week interval. TS was recorded up to 48 hours after dental bleaching with a 0-10 visual analogic scale (VAS) and a 5-point numeric rating scale (NRS). The color was evaluated with VITA Classical and VITA Bleachedguide scales (ΔSGU) and VITA Easyshade spectrophotometer (ΔE*ab and ΔE00). The absolute risk of TS in both groups was evaluated using Fischer’s exact test. Comparisons of the TS intensity (NRS and VAS data) were performed by using the Mann-Whitney test and a two-way repeated measures ANOVA, respectively. The color alteration between the groups was compared with the Student’s t test. The significance level was 5%. There was no statistically significant difference between the groups for the absolute risk of TS (p = 1.00) or for the intensity of TS (p > 0.05). A bleaching of approximately 7 shade guide units was observed on the Vita Classical and Vita Bleachedguide scales, with no statistical difference between the groups. It was concluded that coadministration of ibuprofen and caffeine did not reduce the absolute risk or intensity of TS and did not interfere with the efficacy of dental bleaching.

PMID:34755785 | DOI:10.1590/0103-6440202104138

Rev Lat Am Enfermagem. 2021 Nov 8;29:e3493. doi: 10.1590/1518-8345.5279.3493. eCollection 2021.

ABSTRACT

OBJECTIVE: to evaluate evidence on effectiveness support surfaces for pressure injury prevention in the intraoperative period.

METHOD: systematic review. The search for primary studies was conducted in seven databases. The sample consisted of 10 studies. The synthesis of the results was carried out descriptively and through meta-analysis.

RESULTS: when comparing low-tech support surfaces with regular care (standard surgical table mattress), the meta-analysis showed that there is no statistically significant difference between the investigated interventions (Relative Risk = 0.88; 95%CI: 0.30-2.39). The Higgins inconsistency test indicated considerable heterogeneity between studies (I2 = 83%). The assessment of the certainty of the evidence was very low. When comparing high-tech and low-tech support surfaces, the meta-analysis showed that there is a statistically significant difference between the interventions studied, with high-tech being the most effective (Relative Risk = 0.17; 95%CI: 0.05-0.53). Heterogeneity can be classified as not important (I2 = 0%). The assessment of certainty of evidence was moderate.

CONCLUSION: the use of high-tech support surfaces is an effective measure to prevent pressure injuries in the intraoperative period.

PMID:34755774 | DOI:10.1590/1518-8345.5279.3493

Rev Lat Am Enfermagem. 2021 Nov 8;29:e3497. doi: 10.1590/1518-8345.5383.3497. eCollection 2021.

ABSTRACT

OBJECTIVE: to analyze the perception of patients about health professionals’ adherence to safety barriers in medication administration.

METHOD: cross-sectional and correlational study carried out in a hospital in the countryside of São Paulo, with a total of 249 adult patients admitted to the medical clinic. An electronic form developed by the researcher was used. Quantitative variables were analyzed in mean, median and standard deviation. Likert-type variables were calculated according to the perception score and the Bayesian Information criterion was used. The cutoff point for positive assessment of the patients’ perception was 0.75.

RESULTS: the average perception score was 0.29 and, of the 15 barriers analyzed, eight are never adhered by professionals, in the opinion of most patients. Also, age was the only variable with statistical significance.

CONCLUSION: the younger the patient, the better their perception of health professionals’ adherence to safety barriers in medication administration.

PMID:34755778 | DOI:10.1590/1518-8345.5383.3497

Rev Lat Am Enfermagem. 2021 Nov 8;29:e3485. doi: 10.1590/1518-8345.5104.3485. eCollection 2021.

ABSTRACT

OBJECTIVE: to identify the levels of anxiety and breastfeeding self-efficacy in puerperal women at the intervals of 60, 120, and 180 days postpartum; and to verify the influence of anxiety on breastfeeding self-efficacy among these puerperal women.

METHOD: an analytical, longitudinal and prospective study, conducted with 186 puerperal women, and which used a sociodemographic and obstetric characterization questionnaire, the State-Trait Anxiety Inventory, and the Breastfeeding Self-Efficacy Scale – Short Form. The analyses were performed by means of descriptive statistics, and Fisher’s Exact Test was used.

RESULTS: most of the puerperal women presented low levels of trait anxiety (55.4%) and of state anxiety (66.2% at 60 days, 72.8% at 120 days, and 75.5% at 180 days), and a high level of self-efficacy (77.3% at 60 days, 75.3% at 120 days, and 72.1% at 180 days of puerperium). Low levels of trait anxiety and state anxiety were associated with high self-efficacy at 60 days (p=0.0142 and p=0.0159, respectively).

CONCLUSION: it is necessary to pay greater attention to the mental health of puerperal women, considering that those who presented low levels of anxiety had higher levels of self-efficacy, a situation that can result in longer exclusive breastfeeding.

PMID:34755773 | DOI:10.1590/1518-8345.5104.3485

Acta Cir Bras. 2021 Nov 8;36(9):e360903. doi: 10.1590/ACB360903. eCollection 2021.

ABSTRACT

PURPOSE: To evaluate if the perconditioning affects the antioxidant capacity in mesenteric ischemia and reperfusion injury.

METHODS: Twenty-one Wistar rats were assigned into three groups, as follows: Sham, IR and rPER. The animals were subjected to mesenteric ischemia for 30 min. rPER consisted of three cycles of 5-min hindlimb ischemia followed by 5 min hindlimb perfusion at the same time to mesenteric ischemic period. After 5 minutes, blood and 5 cm of terminal ileum were harvested for thiobarbituric acid reactive substances (TBARS) and Trolox equivalent antioxidant capacity (TEAC) measurement.

RESULTS: rPER technique was able to reduce intestinal tissue TBARS levels (p<0.0001), but no statistic difference was observed in blood levels between groups, although it was verified similar results in rPER and Sham group. rPER technique also enhanced TEAC levels in both blood (p = 0.0314) and intestinal tissue (p = 0.0139), compared to IR group.

CONCLUSIONS: rPER appears as the most promising technique to avoid IR injury. This technique reduced TBARS levels in blood and intestinal tissue and promoted the maintenance of antioxidant defense in mesenteric acute injury.

PMID:34755763 | DOI:10.1590/ACB360903

Acta Cir Bras. 2021 Nov 8;36(9):e360904. doi: 10.1590/ACB360904. eCollection 2021.

ABSTRACT

PURPOSE: The protective effect of silibinin on kidney and lung parenchyma during hepatic ischemia/reperfusion injury (IRI) is explored.

METHODS: Sixty-three Wistar rats were separated into three groups: sham; control (45 min IRI); and silibinin (200 μL silibinin administration after 45 min of ischemia and before reperfusion). Immunohistochemistry and real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR) were used to evaluate the expression levels of MMP2, MMP3, MMP9, and TIMP2 on kidney and lung.

RESULTS: Comparing sham vs. control groups, confirmed that hepatic IRI increased both renal and lung MMP2, MMP3, MMP9 and TIMP2 expressions starting at 180 min (p<0.001). Comparison of the control vs. silibinin groups showed a statistically significant decrease in the expression levels of MMP2, MMP3, and MMP9 and increase of TIMP2 in kidney and lung parenchyma. The starting point of this decrease was at 120 min after reperfusion, both for kidney and lung parameters, and it was statistically significant at 240 min (p<0.001) for kidney, while silibinin showed a peak of lung protection at 180 min after hepatic reperfusion (p<0.001).

CONCLUSIONS: Hepatic IRI causes distant kidney and lung damage, while a statistically significant protective action, both on kidney and lung parenchyma, is conveyed by the intravenous administration of silibinin.

PMID:34755764 | DOI:10.1590/ACB360904

Clinics (Sao Paulo). 2021 Nov 8;76:e3069. doi: 10.6061/clinics/2021/e3069. eCollection 2021.

ABSTRACT

OBJECTIVES: This study explored the clinical efficacy of VitalStim electrical stimulation combined with swallowing function training for patients with dysphagia following an acute stroke.

METHODS: Seventy-two patients with dysphagia following an acute stroke were admitted to our hospital and were further divided into two groups using prospective research methods. There were 36 cases in each group according to the random number table method. The control group received conventional medical treatment and swallowing function training while the experimental group received conventional medical treatment and VitalStim electrical stimulation combined with swallowing function training.

RESULTS: The overall response rate of the experimental group (94.44%) was higher than that of the control group (77.78%), and the difference was statistically significant (p<0.05). Compared with before treatment, the upward and forward movement speeds of the hyoid bone, anterior movement speed, the grading score of the Kubota drinking water test, Caiteng’s grading score, serum superoxide dismutase, 5-hydroxytryptamine, and norepinephrine levels, Fugl-Meyer Assessment score, and multiple quality of life scores of the two groups showed improvement after treatment. While the standard swallowing assessment score, serum malondialdehyde level, and National Institutes of Health Stroke Scale score decreased, the aforementioned indices showed a significant improvement in the experimental group (p<0.05).

CONCLUSION: The results of this study indicate that VitalStim electrical stimulation combined with swallowing function is effective for treating dysphagia following an acute stroke. It can effectively improve swallowing, neurological, and limb motor functions, reduce complications, promote physical recovery, and improve overall quality of life of patients.

PMID:34755758 | DOI:10.6061/clinics/2021/e3069