scholarly journals A highly transmissible tuberculosis outbreak: the importance of bars

2017 ◽  
Vol 145 (16) ◽  
pp. 3497-3504 ◽  
Author(s):  
P. GODOY ◽  
M. ALSEDÀ ◽  
M. FALGUERA ◽  
T. PUIG ◽  
P. BACH ◽  
...  
Keyword(s):  
Latent Tuberculosis Infection ◽  
Linear Trend ◽  
Latent Tuberculosis ◽  
Skin Tests ◽  
X Rays ◽  
Dose Response Relationship ◽  
Chi Square ◽  
Social Events ◽  
Ltbi Prevalence ◽  
Chi Square Test

SUMMARYThe transmission of tuberculosis (TB) in bars is difficult to study. The objective was to describe a large TB outbreak in a company's bar and other leisure settings. A descriptive study of a TB outbreak was carried out. Contacts were studied in the index case's workplace bar (five circles of contacts) and other recreational areas (social network of three bars in the index case's neighbourhood). Chest X-rays were recommended to contacts with positive tuberculin skin tests (TST) (⩾5 mm). The risk of latent tuberculosis infection (LTBI) was determined using an adjusted odds ratio. The dose–response relationship was determined using the chi-square test for linear trend. We studied 316 contacts at the index case's workplace and detected five new cases of TB. The prevalence of LTBI was 57·9% (183/316) and was higher in the first circle, 96·0% (24/25), and lower in the fifth, 46·5% (20/43) (P < 0·0001). Among 58 contacts in the three neighbourhood bars, two TB cases were detected and the LTBI prevalence was 51·7% (30/58). Two children of one secondary TB company patient became ill. Bars may be transmission locations for TB and, as they are popular venues for social events, should be considered as potential areas of exposure.

Improving Water Quality Can Reduce Pyrogenic Reactions Associated With Reuse of Cardiac Catheters

2003 ◽  
Vol 24 (12) ◽  
pp. 955-960 ◽  
Author(s):  
Rosemary E. Duffy ◽  
Braulio Couto ◽  
Jussara M. Pessoa ◽  
Carlos Starling ◽  
Silma Pinheiro ◽  
...  
Keyword(s):  
Water Quality ◽  
Cardiac Catheterization ◽  
Linear Trend ◽  
Phase 1 ◽  
Standard Operating Procedures ◽  
Chi Square ◽  
Cardiac Catheters ◽  
Standard Operating ◽  
Chi Square Test ◽  
Belo Horizonte

AbstractObjective:To report the results of our preintervention investigation and subsequent 19-month three-phase intervention study designed to reduce pyrogenic reactions among patients undergoing cardiac catheterization using reprocessed catheters.Design:A case-control study for the preintervention period and a prospective cohort study for the intervention period.Setting:A 400-bed hospital in Belo Horizonte, Brazil.Participants:Any patient undergoing cardiac catheterization in the hospital.Interventions:Three intervention phases were implemented to improve the quality of the water supplied to the cardiac catheter reprocessing laboratory. Standard operating procedures for reprocessing cardiac catheters were established and reprocessing staff were trained and educated.Results:The rate of pyrogenic reactions decreased significantly during the intervention phases, from 12.8% (159 of 1,239) in phase 1 to 5.3% (38 of 712) in phase 2 to 0.5% (4 of 769) in phase 3 (chi-square test for linear trend, 97.5;P< .001).Conclusion:Improving water quality and using standard operating procedures for reprocessing catheters can prevent pyrogenic reactions in hospitalized patients.

scholarly journals Duration of Exposure Among Close Contacts of Patients With Infectious Tuberculosis and Risk of Latent Tuberculosis Infection

2020 ◽  
Vol 71 (7) ◽  
pp. 1627-1634
Author(s):  
Mary R Reichler ◽  
Awal Khan ◽  
Yan Yuan ◽  
Bin Chen ◽  
James McAuley ◽  
...  
Keyword(s):  
Latent Tuberculosis Infection ◽  
Multivariable Analysis ◽  
Latent Tuberculosis ◽  
Index Patient ◽  
The United States ◽  
Tuberculosis Infection ◽  
Ltbi Prevalence ◽  
Male Sex ◽  
Positive Index ◽  
Close Contacts

Abstract Background Predictors of latent tuberculosis infection (LTBI) among close contacts of persons with infectious tuberculosis (TB) are incompletely understood, particularly the number of exposure hours. Methods We prospectively enrolled adult patients with culture-confirmed pulmonary TB and their close contacts at 9 health departments in the United States and Canada. Patients with TB were interviewed and close contacts were interviewed and screened for TB and LTBI during contact investigations. Results LTBI was diagnosed in 1390 (46%) of 3040 contacts, including 624 (31%) of 2027 US/Canadian-born and 766 (76%) of 1013 non-US/Canadian-born contacts. In multivariable analysis, age ≥5 years, male sex, non-US/Canadian birth, smear-positive index patient, and shared bedroom with an index patient (P &lt; .001 for each), as well as exposure to &gt;1 index patient (P &lt; .05), were associated with LTBI diagnosis. LTBI prevalence increased with increasing exposure duration, with an incremental prevalence increase of 8.2% per 250 exposure hours (P &lt; .0001). For contacts with &lt;250 exposure hours, no difference in prevalence was observed per 50 exposure hours (P = .63). Conclusions Hours of exposure to a patient with infectious TB is an important LTBI predictor, with a possible risk threshold of 250 hours. More exposures, closer exposure proximity, and more extensive index patient disease were additional LTBI predictors.

scholarly journals Comparison of stress in freshman and senior nursing students

2019 ◽  
Vol 53 ◽  
Author(s):  
Fernanda Carneiro Mussi ◽  
Cláudia Geovana da Silva Pires ◽  
Luciana Santos Carneiro ◽  
Ana Lúcia Siqueira Costa ◽  
Fernanda Michelle Santos e Silva Ribeiro ◽  
...  
Keyword(s):  
Nursing Students ◽  
Professional Education ◽  
Linear Trend ◽  
Cross Sectional Study ◽  
Stress Factors ◽  
Chi Square ◽  
Cross Sectional ◽  
Significance Level ◽  
Stress Levels ◽  
Chi Square Test

ABSTRACT Objective: To compare stress levels in freshman and senior nursing students. Method: A cross-sectional study was carried out in a public federal university of the state of Bahia, with students who answered questionnaires about sociodemographic variables, academic life, and a scale for assessing stress in nursing students. Chi-square and Fisher’s exact tests were applied to analyze the relationship between variables. To assess proportional trends between ordinal variables and groups, a chi-square test for linear trend was applied. The significance level was 5%. Results: One hundred and fifty-four students participated in the study. There was a tendency to higher stress levels among students in the last year compared to those in the first year, in four out of six domains: Performance of Practical Activities (p=0.00), Professional Communication (p=0.00), Environment (p=0.00) and Professional Education (p=0.00). Conclusion: High levels of stress were observed in students taking the last year. There is a need for broader research that includes other years of the course, an institutional reflection on stress factors and the adoption of an institutional policy that favors a better confrontation of stress factors.

scholarly journals 1376. Physician Practice Patterns for Screening and Treatment of Latent Tuberculosis Infection in the South Asian Population in Central New Jersey

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S499-S500
Author(s):  
Nupur Gulati ◽  
Sri Ram Pentakota ◽  
Kristina N Feja ◽  
Bishakha Ghoshal ◽  
Rajita Bhavaraju ◽  
...  
Keyword(s):  
New Jersey ◽  
South Asian ◽  
Outcome Measure ◽  
Latent Tuberculosis Infection ◽  
Latent Tuberculosis ◽  
Tuberculosis Infection ◽  
Medical Graduate ◽  
Chi Square ◽  
Ltbi Screening

Abstract Background New Jersey (NJ) has a significant burden of tuberculosis (TB) cases (ranked 8th in the United States) and 22% of the cases are among foreign-born (FB) individuals. We have approximately 33% FB residents in our targeted counties in Central NJ of whom 43% are originally from high TB burden areas of South Asia. Central NJ is home to the county with the second highest TB case rate in NJ. Latent tuberculosis infection (LTBI) treatment remains a key component of the World Health Organization TB elimination strategy. We sought to survey community physicians about their LTBI screening and treatment practices in South Asian (SA) patients. Methods An IRB-approved anonymous survey was distributed online to practicing staff physicians at local hospitals over a 2-month period. The primary outcome measure was whether physicians appropriately screen for LTBI. A secondary outcome measure was whether follow-up after medication initiation was provided. Predictors measured included: age, gender, self -identification of physician as SA, years in practice, and if they were a foreign medical graduate (FMG). Descriptive statistics were provided using counts and proportions. Chi-square tests were used for bivariate analyses to look for factors associated with LTBI screening and treatment. Results A total of 218 physicians responded to the survey; of whom, 137 identified themselves as primary care physicians (i.e., pediatrics (62%), internal medicine (30%), or family medicine (8%)). About half of them were FMG and 40% identify themselves as SA. Three out of four of these physicians (n = 101) indicated they routinely screen their patients for LTBI. Bivariate analyses using chi-square did not find any statistically significant associations with LTBI screening. A quarter of the physicians screened with an IGRA and 60% reported always offering treatment for LTBI. Isoniazid was the most common medication prescribed. A majority of respondents did not report prescribing Rifampin or Rifapentine. Follow-up after initiation of treatment was provided at least every other month by 52.7% of physicians. Conclusion There is wide variability in LTBI screening, treatment, and follow-up among our physician sample. Physicians have not yet adopted newer treatment regimens suggesting the need for an educational intervention. Disclosures All authors: No reported disclosures.

Adjustment of Frequently Used Chi-square Procedures for the Effect of Site-to-Site Dependencies in the Analysis of Dental Data

1989 ◽  
Vol 68 (9) ◽  
pp. 1350-1354 ◽  
Author(s):  
A. Donner ◽  
D. Banting
Keyword(s):  
Linear Trend ◽  
Multiple Site ◽  
Chi Square ◽  
Chi Square Test ◽  
Haenszel Test

Donner and Banting (1988) presented a method of adjusting the standard chi-square test for the comparison of proportions when this procedure is applied to multiple-site dental data. The adjusted procedure allows for a comparison of two or more groups of subjects with respect to the prevalence over all sites of a specified characteristic, while taking site-to-site dependencies into account. In this paper, similar adjustments are presented for two other frequently used chi-square procedures, the chi-square test for linear trend and the Mantel-Haenszel test. Examples are given.

scholarly journals VITAMIN D AND LATENT TUBERCULOSIS INFECTION IN SCHOOLCHILDREN

2019 ◽  
Vol 22 (6) ◽  
pp. 344-348
Author(s):  
A. D. Petrushina ◽  
Daria M. Slashcheva ◽  
N. S. Brynza ◽  
N. D. Pirogova ◽  
S. V. Sosnovskaya ◽  
...  
Keyword(s):  
Vitamin D ◽  
Latent Tuberculosis Infection ◽  
Latent Tuberculosis ◽  
Preventive Treatment ◽  
Tuberculosis Infection ◽  
World Health ◽  
Skin Tests ◽  
Initial Examination ◽  
Treatment And Prevention ◽  
Vitamin D Levels

The World Health Organization has adopted the global TB strategy for the period of 2016-2035. To achieve its targets, it is necessary to propose and introduce new approaches for the prevention and treatment of latent tuberculosis infection (LTBI) in children and adolescents, as a potential source of active tuberculosis development. In this regard, the use of vitamin D (cholecalciferol) may become promising in combating tuberculosis, since most researchers suppose an adequate level of cholecalciferol to have a positive preventive and therapeutic effect in children with active and latent tuberculosis. So far the use of vitamin D may be appropriate, especially in children not adequately provided with vitamin D. The paper presents the results of the vitamin D levels study before and after prescribing cholecalciferol, as well as the dynamics of the tuberculin skin tests in school-age LTBI children receiving preventive treatment with anti-TB drugs. At the initial examination, a normal level of 25-hydroxycholecalciferol (25(OH)D) was not detected in any child. After 3 months of administration of vitamin D in therapeutic doses, a normal concentration of 25(OH)D was observed in 52% of the children examined repeatedly. Analysis of the tuberculin skin test dynamics showed 47.6% of children to have a negative/doubtful test result after 3 months of treatment with anti-TB drugs and vitamin D. In 9.5% of patients, the size of the papule did not change during treatment. It is important to note that in these children, the 25(OH)D level also did not increase. А vitamin D intake at a therapeutic dosage did not cause hypercalcemia or hypercalciuria in any child. LTBI children are inadequately provided with cholecalciferol. There fore it is necessary to determine the level of vitamin D in the blood, then to prescribe the vitamin D, regardless of the time of year, along with standard therapy for a more effective outcome of LTBI treatment and prevention of active forms of tuberculosis in the future.

scholarly journals The knowledge, attitude and practices of Turkish general dentists on dental x-rays in pregnant women

2019 ◽  
Vol 9 (1) ◽  
pp. 9-15
Author(s):  
Katibe Tuğçe Temur ◽  
İsa Temur ◽  
Ömer Hatipoğlu
Keyword(s):  
Pregnant Women ◽  
X Rays ◽  
Chi Square ◽  
Dental Procedures ◽  
Dental Practitioners ◽  
The Usa ◽  
Chi Square Test ◽  
Native Speakers Of English ◽  
General Dentists ◽  
Demographical Data

Aim: The purpose of this study was to evaluate the knowledge, attitude and practices of the general dental dentists working in Turkey on the dental x-rays in pregnant women; and to develop awareness for the purpose of not delaying their dental treatments. Methodology: The questionnaire that was used in the study was applied to 270 dental dentists who worked in Turkey in electronic medium. The questionnaire consisted of 2 sections each of which had 11 questions. In the first section, the demographical data were questioned. In the second section, there were questions to determine the knowledge, attitude and practices of the dentists on x-ray in pregnant women. The questionnaires that were completed were examined and analyzed statistically by using the results and the Chi-Square Test and the Chi-Square Test. Data analysis was performed by using Statistical Package for the Social Sciences version 23.0 (SPSS Inc., Chicago, IL, the USA). Results: A total of 71.1% of the dental practitioners who participated in the study stated that they did not request radiography from pregnant women. A total of 62.2% of the dental dentists stated that they preferred the 2nd Trimester for requesting radiography. A total of 38.9% of the general dentists who participated in the study stated that the diagnostic radiographies used in dentistry caused anomalies in the fetus, 18.9% stated that they did not have any information. Conclusion: Further training courses must be planned to increase and update the awareness of the dental dentists on the precautions and procedures for radiography practice in pregnant women; and brochures must be prepared for pregnant women to provide information about this subject. Also, dental dentists and obstetricians should work in agreement about dental procedures in pregnancy and diagnostic radiography in terms of its being safe when necessary.   How to cite this article: Temur KT, Temur İ, Hatipoğlu Ö.  The knowledge, attitude and practices of Turkish general dentists on dental x-rays in pregnant women. Int Dent Res 2019;9(1):9-15.    Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

184 EFFECTS OF X-RAY ELECTROMAGNETIC RADIATION ON BOVINE OOCYTE DEVELOPMENT

2010 ◽  
Vol 22 (1) ◽  
pp. 250
Author(s):  
W. E. Snyder ◽  
J. T. Aaltonen ◽  
H. D. Sigal ◽  
N. M. Loskutoff
Keyword(s):  
Electromagnetic Radiation ◽  
High Energy ◽  
X Rays ◽  
Embryo Production ◽  
Chi Square ◽  
X Ray ◽  
Chi Square Test ◽  
Bovine Oocytes ◽  
Experimental Group

This study examined the effects of X-rays on bovine oocytes used for in vitro embryo production. In recent years, airport security has become more stringent and the use of X-ray screening may be required for all items, which could be problematic when transporting oocytes. Ionizing radiation such as X-rays are high-energy particles that can penetrate into the nucleus of a cell and cause single and double-strand breaks in the DNA chain. Oocytes exposed to X-ray radiation may have DNA damage affecting maturation, fertilization, and embryonic development. Bovine ovaries obtained from a local abattoir were used to collect immature oocytes by follicular aspiration. The oocytes were divided into a control group and an experimental group then placed in maturation medium. The oocytes in the experimental group were placed in a hospital X-ray machine with a single exposure of 100 mA, 120 kVp for 0.3 s. This exposure challenged the oocytes with a comparable, calculated amount of mrems equivalent to a single screening from an airport X-ray machine (30 mrems). After X-ray exposure, the experimental group was cultured with the control at 37°C and 5% CO2. After 18 h, cryopreserved bovine sperm were thawed and processed using BoviPure (Nidacon International, Mölndal, Sweden) density gradient centrifugation and the oocytes were inseminated with 1 × 106 sperm in fertilization medium at 37°C and 5% CO2. After 24 h, both groups were transferred to 50-μL droplets of G1 medium (Vitrolife, Göteborg, Sweden) at 37°C and 6% CO2 and both were transferred into G2 medium after 72 h. Development of the oocytes was scored after an additional 72 h. Results were based on 2 criteria: the percent cleaved (presumptive fertilization) and the percent cleaved that developed to morula and blastocyst stages. The results indicated no significant difference in the percentages of oocytes cleaving after insemination for the control and experimental groups (P = 0.403, chi-square test). However, there was a significant increase (P = 0.037, chi-square test) in the percentages of morulae and blastocysts developing in the control (non-irradiated) v. experimental (X-rayed) groups. The outcome of this study cautions on the potential damage caused to bovine oocytes used for embryo production in vitro when exposed to X-ray electromagnetic radiation during routine air transport screening operations. Table 1.

scholarly journals Prevalence of latent tuberculosis infection and risk of infection in patients with chronic kidney disease undergoing hemodialysis in a referral center in Brazil

2013 ◽  
Vol 39 (2) ◽  
pp. 214-220 ◽  
Author(s):  
Jane Corrêa Fonseca ◽  
Waleska Teixeira Caiaffa ◽  
Mery Natali Silva Abreu ◽  
Katia de Paula Farah ◽  
Wânia da Silva Carvalho ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Latent Tuberculosis Infection ◽  
Latent Tuberculosis ◽  
Tuberculosis Infection ◽  
Skin Tests ◽  
Risk Of Infection ◽  
The Mean ◽  
Annual Risk ◽  
Booster Effect

OBJECTIVE: To determine the prevalence of latent tuberculosis infection (LTBI) and the risk of infection in patients with chronic kidney disease treated at a hemodialysis center. METHODS: We included 307 patients with chronic kidney disease undergoing hemodialysis at the Mineiro Institute of Nephrology, located in the city of Belo Horizonte, Brazil. All of the patients were submitted to tuberculin skin tests (TSTs). We investigated the booster effect and TST conversion. If the initial TST (TST1) was negative, a second TST (TST2) was performed 1-3 weeks later in order to investigate the booster effect. If TST2 was also negative, a third TST (TST3) was performed one year after TST2 in order to determine whether there was TST conversion. RESULTS: When we adopted a cut-off induration of 5 mm, the prevalence of LTBI was 22.2% on TST1, increasing by 11.2% on TST2. When we adopted a cut-off induration of 10 mm, the prevalence of LTBI was 28.5% on TST1, increasing by 9.4% on TST2. The prevalence of LTBI increased significantly from TST1 to TST2 (booster effect), as well as from TST2 to TST3 (p < 0.01 for both). In our sample, the mean annual risk of infection was 1.19%. CONCLUSIONS: In the population studied, the prevalence of LTBI was high, and the mean annual risk of infection was similar to that reported for the general population of Brazil, which suggests recent infection.

scholarly journals Powerful Statistical Tests for Ordered Data

2020 ◽  
Author(s):  
Juergen Koefinger ◽  
Gerhard Hummer
Keyword(s):  
Statistical Tests ◽  
X Rays ◽  
Test Statistics ◽  
Chi Square ◽  
P Values ◽  
Gamma Distributions ◽  
Versatile Tool ◽  
Chi Square Test ◽  
Common Sign ◽  
Ordered Data

<p>The inference of models from one-dimensional ordered data subject to noise is a fundamental and ubiquitous task in the physical and life sciences. A prototypical example is the analysis of small- and wide-angle solution scattering experiments using x-rays (SAXS/WAXS) or neutrons (SANS). In such cases, it is common practice to check the quality of a fit by using Pearson's chi-square test, which ignores the order of the data. We usually plot the residuals and check visually for systematic deviations without quantifying them. To quantify these deviations, we developed test statistics based on the distributions of the lengths of the runs of the signs of the residuals. Specifically, we use the probability of run-length distributions, for which we provide analytical expressions, to rank them and to calculate their P-values. We introduce the Shannon information distribution as an elegant and versatile tool for calculating P-values. We find that these distributions follow shifted gamma distributions, such that they are summarized by three parameters only. We show for a set of six models that our test statistics are more powerful than Pearson's chi-square test and common sign-based tests. We provide an open source Python 3 implementation of our tests free of charge at https://github.com/bio-phys/hplusminus.</p>

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