scholarly journals Post-COVID-19 Fatigue: Demographic Distribution and Relation to Chronic Illnesses

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Aysha Chaudhary ◽  
Jessica Paters ◽  
Mindy Flanagan ◽  
Rachel Pfafman ◽  
Jeanne Carroll ◽  
...  
Keyword(s):  
Demographic Variables ◽  
Chronic Illnesses ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Chi Square ◽  
Exact Test ◽  
Obesity Status ◽  
Qualitative Variables ◽  
Demographic Distribution ◽  
The Relationship

Objective: This retrospective study examined the relationship between post-COVID (PC) fatigue and the presence of chronic illnesses. Materials and Methods: Electronic health records of 122 Parkview PC Clinic patients were reviewed for demographics (age, gender, race), chronic illnesses (diabetes, hypothyroidism, hypertension, congestive heart failure, anemia, cancer, orthostatic hypotension), obesity (weight, BMI), complaint of fatigue, and activities affected by fatigue. Data was analyzed using Chi-square tests for categorical variables (or Fisher’s exact test for small cell sizes) and t-tests for continuous variables. Open thematic coding of activities most affected by PC fatigue was performed. Results: 95 out of 122 patients (77.9%) were found to have PC fatigue. Except for measures related to obesity, none of the chronic illnesses assessed were correlated with the presence of fatigue. The weight of PC fatigue patients was significantly higher than those without fatigue (p=0.04). Examination of BMI and obesity status also indicated significantly higher BMI (p=0.01) and levels of obesity (p= 0.004) in PC fatigue groups compared to the PC non-fatigue groups. No significant differences were observed between the groups in either PT test. Examination of patient described activities effected by PC fatigue found work (30.4%), daily stamina (28.6%) and ability to exercise (16.7%) most impacted by PC fatigue.  Other activities affected by PC fatigue included housework (5.6%), hobbies (3.7%), shopping (1.9%) and driving (1.9%). Conclusion: 77.9% of our PC patients showed symptoms of fatigue. This is comparable with existing literature. None of the demographic variables and PT tests, or most of the chronic health conditions investigated, were correlated with the presence of fatigue in PC patients. In contrast, measures associated with obesity, including high BMI and weight, were significantly associated with increased PC fatigue presentation. Open thematic coding of qualitative variables indicated work, daily stamina, and exercise were most affected in PC patients. 

scholarly journals Evaluation of the Risk of Clinical Deterioration among Inpatients with COVID-19

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Víctor O. Costa ◽  
Eveline M. Nicolini ◽  
Bruna M. A. da Costa ◽  
Fabrício M. Teixeira ◽  
Júlia P. Ferreira ◽  
...  
Keyword(s):  
Clinical Laboratory ◽  
Lung Parenchyma ◽  
Clinical Deterioration ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Chi Square ◽  
Exact Test ◽  
Laboratory Confirmation ◽  
Chi Square Test ◽  
Imaging Markers

This study aims to assess the risk of severe forms of COVID-19, based on clinical, laboratory, and imaging markers in patients initially admitted to the ward. This is a retrospective observational study, with data from electronic medical records of inpatients, with laboratory confirmation of COVID-19, between March and September 2020, in a hospital from Juiz de Fora-MG, Brazil. Participants (n = 74) were separated into two groups by clinical evolution: those who remained in the ward and those who progressed to the ICU. Mann–Whitney U test was taken for continuous variables and the chi-square test or Fisher’s exact test for categorical variables. Comparing the proposed groups, lower values of lymphocytes ( p  = <0.001) and increases in serum creatinine ( p  = 0.009), LDH ( p  = 0.057), troponin ( p  = 0.018), IL-6 ( p  = 0.053), complement C4 ( p  = 0.040), and CRP ( p  = 0.053) showed significant differences or statistical tendency for clinical deterioration. The average age of the groups was 47.9 ± 16.5 and 66.5 ± 7.3 years ( p  = 0.001). Hypertension ( p  = 0.064), heart disease ( p  = 0.048), and COPD ( p  = 0.039) were more linked to ICU admission, as well as the presence of tachypnea on admission ( p  = 0.051). Ground-glass involvement >25% of the lung parenchyma or pleural effusion on chest CT showed association with evolution to ICU ( p  = 0.027), as well as bilateral opacifications ( p  = 0.030) when compared to unilateral ones. Laboratory, clinical, and imaging markers may have significant relation with worse outcomes and the need for intensive treatment, being helpful as predictive factors.

scholarly journals Factors related to academic success among paramedic students

2019 ◽  
Vol 16 ◽  
Author(s):  
Simpiwe Sobuwa ◽  
Bill Lord
Keyword(s):  
Academic Success ◽  
Emergency Care ◽  
Demographic Variables ◽  
Categorical Variables ◽  
Chi Square ◽  
Cross Sectional ◽  
Black African ◽  
Exact Test ◽  
Chi Square Test ◽  
Descriptive Survey

BackgroundSouth Africa is one of the few countries to produce emergency care graduates in Africa. However, a large number of these graduates are emigrating from Africa. Although academic success has been studied in various contexts in Africa, none have looked into the Bachelor of Emergency Medical Care (BEMC). Maximising academic success in the BEMC might ensure a sustainable skilled workforce in an area which has a shortage of skilled personnel.AimsThis study aimed to describe the socio-demographic variables of current South African BEMC students. We also aimed to describe whether any associations exist between socio-demographic variables, various racial groupings and repeating a year during the course of study.MethodsA cross-sectional descriptive survey was conducted among students enrolled for the BEMC in 2016. Continuous and categorical variables were analysed using descriptive statistics. The Fisher’s exact test and Pearson chi-square test were used to test associations between the survey variables and repeating a year.ResultsA total of 176 participants responded to the survey. Having a pre-existing emergency care qualification was associated with not repeating a year on the BEMC (p=0.02). The statistical difference between race and not repeating a year in the BEMC was not significant (p=0.07). However, when the black-African and minority cohort are grouped together, it is significant (p=0.05).ConclusionA number of socio-demographics were described in this study. Students with pre-existing emergency care qualifications were least likely to repeat a year. 

scholarly journals Bacterial Profile, Multi-Drug Resistance and Seasonality Following Lower Limb Orthopaedic Surgery in Tropical and Subtropical Australian Hospitals: An Epidemiological Cohort Study

2020 ◽  
Vol 17 (2) ◽  
pp. 657
Author(s):  
Mark L. Vickers ◽  
Emma L. Ballard ◽  
Patrick N. A. Harris ◽  
Luke D. Knibbs ◽  
Anjali Jaiprakash ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Lower Limb ◽  
Orthopaedic Surgery ◽  
Categorical Variables ◽  
Multi Drug Resistance ◽  
Continuous Variables ◽  
Exact Test ◽  
Chi Squared ◽  
The Relationship ◽  
Epidemiological Cohort

We aimed to describe the epidemiology, multi-drug resistance and seasonal distribution of bacteria cultured within 12 months following lower limb orthopaedic surgery in tropical and subtropical Australian hospitals between 2010 and 2017. We collected data from four tropical and two subtropical hospitals. Categorical variables were examined using the Pearson Chi-squared test or Fisher’s Exact test, and continuous variables with the Student t-test or Mann–Whitney U test. A Poisson regression model was used to examine the relationship between season, weather and the incidence of Staphylococcus and nonfermentative species. We found that at tropical sites, nonfermenters (Pseudomonas aeruginosa and Acinetobacter baumannii) were more common (28.7% vs. 21.6%, p = 0.018), and patients were more likely to culture multi-drug-resistant (MDR) nonfermenters (11.4% vs. 1.3%, p = 0.009) and MDR Staphylococcus aureus (35.9% vs. 24.6%, p = 0.006). At tropical sites, patients were more likely to be younger (65.9 years vs. 72.0, p = < 0.001), male (57.7% vs. 47.8%, p = 0.005), having knee surgery (45.3% vs. 34.5%, p = 0.002) and undergoing primary procedures (85.0% vs. 73.0%, p = < 0.001). Species were similar between seasons in both tropical and subtropical hospitals. Overall, we found that following lower limb orthopaedic surgery in tropical compared with subtropical Australia, patients were more likely to culture nonfermenters and some MDR species.

Vanishing congenital lung malformations: What is the incidence of true regression?

2021 ◽  
pp. 1-7
Author(s):  
C. Griggs ◽  
M. Schmaedick ◽  
C. Gerall ◽  
W. Fan ◽  
C. Orlas ◽  
...  
Keyword(s):  
Neonatal Intensive Care ◽  
Statistical Significance ◽  
Multivariable Analysis ◽  
Retrospective Chart Review ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Chi Square ◽  
Exact Test ◽  
Congenital Lung Malformation ◽  
Nicu Admission

BACKGROUND: A congenital lung malformation (CLM) that is diagnosed on prenatal ultrasound exam may subsequently become undetectable on later scans, a “vanishing” CLM. OBJECTIVE: The purpose of our study is to characterize the prenatal natural history and postnatal outcomes of “vanishing” lesions treated at our institution. METHODS: We performed a retrospective chart review of 107 patients diagnosed prenatally with CLM at our institution. Comparisons were made using Kruskal-Wallis or t-test for continuous variables and Fisher’s exact test or Chi-Square test for categorical variables. Multivariable analysis using logistic regression was performed. RESULTS: Of the 104 patients, 59 (56.7%) had lesions that became sonographically undetectable on serial ultrasound scans. Patients with lesions that vanished prenatally tended to need less Neonatal Intensive Care Unit (NICU) admission at birth (persistent CLM: 54.8%vs vanished CLM: 28.8%), decreased need for supplemental O2 at birth (persistent CLM: 31.0%vs vanished CLM: 11.9%), and decreased delay in feeds (persistent CLM: 26.2%vs vanished CLM: 8.5%) compared to those with persistent CLM. After multivariate analysis controlling for maternal steroid administration and sex, admission to NICU maintained a slight statistical significance, with patients in the vanishing CLM group 2.5 times less likely to be admitted to the NICU. None of our patients whose lesions vanished prenatally required mechanical ventilation. Eighty-six patients underwent postnatal computed tomography (CT) chest. Only 2 patients had lesions that regressed on postnatal CT. CONCLUSION: Lesions that vanish on prenatal imaging may be associated with improved clinical outcomes. The rate of true regression at our institution was as low as 2.3%.

Abstract TP236: Eval to Groin Puncture Times: Efficiencies and Deficiencies of Live Physician vs Telemedicine Triage

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
David Rosenbaum-Halevi ◽  
Sujan T Reddy ◽  
Alyssa D Trevino ◽  
Muhammad Bilal Tariq ◽  
Mahan Shahrivari ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Chi Square ◽  
Specific Level ◽  
Site Specific ◽  
Exact Test ◽  
Wilcoxon Rank Sum Test ◽  
Significant Difference ◽  
A Site

Introduction: Telemedicine (TM) is increasingly implemented in community hospitals acute ischemic stroke (AIS). The efficiency of TM to facilitate thrombectomy (IAT) is unknown. We addressed this question by studying our spoke hospitals which are staffed by both in-person (IP) consultation (Day: 8am-5pm) and TM (Night: 5pm-8am) to analyze differences between TM and IP and comparing to our university hub which has IP staffing day and night. Methods: We performed a retrospective analysis from 3/2016 to 3/2019 of all IAT cases directly admitted to 4 IAT capable centers (1 hub + 3 spokes) in our system. Demographic, clinical, and time metrics were analyzed. Primary outcome was door to groin (DTG) time. Continuous variables were analyzed with Wilcoxon rank sum test, and categorical variables with chi-square or Fischer’s exact test. Results: Table 1 summarizes the cohort. Eval to tPA (ETPA) time was faster at spokes vs hub (p < 0.0001), with no significant difference in DTG between spoke and hub (p= 0.444). At spokes, while DTPA times were no different between IP and TM at spokes, IP achieved faster DTG times (p<0.0001) (Fig.1A). DTG was equal during day vs. night at the hub. At the spokes, day (IP) DTG times were faster than night (TM) at some but not all spokes (Fig.1B). TPA administration did not delay DTG at either the hub or the spokes (Fig. 1C). At spokes, TM-TPA cases were associated with faster DTG than TM-noTPA (Fig. 1D). Conclusions: While no difference is noted between TM and IP in rapid TPA treatment, our data show delayed DTG at spokes during the TM day and night service. While DTG in TM was prolonged, differences in spoke metrics imply that availability of staff and resources play a significant role. Further analysis is needed to identify factors that prolong DTG at a site-specific level.

Abstract TP69: Safety and Outcomes of IV Thrombolysis with Alteplase for Acute Ischemic Stroke Patients with Thrombocytopenia

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Haris Kamal ◽  
Nour Abdelhamid ◽  
Liang Zhu ◽  
Sean Savitz ◽  
James Grotta ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Strong Evidence ◽  
Demographic Data ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Chi Square ◽  
Exact Test ◽  
Chi Square Test ◽  
Iv Tpa

Background: Intravenous tPA (IV tPA) has been the mainstay for reperfusion therapies for acute ischemic stroke (AIS) patients for 2 decades. Many contraindications from the initial NINDS trial were derived from experts’ consensus and not tested in the trial. Many AIS patients present with thrombocytopenia (< 100,000) and may be excluded from treatment in spite of lack of strong evidence. Some clinicians opt to treat these patients weighing the benefits and risks along with the lack of strong evidence behind this exclusion. We sought to evaluate the safety in AIS patients with low platelets receiving IV tPA as compared to those who do not. Methods: Restrospective chart review of all patients presenting with AIS between 1/2006 to 7/2016 at our center. We analyzed patients who had platelets <100,000 among this cohort and stratified them into those who were treated with IV tPA and those who received antiplatelet therapy only. Demographic data, medical history, medications, presence of sICH after treatment, presenting NIHSS were collected. Two sample Wilcoxon rank sum test was used to compare continuous variables between the two groups, and chi-square test or Fisher’s exact test used to compare categorical variables. Results: 21 patients were treated with IV tPA while 122 patients were treated with antiplatelets. Table 1 lists the demographic variables of the two groups with and without IV tPA. Patients included had moderate thrombocytopenia with very few <50,000. No significant differences were found in presenting NIHSS, race, gender, and history of atrial fibrillation between the two groups except platelets (p=0.0128), age (p=0.0462) and glucose (p=0.0279). Table 2 lists the outcome variables of mRS and symptomatic ICH. There was no petechial or sICH among 21 treated patients. Conclusion: While limited by small numbers and lack of randomization, our data suggest that IV tPA is safe in patients with moderately reduced platelet counts.

The Recipient Venule in Supermicrosurgical Lymphaticovenular Anastomosis: Flow Dynamic Classification and Correlation with Surgical Outcomes

2018 ◽  
Vol 34 (08) ◽  
pp. 581-589 ◽  
Author(s):  
Marzia Salgarello ◽  
Akitatsu Hayashi ◽  
Giuseppe Visconti
Keyword(s):  
Surgical Outcomes ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Composite Outcome ◽  
Compression Garment ◽  
Flow Dynamic ◽  
Chi Square ◽  
Exact Test ◽  
Preoperative Mapping ◽  
Classification Quantitative

Background Venules have been usually neglected in the literature on lymphaticovenular anastomosis (LVA). The aim of this study was to analyze the flow dynamic of recipient venules in LVA and their impact on the surgical outcomes. Patients and Methods Data from 128 patients affected by extremity lymphedema, who underwent LVA, were collected in two institutions from August 2014 to May 2016. Recipient venules were classified according to their flow dynamic into backflow, slack, and outlet (BSO classification). Quantitative (lower extremity lymphedema/upper extremity lymphedema index) and qualitative outcomes (needing of compression garment and compression garment class) were evaluated. Chi-square test or Fisher's exact test was used for categorical variables and independent-samples t-test for continuous variables. The association between lymphatic collector degeneration status (normal, ectasis, contractile, sclerotic type [NECST]) and BSO classification with the outcomes was analyzed by the Mantel–Haenszel test. Results On a total of 128 patients, 37 suffered from upper and 91 from lower limb lymphedema. An average number of four LVA were performed for each patient (range: 2–8). A significant association was observed between NECST and BSO categories and the outcomes were evaluated. Patients with contractile and sclerotic collectors had 2.24 times the odd of having poor composite outcome compared with those with normal-to-ectasis collectors (p < 0.05). Patients with backflow venules had 3.32 times the odd of having poor composite outcome compared with those without outlet or slack pattern (p < 0.05). Conclusion The subtype of recipient venule flow dynamic has a significant impact on the surgical outcome of patients undergoing LVA for the treatment of lymphedema, regardless of the lymphatic collector degeneration status. Locating favorable venules in the preoperative mapping might enhance the surgical outcomes.

Differences in response to imatinib between gastrointestinal stromal tumors involving the liver and tumors that do not: Experience from Nairobi.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e20504-e20504
Author(s):  
Nicolas Anthony Othieno-Abinya ◽  
Malkit Singh Riyat ◽  
Raymond Omollo ◽  
Gladwell Wantiru Gichuru
Keyword(s):  
Mutational Analysis ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Chi Square ◽  
Assistance Program ◽  
Apparent Lack ◽  
Exact Test ◽  
Prognostic Features ◽  
Cell Counts ◽  
Level Of Significance

e20504 Background: More than 60% of gastrointestinal stromal tumours (GISTs) arise from the stomach and about 20% from the small intestines. About 95% of GISTs express kit receptor tyrosine kinase (CD117) which is used for purposes of diagnosis and targeted treatment. However, kit expression alone is not specific for GIST, nor does it necessarily imply kinase activation. Poor prognostic features include involvement of the liver, and other bulky sites of disease. Methods: Patients with CD117-positive leiomyosarcomas arising in the abdomen and treated through the Glivec International Patient Assistance Program (GIPAP) clinics in Nairobi were studied. Details taken included sites involved by disease at diagnosis, stage, sites of metastases, whether the tumour had been resected or not, and outcome of treatment with imatinib. Data were summarized using proportions where the variables were categorical while mean (SD) or median (range) was used for continuous variables. Comparisons for categorical variables were done using chi square tests (or Fishers exact test for cell counts less than 5). The statistical level of significance was set to 5%. Results: In total 54 patients were included. Males were 36 (66.7%) and females 18 (33.3%). Age range was 25-86 years, median 50. Stomach was involved primarily in 22 of 47 cases evaluable (46.8%). The liver was primarily involved in 3 (6.4%) and liver metastases in 7 (15%). None of 8 patients (0%) with evaluable liver involvement regressed or stabilized on treatment for at least 6 months compared with 10 of 14 (71.4%) from the stomach, 7 of 7 (100%) from small bowel, and 7 of 13 (53.8%) with mesenteric/omental involvement. These differences were statistically significant (p = 0.001). Conclusions: Apparent lack of response by tumours involving the liver could suggest that the kit expression here may not be the factor activating the kit target in this subset of patients, or they could be of exon 9 mutation predominantly. Mutational analysis studies may shed more light in this issue.

Prevalence of esophageal malignant and premalignant lesions in a Michigan cohort, 2013-2017.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e15541-e15541
Author(s):  
Shilpa Tatineni ◽  
Divyesh Reddy Nemakayala ◽  
Ikponmwosa Enofe ◽  
Ling Wang ◽  
Heather Laird-Fick
Keyword(s):  
Community Sample ◽  
Treatment Options ◽  
Cell Cancer ◽  
Premalignant Lesions ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Post Discharge ◽  
Chi Square ◽  
Exact Test ◽  
Pathology Reports

e15541 Background: Esophageal cancer is diagnosed in roughly 4 per 100,000 US population. Older men are most frequently affected. Adenocarcinoma is most common and incidence is increasing. EGD with biopsy is important for diagnosis. Many patients present with metastases, limiting treatment options. EGD can identify Barrett’s esophagus, a precursor lesion for adenocarcinoma, but evaluation of biopsy specimens is difficult. This study describes findings from esophageal biopsies in a large community-based Michigan cohort. Methods: Patients aged ≥18 years undergoing EGD with esophageal biopsies in Sparrow Health System were identified. Pathology reports were abstracted for sociodemographics, procedure information, and pathologic findings. Only patients with complete data were included for analysis. Statistical comparisons were assessed by chi-square tests or Fisher’s exact test in contingency tables for categorical variables, or t-tests for continuous variables as appropriate. Results: 4,471 patients were included. 3,279 (73.3%) had benign findings, 1,117 (25%) premalignant changes, 69 (1.54%) malignancy including adenocarcinoma, poorly differentiated cancer or high-grade dysplasia, 1 (0.022%) squamous cell cancer, and 5 (0.11%) neuroendocrine tumors. The latter six were excluded from analyses.Most procedures were performed for inpatients (70.5% for benign, 72.5% malignant and 76.3% pre-malignant; p< 0.001 for all comparisons). Patients with malignancy were older than those with premalignancy [mean 69.8 (SD = 10.4) vs 62.6 (SD = 12.2) years; p< 0.001], who were older than those with benign findings [62.6 (SD = 12.2) vs 56.2 (SD = 14.7) years; p< 0.001]. Patients with premalignancy came from areas with higher average household incomes ($42,179 vs $41,247; p< 0.01). There were no other socioeconomic or sex differences between groups. Conclusions: In a community sample, esophageal malignancy was uncommon but premalignant changes common. Most procedures occurred during hospitalizations. Ensuring appropriate post-discharge follow up for premalignant changes could be challenging. Association between premalignant changes and higher average household income is intriguing and merits additional study.

scholarly journals Association between anxiety and obesity: A study of a young.adult Nigerian population

2013 ◽  
Vol 04 (S 01) ◽  
pp. S13-S18 ◽  
Author(s):  
Chukwunonso ECC Ejike
Keyword(s):  
Bioelectrical Impedance ◽  
Impedance Analysis ◽  
Normal Weight ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Chi Square ◽  
Study Materials ◽  
Nigerian Population ◽  
Low Prevalence ◽  
The Relationship

ABSTRACT Background: The relationship between anxiety and obesity is still debatable and seems to vary between cultures. The subject has been scarcely investigated in Nigeria, hence this study. Materials and Methods: A total of 1584 young‑adult Nigerians (56.4% males) of mean age 21.8 ± 2.2 years were studied. Anxiety was assessed using the Beck’s Anxiety Index (BAI), while obesity was determined using the bioelectrical impedance analysis (BIA) and body mass index (BMI) methods. Standard protocols were followed for all assessments and measurements. Appropriate descriptive statistics were carried out, while regression and correlation analyses (for continuous variables) and the Chi square tests (for categorical variables) were used to assess the relationship between anxiety and obesity. Results: The degree of adiposity of the subjects (males and females alike) classified by %BF standards did not significantly (P > 0.05) affect the proportion of the population with any degree of anxiety. The proportion of population with high anxiety (for both sexes) was similar (P > 0.05) irrespective of their BMI status. All the obese (BMI‑wise only) males had low anxiety, while the proportion of thin females (in the low anxiety group) was significantly (P < 0.05) higher than that of their normal weight counterparts. There was neither a significant correlation nor a significant association (P > 0.05) between the BAI scores and the studied measures of adiposity in both male and female subjects. Conclusion: The low prevalence of both anxiety and obesity in the studied population may explain the observed lack of association between the studied variables. These findings do not support the “jolly fat” hypothesis.

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