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  • 1
    In: Clinical Infectious Diseases, Oxford University Press (OUP), Vol. 72, No. 11 ( 2021-06-01), p. e736-e741
    Abstract: A local increase in angiotensin 2 after inactivation of angiotensin-converting enzyme 2 by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may induce a redox imbalance in alveolar epithelium cells, causing apoptosis, increased inflammation and, consequently, impaired gas exchange. We hypothesized that N-acetylcysteine (NAC) administration could restore this redox homeostasis and suppress unfavorable evolution in patients with coronavirus disease 2019 (COVID-19). Methods This was a double-blind, randomized, placebo-controlled, single-center trial conducted at the Emergency Department of Hospital das Clínicas, São Paulo, Brazil, to determine whether NAC in high doses can avoid respiratory failure in patients with COVID-19. We enrolled 135 patients with severe COVID-19 (confirmed or suspected), with an oxyhemoglobin saturation & lt;94% or respiratory rate & gt;24 breaths/minute. Patients were randomized to receive NAC 21 g (~300 mg/kg) for 20 hours or dextrose 5%. The primary endpoint was the need for mechanical ventilation. Secondary endpoints were time of mechanical ventilation, admission to the intensive care unit (ICU), time in ICU, and mortality. Results Baseline characteristics were similar between the 2 groups, with no significant differences in age, sex, comorbidities, medicines taken, and disease severity. Also, groups were similar in laboratory tests and chest computed tomography scan findings. Sixteen patients (23.9%) in the placebo group received endotracheal intubation and mechanical ventilation, compared with 14 patients (20.6%) in the NAC group (P = .675). No difference was observed in secondary endpoints. Conclusions Administration of NAC in high doses did not affect the evolution of severe COVID-19. Clinical Trials Registration Brazilian Registry of Clinical Trials (REBEC): U1111-1250-356 (http://www.ensaiosclinicos.gov.br/rg/RBR-8969zg/).
    Type of Medium: Online Resource
    ISSN: 1058-4838 , 1537-6591
    RVK:
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 2002229-3
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  • 2
    In: Open Forum Infectious Diseases, Oxford University Press (OUP), Vol. 7, No. Supplement_1 ( 2020-12-31), p. S483-S483
    Abstract: In Belo Horizonte (a 3,000,000 inhabitants city) a survey was carried out in five hospitals, between July 2016 and June 2018, about surgical site infection (SSI) in patients undergoing colon surgery procedures. The general objective is to statistically evaluate such incidences and enable an analysis of the SSI predictive power, through MLP (Multilayer Perceptron) pattern recognition algorithms. Methods Through the Hospital Infection Control Committees (CCIH) of the hospitals a data collection on SSI was carried out. Such data was used in the analysis during your routine SSI surveillance procedures. So, three procedures were performed: a treatment of the collected database for use of intact samples; a statistical analysis on the profile of the collected hospitals and; an assessment of the predictive power of five types of MLPs (Backpropagation Standard, Momentum, Resilient Propagation, Weight Decay and Quick Propagation) for SSI prediction. The MLPs were tested with 3, 5, 7 and 10 neurons in the hidden layer and with a division of the database for the resampling process (65% or 75% for testing, 35% or 25% for validation). They were compared by measuring the AUC (Area Under the Curve - ranging from 0 to 1) presented for each of the configurations. Results From 2126 records, 638 were complete for analysis. It was found: the average age is 55 years (from 1 to 94 years); the surgeries had an average time of approximately 197 minutes; the average hospital stay is 8 days, the death rate reached 5.625% and the SSI rate reached 6%. Regarding the predictive power, a maximum predictive power of 0.8316 was found. Conclusion There was a loss of 70% of the database samples due to the presence of noise. However, it was possible to have a relevant sample to assess the profile of these five hospitals. The predictive process presented some configurations with results that reached 0.8316, which promises the use of the structure for the monitoring of automated SSI for patients undergoing colon surgeries. To optimize data collection, enable other hospitals to use the prediction tool and minimize noise from the database, two mobile application were developed: one for monitoring the patient in the hospital and the other for monitoring after hospital discharge. The SSI prediction analysis tool is available at www.nois.org.br. Disclosures All Authors: No reported disclosures
    Type of Medium: Online Resource
    ISSN: 2328-8957
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
    detail.hit.zdb_id: 2757767-3
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  • 3
    In: Open Forum Infectious Diseases, Oxford University Press (OUP), Vol. 7, No. Supplement_1 ( 2020-12-31), p. S481-S481
    Abstract: A research was conducted between July 2016 and June 2018 in five hospitals in Belo Horizonte, a city of 3,000,000 inhabitants, focused on surgical site infection (SSI) in patients undergoing limb amputation surgery procedure. The main objective is to statistically evaluate such incidences and enable a study of the prediction power of SSI through MLPs (Multilayer Perceptron), a pattern recognition algorithm. Methods Data were collected on SSI by the Hospital Infection Control Committees (CCIH) of the hospitals involved. The information was forwarded to the NOIS (Nosocomial Infection Study) Project. After data collection, three procedures were performed: a treatment of the database collected for the use of intact samples; a statistical analysis on the profile of the hospitals collected and; an assessment of the predictive power of five types of MLP (Backpropagation Standard, Momentum, Resilient Propagation, Weight Decay, and Quick Propagation) for SSI prediction. MLPs were tested with 3, 5, 7, and 10 hidden layer neurons and a database split for the resampling process (65% or 75% for testing, 35% or 25% for validation). They were compared by measuring AUC (Area Under the Curve - ranging from 0 to 1) presented for each of the configurations. Results From 969 data, only 507 were intact for analysis. Statistically: in 12.45% there was an incidence of global infection and that in 10.67% of the cases were SSI (among which, 94.6% had to be hospitalized for more than 10 days); patients were hospitalized on average 21 days (from 0 to 141 days); the average duration is 78 minutes (maximum 360 minutes); 53 deaths (a 16.98% death rate in case of SSI). A maximum prediction power of 0.688 was found. Conclusion Despite the loss rate of almost 40% of the database samples due to the presence of noise, it was obtained a relevant sampling to evaluate the profile the hospitals. For the predictive process, although some configurations reached 0.688, which makes promising the use of the automated SSI monitoring framework for patients undergoing limb amputation surgery. To optimize data collection and enable other hospitals to use the SSI prediction tool (available in www.sacihweb.com), two mobile application were developed: one for monitoring the patient in the hospital and the other for post-hospital discharge monitoring. Disclosures All Authors: No reported disclosures
    Type of Medium: Online Resource
    ISSN: 2328-8957
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
    detail.hit.zdb_id: 2757767-3
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  • 4
    In: Open Forum Infectious Diseases, Oxford University Press (OUP), Vol. 7, No. Supplement_1 ( 2020-12-31), p. S484-S485
    Abstract: This research represents an experiment on surgical site infection (SSI) in patients undergoing knee arthroplasty surgery procedures in hospitals in Belo Horizonte, between July 2016 and June 2018. The objective is to statistically evaluate such incidences and enable a study of the prediction power of SSI of pattern recognition algorithms, in this case the Multilayer Perceptron (MLP). Methods Data were collected on SSI in five hospitals. The Hospital Infection Control Committees (CCIH) of the hospitals involved collected all data used in the analysis during their routine SSI surveillance procedures and sent the information to the Nosocomial Infection Study Project (NOIS). Three procedures were performed: a treatment of the database collected for use of intact samples; a statistical analysis on the profile of the hospitals collected and; an assessment of the predictive power of five types of MLP (Backpropagation Standard, Momentum, Resilient Propagation, Weight Decay, and Quick Propagation) for SSI prediction. MLPs were tested with 3, 5, 7, and 10 hidden layer neurons and a database split for the resampling process (65% and 75% for testing, 35% and 25% for validation). They were compared by measuring AUC (Area Under the Curve - ranging from 0 to 1) presented for each of the configurations. Results From the 1438 data collected, 390 records were usable and it was verified: the average age of the patients who underwent this surgical procedure was 70 (ranging from 29 to 92), average surgery time was 171 minutes (between 50 and 480), 47% presented a hospital contamination, 1% SSI and no deaths. During the MLP experiments, due to the low number of SSI cases, the prediction rate for this specific surgery was 0.5. Conclusion Despite the large noise index of the database, it was possible to have a relevant sampling to evaluate the profile of hospitals in Belo Horizonte. However, for the predictive process, despite some results equal to 0.5, the database demands more samples of SSI cases, as only 1% of positive samples generated an unbalance of the database. To optimize data collection and enable other hospitals to use the SSI prediction tool (available in www.sacihweb.com), two mobile application were developed: one for monitoring the patient in the hospital and the other for monitoring after hospital discharge. Disclosures All Authors: No reported disclosures
    Type of Medium: Online Resource
    ISSN: 2328-8957
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
    detail.hit.zdb_id: 2757767-3
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  • 5
    In: Open Forum Infectious Diseases, Oxford University Press (OUP), Vol. 8, No. Supplement_1 ( 2021-12-04), p. S499-S499
    Abstract: A research focused on surgical site infection (SSI) was performed in patients undergoing cardiac pacemaker implantation surgery. The main objective is to statistically evaluate such incidences and enable a study of the prediction power of SSI through pattern recognition algorithms, in this case the Multilayer Perceptron (MLP). Methods Data were collected from five hospitals in the city of Belo Horizonte (more than 3,000,000 inhabitants), between July 2016 and June 2018, on SSI by the Hospital Infection Control Committees (CCIH) of the hospitals involved in the search. All data used in the analysis during their routine SSI surveillance procedures were collected. So, three procedures were performed: a treatment of the collected database for use of intact samples; a statistical analysis on the profile of the hospitals collected and; an assessment of the predictive power of five types of MLP (Backpropagation Standard, Momentum, Resilient Propagation, Weight Decay, and Quick Propagation) for SSI prediction. MLPs were tested with 3, 5, 7, and 10 hidden layer neurons and a database split for the resampling process (65% and 75% for testing, 35% and 25% for validation). They were compared by measuring AUC (Area Under the Curve - from 0 to 1) presented for each of the configurations. Results From 1394, 572 records were: 21% of deaths and 2.4% patients had SSI; from the confirmed SSI cases, approximately 64.3% had sites classified as “clean”; length of hospital stay ranged from 0 to 175 days (from 1 to 70 days); the average age is 67 years. The prediction power of SSI, the experiments achieved from 0.409 to 0.722. Conclusion Despite the considerable loss rate of more than 65% of the database samples due to the presence of noise, it was possible to have a relevant sampling for the profile evaluation of Belo Horizonte hospitals. Moreover, for the predictive process, although some configurations reached 0.722. To optimize data collection and enable other hospitals to use the SSI prediction tool (available in www.nois.org.br ), two mobile application were developed: one for monitoring the patient in the hospital and the other for monitoring after hospital discharge. Disclosures All Authors: No reported disclosures
    Type of Medium: Online Resource
    ISSN: 2328-8957
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 2757767-3
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  • 6
    In: Open Forum Infectious Diseases, Oxford University Press (OUP), Vol. 7, No. Supplement_1 ( 2020-12-31), p. S482-S482
    Abstract: A survey was carried out in five hospitals, between July 2016 and June 2018, on surgical site infection (SSI) in patients undergoing infected surgery procedures, in the city of Belo Horizonte (3,000,000 inhabitants). The general objective is to statistically evaluate such incidences and enable an analysis of the SSI predictive power, through MLP (Multilayer Perceptron) pattern recognition algorithms. Methods Through the Hospital Infection Control Committees (CCIH) of the hospitals, a data collection on SSI was carried out. Such data is used in the analysis during your routine SSI surveillance procedures. So, three procedures were performed: a treatment of the collected database for use of intact samples; a statistical analysis on the profile of the collected hospitals and; an assessment of the predictive power of five types of MLPs (Backpropagation Standard, Momentum, Resilient Propagation, Weight Decay and Quick Propagation) for SSI prediction. The MLPs were tested with 3, 5, 7 and 10 neurons in the hidden layer and with a division of the database for the resampling process (65% or 75% for testing, 35% or 25% for validation). They were compared by measuring the AUC (Area Under the Curve - ranging from 0 to 1) presented for each of the configurations. Results From 1770 records, 810 were intact for analysis. It was found that: the average age is 53 years old (from 0 to 98 years old); the surgeries had an average time of approximately 140 minutes; the average hospital stay is 19 days, the death rate reached 10.86% and the SSI rate was 6.04%. A maximum prediction power of 0.729 was found. Conclusion There was a loss of 54% of the database samples due to the presence of noise. However, it was possible to have a relevant sample to assess the profile of these five hospitals. The predictive process, presented some configurations with results that reached 0.729, which promises the use of the structure for the monitoring of automated SSI for patients submitted to infected surgeries. To optimize data collection, enable other hospitals to use the prediction tool and minimize noise from the database, two mobile application were developed: one for monitoring the patient in the hospital and another for monitoring after hospital discharge. The SSI prediction analysis tool is available at www.nois.org.br. Disclosures All Authors: No reported disclosures
    Type of Medium: Online Resource
    ISSN: 2328-8957
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
    detail.hit.zdb_id: 2757767-3
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  • 7
    In: Open Forum Infectious Diseases, Oxford University Press (OUP), Vol. 7, No. Supplement_1 ( 2020-12-31), p. S476-S477
    Abstract: A survey was conducted in three hospitals, between July 2016 and June 2018, about surgical site infection (SSI) in patients undergoing surgeries to correct aortic artery aneurysms in the city of Belo Horizonte, with more than 3,000,000 of inhabitants. The general objective is to statistically evaluate such incidences and enable an analysis of the predictive power of SSI, through MLP (Multilayer Perceptron) pattern recognition algorithms. Methods Through the Hospital Infection Control Committees (CCIH) of the hospitals involved in the research, data collection on SSI was carried out. Such data is used in the analysis during your routine SSI surveillance procedures. Thus, three procedures were performed: a treatment of the database collected for use of intact samples; a statistical analysis on the profile of the collected hospitals and; an assessment of the predictive power of five types of MLPs (Backpropagation Standard, Momentum, Resilient Propagation, Weight Decay and Quick Propagation) for SSI prediction. The MLPs were tested with 3, 5, 7 and 10 neurons in the hidden layer and with a division of the database for the resampling process (65% or 75% for testing, 35% or 25% for validation). They were compared by measuring the AUC (Area Under the Curve - ranging from 0 to 1) for each of the configurations. Results From 600 records, 575 were complete for analysis. It was found that: the average age is 68 years (from 24 to 98 years); the average hospital stay is 9 days (with a maximum of 127 days), the death rate reached 6.43% and the SSI rate 2.78%. A maximum prediction power of 0.75 was found. Conclusion There was a loss of 4% of the database samples due to the presence of noise. It was possible to evaluate the profile of the three hospitals. The predictive process presented configurations with results that reached 0.75, which promises the use of the structure for the monitoring of automated SSI for patients undergoing surgery to correct aortic artery aneurysms. To optimize data collection, enable other hospitals to use the prediction tool and minimize noise from the database, two mobile application were developed: one for monitoring the patient in the hospital and another for monitoring after hospital discharge. The SSI prediction analysis tool is available at www.nois.org.br. Disclosures All Authors: No reported disclosures
    Type of Medium: Online Resource
    ISSN: 2328-8957
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
    detail.hit.zdb_id: 2757767-3
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  • 8
    In: Open Forum Infectious Diseases, Oxford University Press (OUP), Vol. 7, No. Supplement_1 ( 2020-12-31), p. S487-S487
    Abstract: In Belo Horizonte, a city with 3,000,000 inhabitants, a survey was performed in six hospitals, between July 2016 and June 2018, about surgical site infection (SSI) in patients undergoing clean surgery procedures. The main objective is to statistically evaluate such incidences and enable an analysis of the SSI predictive power, through MLP (Multilayer Perceptron) pattern recognition algorithms. Methods Through the Hospital Infection Control Committees (CCIH) of the hospitals, a data collection on SSI was carried out through the software SACIH - Automated System for Hospital Infection Control. So, three procedures were performed: a treatment of the collected database for use of intact samples; a statistical analysis on the profile of the collected hospitals; an evaluation of the predictive power of five types of MLPs (Backpropagation Standard, Momentum, Resilient Propagation, Weight Decay and Quick Propagation) for SSI prediction. The MLPs were tested with 3, 5, 7 and 10 neurons in the hidden layer and with a division of the database for the resampling process (65% or 75% for testing, 35% or 25% for validation). They were compared by measuring the AUC (Area Under the Curve - ranging from 0 to 1) presented for each of the configurations. Results From 45,990 records, 12,811 were able for analysis. The statistical analysis results were: the average age is 49 years old (predominantly between 30 and 50); the surgeries had an average time of 134.13 minutes; the average hospital stay is 4 days (from 0 to 200 days), the death rate reached 1% and the SSI 1.49%. A maximum prediction power of 0.742 was found. Conclusion There was a loss of 60% of the database samples due to the presence of noise. However, it was possible to have a relevant sample to assess the profile of these six hospitals. The predictive process, presented some configurations with results that reached 0.742, what promises the use of the structure for the monitoring of automated SSI for patients submitted to surgeries considered clean. To optimize data collection, enable other hospitals to use the prediction tool and minimize noise from the database, two mobile application were developed: one for monitoring the patient in the hospital and other for monitoring after hospital discharge. The SSI prediction analysis tool is available at www.nois.org.br. Disclosures All Authors: No reported disclosures
    Type of Medium: Online Resource
    ISSN: 2328-8957
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
    detail.hit.zdb_id: 2757767-3
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  • 9
    In: Open Forum Infectious Diseases, Oxford University Press (OUP), Vol. 7, No. Supplement_1 ( 2020-12-31), p. S482-S483
    Abstract: In the hospitals of Belo Horizonte (a city with more than 3,000,000 inhabitants), a survey was conducted between July 2016 and June 2018, focused on surgical site infection (SSI) in patients undergoing bariatric surgery procedures. The main objective is to statistically evaluate such incidences and enable a study of the prediction power of SSI through MLPs (Multilayer Perceptron), a pattern recognition algorithm. Methods Data were collected on SSI by the Hospital Infection Control Committees (CCIH) of the hospitals involved in the research. After data collection, three procedures were performed: a treatment of the database collected for the use of intact samples; a statistical analysis on the profile of the hospitals collected and; an assessment of the predictive power of five types of MLP (Backpropagation Standard, Momentum, Resilient Propagation, Weight Decay, and Quick Propagation) for SSI prediction. MLPs were tested with 3, 5, 7, and 10 hidden layer neurons and a database split for the resampling process (65% or 75% for testing, 35% or 25% for validation). They were compared by measuring AUC (Area Under the Curve - ranging from 0 to 1) presented for each of the configurations. Results From 3473 initial data, only 2491 were intact for analysis. Statistically, it was found that: the average age of the patients was 39 years (ranging from 16 to 65); the average duration of surgery was 138 minutes; and 0.8% of patients had SSI. Regarding the predictive power of SSI, the experiments have a minimum value of 0.350 and a maximum of 0.756. Conclusion Despite the loss rate of almost 30% of the database samples due to the presence of noise, it was possible to have a relevant sampling for the profile evaluation of Belo Horizonte hospitals. Moreover, for the predictive process, although some configurations have results that reached 0.755, which makes promising the use of the structure for automated SSI monitoring for patients undergoing bariatric surgery. To optimize data collection and enable other hospitals to use the SSI prediction tool (available in www.sacihweb.com), two mobile application were developed: one for monitoring the patient in the hospital and the other for monitoring after hospital discharge. Disclosures All Authors: No reported disclosures
    Type of Medium: Online Resource
    ISSN: 2328-8957
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
    detail.hit.zdb_id: 2757767-3
    Location Call Number Limitation Availability
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  • 10
    In: Open Forum Infectious Diseases, Oxford University Press (OUP), Vol. 7, No. Supplement_1 ( 2020-12-31), p. S476-S476
    Abstract: Between July 2016 and June 2018, a survey was carried out in five hospitals on surgical site infection (SSI) in patients over 70 years old, who underwent surgery procedures, in the city of Belo Horizonte, a city with more of 3,000,000 inhabitants. The general objective is to statistically evaluate such incidences and enable an analysis of the predictive power of SSI, through MLP (Multilayer Perceptron) pattern recognition algorithms. Methods Through the Hospital Infection Control Committees (CCIH) of the hospitals involved in the research, data collection on SSI was carried out. Such data is used in the analysis during your routine SSI surveillance procedures. Thus, three procedures were performed: a treatment of the database collected for use of intact samples; a statistical analysis on the profile of the collected hospitals and; an evaluation of the predictive power of five types of MLPs (Backpropagation Standard, Momentum, Resilient Propagation, Weight Decay and Quick Propagation) for SSI prediction. The MLPs were tested with 3, 5, 7 and 10 neurons in the hidden layer and with a division of the database for the resampling process (65% or 75% for testing, 35% or 25% for validation). They were compared by measuring the AUC (Area Under the Curve - ranging from 0 to 1) for each of the configurations. Results From 11277 records, 3350 were complete for analysis. It was found that: the average age is 79 years (from 74 to 84 years); the average surgery time is 123 minutes; the average hospital stay is 58 days (with a maximum of 114 days), the death rate reached 7.1% and that of SSI 2.59%. A maximum prediction power of 0.642 was found. Conclusion There was a loss of almost 70% of the database samples due to the presence of noise, however it was possible to evaluate the hospitals profile. The predictive process, presented configurations with results that reached 0.642, what promises the use of the structure for the monitoring of automated SSI for patients over 70 years submitted to surgeries. To optimize data collection, enable other hospitals to use the prediction tool and minimize noise from the database, two mobile application were developed: one for monitoring the patient in the hospital and another for monitoring after hospital discharge. The SSI prediction analysis tool is available at www.nois.org.br. Disclosures All Authors: No reported disclosures
    Type of Medium: Online Resource
    ISSN: 2328-8957
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
    detail.hit.zdb_id: 2757767-3
    Location Call Number Limitation Availability
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