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Evaluation of Infectious Agents, Species, and Resistance Profiles of Healthcare-Associated Infections 医疗相关感染的传染源、种类和耐药性评估
IF 0.3 Q4 Medicine Pub Date : 2023-06-30 DOI: 10.36519/kd.2023.4163
Esra Gurbuz, Mehmet Çelik, Azize Yildiz
Objective: Healthcare-associated infections are critical medical conditions as they prolong hospital stays, cause multi-organ dysfunction, and increase mortality because of limited treatment options. In this study, we aimed to investigate the type of infection, causative agents, and resistance profiles in patients followed by healthcare-associated infections.Methods: A total of 1235 patients diagnosed with healthcare-associated infections in our hospital between January 2016 and December 2020 were included in this study. Results: The rates of healthcare-associated infections were 0.60% in 2016, 0.27% in 2017, 0.20% in 2018, 0.89% in 2019, and 3.77% in 2020. The most common type of healthcare-associated infection was bloodstream infection in all years. We observed that healthcare-associated infections were detected more frequently in the Anesthesiology and Reanimation Intensive Care Unit compared to other clinics (53.3%), and Acinetobacter spp. was the most common cause with a rate of 45.2%. Gram-negative bacteria were the most frequently isolated etiologic subgroup in all years. In terms of antimicrobial resistance, while an increase in carbapenem resistance was observed in Acinetobacter spp. and Klebsiella pneumoniae over the years, no significant difference was found in the extended-spectrum beta-lactamase (ESBL) rate in Escherichia coli. In addition, while ESBL rates decreased in Pseudomonas spp. over the years, an increase was detected in carbapenem resistance in 2017 and 2018, and we observed that the resistance remained at the same level in the following years.Conclusion: Healthcare-associated infections continue to be a significant health problem. Although our rates of healthcare-associated infections were lower than the literature, we observed that drug resistance, especially carbapenem resistance, increased in almost all agents. Acinetobacter species remained the most problematic agent.
目的:医疗保健相关感染是一种严重的医疗状况,因为它们延长了住院时间,导致多器官功能障碍,并由于治疗选择有限而增加死亡率。在这项研究中,我们的目的是调查感染类型,病原体和耐药概况的患者随后的医疗保健相关感染。方法:选取2016年1月至2020年12月在我院诊断为医疗相关感染的1235例患者为研究对象。结果:2016年卫生保健相关感染率为0.60%,2017年为0.27%,2018年为0.20%,2019年为0.89%,2020年为3.77%。在所有年份中,最常见的医疗相关感染类型是血液感染。我们观察到,与其他诊所相比,在麻醉和复苏重症监护病房(53.3%)检测到医疗保健相关感染的频率更高,不动杆菌属是最常见的原因,发生率为45.2%。革兰氏阴性菌是所有年份中最常见的病原亚群。在抗菌素耐药性方面,不动杆菌和肺炎克雷伯菌对碳青霉烯类药物的耐药性逐年增加,而大肠杆菌的广谱β -内酰胺酶(ESBL)率无显著差异。此外,虽然假单胞菌的ESBL率逐年下降,但在2017年和2018年,碳青霉烯类耐药性有所增加,并且我们观察到抗性在接下来的几年中保持在相同水平。结论:医疗保健相关感染仍然是一个重要的健康问题。虽然我们的医疗保健相关感染率低于文献,但我们观察到耐药性,特别是碳青霉烯类耐药性,在几乎所有药物中都有所增加。不动杆菌种类仍然是最有问题的病原体。
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引用次数: 0
Evaluation of the Correlation Between Serum Tumor Necrosis Factor Alpha, Transforming Growth Factor-Beta, Interleukin-10 and Alanine Aminotransferase Levels and Liver Histological Activity in Naive Chronic Hepatitis C Patients 慢性丙型肝炎患者血清肿瘤坏死因子α、转化生长因子β、白细胞介素-10和丙氨酸氨基转移酶水平与肝组织学活性的相关性评价
IF 0.3 Q4 Medicine Pub Date : 2023-03-21 DOI: 10.36519/kd.2023.3588
Barış Balasar, I. Erayman, E. Turk-Aribas
Objective: In this study serum tumor necrosis factor alpha (TNF-alpha), transforming growth factor beta (TGF- beta), interleukin-10 (IL–10) and alanine transferase (ALT) levels were measured in naive chronic hepatitis C patients and healthy control group. The relationship between the values and the histological activity of the liver was evaluated to make predictions about liver histology without the need for biopsy.Methods: A total of 86 individuals including 43 patients and 43 controls participated in the study. Serum AST, ALT, TNF-alpha, TGF- beta and IL–10 values were analyzed in patient and control groups. The correlation between liver fibrosis degree (stage) and histological activity index (HAI) scores and the IL–10, TNF-alpha, IL-10, TGF-BETA values of the case and control group was evaluated.Results: A very strong correlation was found between HAI and TNF-alpha (rho=0965). A significant relation was found between HAI and TGF-beta (rho=0.446) and statistical correlation was not found between HAI and IL-10. A significant relation was found between HAI and serum ALT values in the patient group.Conclusion: Liver biopsy is an invasive procedure with complications which may have severe results. There is a need for biochemical or radiological markers which extrapolate to liver biopsy. In our study, measurement of serum cytokine and ALT values was observed as a noninvasive method which can help to meet this need.
目的:测定初发慢性丙型肝炎患者和健康对照组血清肿瘤坏死因子- α (tnf - α)、转化生长因子- β (TGF- β)、白细胞介素-10 (IL-10)和丙氨酸转移酶(ALT)水平。评估了这些值与肝脏组织活动之间的关系,以便在不需要活检的情况下预测肝脏组织。方法:共86例患者43例,对照组43例。分析患者和对照组血清AST、ALT、tnf - α、TGF- β和IL-10值。评估病例组和对照组肝纤维化程度(分期)、组织学活性指数(HAI)评分与IL-10、tnf - α、IL-10、tgf - β值的相关性。结果:HAI与tnf - α有很强的相关性(rho=0965)。HAI与tgf - β呈显著相关(rho=0.446),与IL-10无统计学相关性。患者组HAI与血清ALT值有显著相关性。结论:肝活检是一种有侵入性的手术,其并发症可能会导致严重的后果。需要生化或放射学标志物来推断肝活检。在我们的研究中,检测血清细胞因子和ALT值是一种无创的方法,可以帮助满足这一需求。
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引用次数: 0
Crimean-Congo Hemorrhagic Fever (CCHF) and Brucellosis Coinfection in Alanya: A Case Report 阿拉尼亚地区克里米亚-刚果出血热(CCHF)和布鲁氏菌病合并感染1例
IF 0.3 Q4 Medicine Pub Date : 2023-03-21 DOI: 10.36519/kd.2023.4063
A. Erdogan, H. Erdoğan
The combination of Crimean-Congo hemorrhagic fever (CCHF) and brucellosis is unusual and can easily go unnoticed. Herein we report a case of CCHF and brucellosis coinfection and review the pertinent literature. The presented case occurred in Alanya, where the non-endemic region of CCHF and critical bradycardia was present during the course. As Alanya is a tourism center and tours are given in the rural areas surrounding the city, it is essential to watch for possible signs of CCHF in patients.
克里米亚-刚果出血热(CCHF)和布鲁氏菌病的结合是不寻常的,很容易被忽视。在此,我们报告了一例CCHF和布鲁氏菌病合并感染的病例,并回顾了相关文献。该病例发生在Alanya,在该过程中出现CCHF和严重心动过缓的非地方性区域。由于阿拉尼亚是一个旅游中心,旅游在城市周围的农村地区进行,因此有必要观察患者可能出现的CCHF迹象。
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引用次数: 0
HBV and HCV Coinfection in Patients Living with HIV HIV患者的HBV和HCV合并感染
IF 0.3 Q4 Medicine Pub Date : 2023-03-21 DOI: 10.36519/kd.2023.4473
S. Tekin, G. Cınar, Orçun Barkay, I. Çelik
Coinfection with hepatitis B virus (HBV) and hepatitis C virus (HCV) in human immunodeficiency virus (HIV) infected individuals results in increased hepatic complications. HBV and HIV viruses are transmitted by blood and unprotected sexual intercourse. People with HIV and HBV coinfection are at increased risk for liver-related morbidity and mortality. HCV-related liver injury progresses more rapidly among people coinfected with HIV. HCV coinfection may also affect the management of HIV infection. This review aims to go over the management of HIV-HCV and HIV-HBV coinfections.
人类免疫缺陷病毒(HIV)感染者同时感染乙型肝炎病毒(HBV)和丙型肝炎病毒(HCV)会导致肝脏并发症增加。HBV和HIV病毒通过血液和无保护的性交传播。HIV和HBV合并感染者与肝脏相关的发病率和死亡率增加。与HCV相关的肝损伤在同时感染HIV的人群中进展更快。HCV合并感染也可能影响HIV感染的管理。本综述旨在对HIV-HCV和HIV-HBV合并感染的管理进行综述。
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引用次数: 0
Examination Findings of Type 2 Diabetes Patients’ Feet with and without Ulcers 2型糖尿病足部有无溃疡的检查结果
IF 0.3 Q4 Medicine Pub Date : 2023-03-21 DOI: 10.36519/kd.2023.4166
Sahizer Eraydin
Objective: We conducted this study to determine the factors that cause foot ulcers in patients with type 2 diabetes mellitus (DM) with or without diabetic foot ulcer (DFU).Methods: This cross-sectional, descriptive study compared the feet examination results of 43 Type 2 DM patients with or without DFU. The study data were collected using a patient identification form and a diabetic foot examination form. Data are presented as percent, mean, and standard deviation. Chi-square and Fisher’s exact tests were used for statistical analysis. The statistical significance level was taken as p<0.05.Results: Of the patients, 63% were male, 79% were married, their mean age was 63.16±9.43, and the mean diabetes year was 18.44±7.77. 74% of the patients had a previous DFU. Of the existing DFU, 58% were on the right foot, 49% were on the toes, 49% were Wagner grade 2, and 37% were infected. There was edema and warmth in the DFU foot (p<0.05). DFU foot had a weaker sense of touch and vibration than the other. Ankle-Brakial Index was below 0.9. Foot pulses were weak, and there were deformities.Conclusion: Patients with DFU feet have an increased risk of recurrent ulcer formation. These patients should be followed periodically and educated about ulcer formation and signs and symptoms of infection.
目的:我们进行了这项研究,以确定导致伴有或不伴有糖尿病足溃疡(DFU)的2型糖尿病(DM)患者足溃疡的因素。方法:本横断面描述性研究比较了43例伴有或不伴有DFU的2型糖尿病患者的足部检查结果。研究数据是通过患者识别表和糖尿病足检查表收集的。数据以百分比、平均值和标准差表示。采用卡方检验和Fisher精确检验进行统计分析。以p<0.05为差异有统计学意义。结果:男性占63%,已婚占79%,平均年龄63.16±9.43岁,平均糖尿病年18.44±7.77岁。74%的患者既往有DFU。在现有的DFU中,58%在右脚,49%在脚趾,49%为Wagner 2级,37%感染。DFU足部有水肿和发热(p<0.05)。DFU足有较弱的触觉和振动感。踝关节制动指数低于0.9。足部脉搏微弱,有畸形。结论:DFU足患者复发性溃疡形成的风险增加。这些患者应定期随访,并了解溃疡的形成和感染的体征和症状。
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引用次数: 0
6th February Earthquakes and Infectious Diseases: What are the Turkish Society of Clinical Microbiology and Infectious Diseases and Klimik Journal Doing? 2月6日地震和传染病:土耳其临床微生物学和传染病学会和Klimik杂志在做什么?
IF 0.3 Q4 Medicine Pub Date : 2023-03-21 DOI: 10.36519/kd.2022.4597
A. Azap
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引用次数: 0
Bibliometric Analysis of Literature on HIV/AIDS-Associated HHV-8/KSHV in Turkey: 2001-2020 2001-2020年土耳其HIV/ aids相关HHV-8/KSHV文献计量学分析
IF 0.3 Q4 Medicine Pub Date : 2023-03-21 DOI: 10.36519/kd.2023.4291
Yagmur Ekenoglu-Merdan, A. Ozel, Pınar Etiz
Objective: Human herpesvirus-8 (HHV-8) infection—also known as Kaposi sarcoma-associated herpesvirus (KSHV)—is the causative agent of Kaposi’s sarcoma, especially in human immunodeficiency virus (HIV) / acquired immune deficiency syndrome (AIDS) patients. The prevalence of HHV-8/KSHV varies according to country and geographical region. However, despite the increasing amount of research on HHV-8/KSHV after identifying the virus, few studies have systematically collected data on the scientific production process. Therefore, this study aimed to make a bibliometric evaluation of the literature on HIV/AIDS-associated HHV-8/KSHV. Methods: Scientific publications produced in Turkey were analyzed using specific keywords of AIDS-related HHV-8/KSHV in the Scopus database between 2001 and 2020. Quantitative and qualitative analysis of the collected data was reviewed using appropriate bibliometric indicators regarding the number of publications, publication language, most influential institutions, most cited publications, active authors, and active journals. In addition, the VOSviewer v.1.6.16 program (Leiden University’s Centre for Science and Technology Studies, Leiden, Holland) was used to create a keyword network map and determine research interest areas and relationships. Results: There were 40 scientific publications produced in Turkey. The first publication of AIDS-related HHV-8/KSHV in Turkey was in 2001 (n=5, 5%). Most studies were conducted in 2013 and 2020 (n=5, 12.5%). The highest number of publications were in English (82.5%), and 7.5% were published in the Journal of Microbiology Bulletin. Generally, the publications were in article form (82.5%) and in the area of medical sciences (95%). Kaposi’s sarcoma was the most frequently used word in the map created with the network analysis of the keywords.
目的:人疱疹病毒-8 (HHV-8)感染,也被称为卡波西肉瘤相关疱疹病毒(KSHV),是卡波西肉瘤的病原体,特别是在人类免疫缺陷病毒(HIV) /获得性免疫缺陷综合征(AIDS)患者中。HHV-8/KSHV的流行率因国家和地理区域而异。然而,尽管在确定病毒后,对HHV-8/KSHV的研究越来越多,但很少有研究系统地收集科学生产过程的数据。因此,本研究旨在对HIV/ aids相关的HHV-8/KSHV文献进行文献计量学评价。方法:使用Scopus数据库中2001 - 2020年与艾滋病相关的HHV-8/KSHV的特定关键词对土耳其发表的科学出版物进行分析。使用适当的文献计量指标对收集到的数据进行定量和定性分析,包括出版物数量、出版语言、最具影响力的机构、最常被引用的出版物、活跃作者和活跃期刊。此外,使用VOSviewer v.1.6.16程序(荷兰莱顿大学科学技术研究中心)创建关键字网络地图,确定研究兴趣领域和关系。结果:土耳其共发表科学出版物40篇。2001年,土耳其首次发表了与艾滋病相关的HHV-8/KSHV (n= 5,5 %)。大多数研究在2013年和2020年进行(n=5, 12.5%)。以英文发表的论文最多(82.5%),在Journal of Microbiology Bulletin上发表的论文占7.5%。一般来说,这些出版物以文章形式发表(82.5%),在医学领域发表(95%)。卡波西肉瘤(Kaposi’s sarcoma)是通过对关键词进行网络分析而生成的地图中使用频率最高的单词。
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引用次数: 0
Validation of Turkish Parental Perception on Antibiotics Scale 土耳其父母对抗生素认知量表的验证
IF 0.3 Q4 Medicine Pub Date : 2023-03-06 DOI: 10.36519/kd.2023.3996
Caner Ozdemir, A. Ergin
Objective: Antibiotic misuse is a significant public health problem worldwide. Parents’ perceptions of antibiotics are critical for the antibiotic intake of children. The study’s aim was to validate the Turkish Parental Perception on Antibiotics Scale.Methods: This is a scale validation study. The data were collected through a questionnaire that consisted of 15 questions about the demographic and socioeconomic characteristics of the family and the Turkish Parental Perception on Antibiotics Scale. The scale, developed by Alumran et al., is a 5-point Likert type and consists of 31 items. The high scores obtained from the non-cut-off scale indicate better antibiotics perception. Experts completed the language adaption and content validity of the scale. Confirmatory factor analysis was used for construct validity. Reliability was tested by internal consistency coefficients.Results: One thousand eight people participated in the study. 68.8% of the participants were mothers. The mean age of the mothers was 35.7±5.0, and the mean age of the fathers was 39.4±5.2 years. The percent of high school and above graduates was 51.2% among mothers and 56.0% among fathers. According to the confirmatory factor analysis, the fit index values were standardized root mean square residual (SRMR)=0.06, goodness-of-fit index (GFI)=0.90, root mean square error of approximation (RMSEA)=0.06, comparative fit index (CFI)=0.95, non-normed fit index (NNFI)=0.93. The fit index values were good or excellent and confirmed the 5-factor structure. It was found that the internal consistency coefficients calculated for reliability were 0.79 for the whole scale and ranged between 0.63 and 0.86 for the subscales.Conclusion: The Turkish Parental Perception on Antibiotics Scale is a valid and reliable measurement tool. Further research is needed to determine the current situation regarding antibiotic perception.
目的:抗生素滥用是世界范围内一个重大的公共卫生问题。父母对抗生素的认知对儿童抗生素的摄入至关重要。该研究的目的是验证土耳其父母对抗生素的感知量表。方法:这是一项量表验证研究。数据是通过一份问卷收集的,该问卷包括15个关于家庭人口统计和社会经济特征以及土耳其父母对抗生素的感知量表的问题。该量表由Alumran等人开发,为Likert型5分量表,由31个项目组成。从非截断量表中获得的高分表明更好的抗生素感知。专家完成了量表的语言适应性和内容有效性。结构有效性采用验证性因素分析。可靠性通过内部一致性系数进行检验。结果:108人参与了这项研究。68.8%的参与者是母亲。母亲平均年龄为35.7±5.0岁,父亲平均年龄为39.4±5.2岁。高中及以上毕业生的比例在母亲中为51.2%,在父亲中为56.0%。根据验证性因素分析,拟合指数值为标准化均方根残差(SRMR)=0.06,拟合优度指数(GFI)=0.90,近似均方根误差(RMSEA)=0.06、比较拟合指数(CFI)=0.95,非赋范拟合指数(NNFI)=0.93。拟合指数值良好或优秀,证实了5因子结构。研究发现,为可靠性计算的内部一致性系数在整个量表中为0.79,在分量表中为0.63至0.86。结论:土耳其父母抗生素认知量表是一种有效、可靠的测量工具。需要进一步的研究来确定抗生素感知的现状。
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引用次数: 1
Evaluation of Sharps Injuries of Health Professionals Working in a Tertiary Care Hospital During Five Years 某三级医院卫生专业人员5年锐器伤害评价
IF 0.3 Q4 Medicine Pub Date : 2023-03-06 DOI: 10.36519/kd.2023.3865
Rezan Harman-Gunerken
Objective: This study aims to evaluate occupational injuries in healthcare professionals exposed to the blood and body fluids of patients in our hospital for five years.Methods: A retrospective analysis of applications of healthcare professionals to the Infection Control Committee (ICC) between 2013-2017 was conducted based on the “registry and follow-up form for exposure to body fluids.”Results:175 personnel applied to the ICC, and the average age of applicants was 31.5±8. 58.5% of the cases were male, and 41.5% were female. Nurses constituted the majority of applicants at 37.7%, followed by caregivers at 21.7% and interns at 17.1%. Most injuries were inflicted in operating rooms 22.3%, emergency services 18.8%, intensive care units 18.3% and surgical clinics 12.6%. 62.5% of the cases were needlestick injuries, 24.0% were due to sharps, and 13.5% were due to mucosal exposure. The source patient was identified in 144 cases (82%), whereas in 31 cases (%18), the source patient could not be identified. Sixteen of the source patients were HBsAg positive, five were anti-HCV positive, and one was anti-HIV positive. None of the personnel was infected due to the injuries.Conclusion: The number of sharp injuries can be reduced by employing more personnel, reducing work hours, and encouraging the use of personal protective equipment. In addition to providing fundamental medical knowledge, training programs should also encourage a positive attitude toward HIV / AIDS.
目的:本研究旨在评估我院医护人员接触患者血液和体液五年的职业伤害情况。方法:根据“体液暴露登记和随访表”,对2013-2017年期间医疗保健专业人员向感染控制委员会(ICC)提出的申请进行回顾性分析。结果:175名人员向ICC提出申请,申请者的平均年龄为31.5±8岁。男性占58.5%,女性占41.5%。护士占申请者的大多数,占37.7%,其次是护理人员,占21.7%,实习生占17.1%。大多数受伤发生在手术室22.3%,急救服务18.8%,重症监护室18.3%,外科诊所12.6%。62.5%的病例是针刺伤,24.0%是锐器伤,13.5%是粘膜暴露伤。在144例(82%)中确定了来源患者,而在31例(%18)中,无法确定来源患者。16名来源患者HBsAg阳性,5名抗-HCV阳性,1名抗-HIV阳性。没有一名人员因受伤而受到感染。结论:可以通过雇佣更多的人员、减少工作时间和鼓励使用个人防护装备来减少尖锐伤害的数量。除了提供基本的医学知识外,培训项目还应鼓励对艾滋病毒/艾滋病持积极态度。
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引用次数: 0
Evaluation of Adverse Effects due to Inactive COVID-19 Vaccination in Healthcare Workers with or without a History of COVID-19 有或无COVID-19病史的医护人员非活性COVID-19疫苗接种的不良反应评估
IF 0.3 Q4 Medicine Pub Date : 2023-03-06 DOI: 10.36519/kd.2023.3829
Gamze Kalin-Unuvar, Zeynep Ture-Yuce, Nadir Kahveci, Orhan Yıldız, B. Aygen
Objective: Vaccines are one of the promising approaches to control the pandemic. The aim of this study, which was conducted on healthcare workers who previously were or were not infected with COVID-19, was to evaluate the undesirable effects that developed after the CoronaVac (Sinovac Life Sciences, Beijing, China).Methods: Volunteers who were administered the first dose of inactivated CoronaVac vaccine between January 14-24, 2021, were included in this retrospective study. Demographic information was obtained from the questionnaire results and from the data of the applications made due to side effects.Results: 911 healthcare workers, 232 of whom had a history of COVID-19 were included in the study. The mean age of those with a history of COVID-19, was 36 (20-66), and 33.6% were men. 26.7% were doctors, 34.9% were nurses, 155 (66.8%) worked in internal and 62 (26.7%) in surgical units. There was no significant difference between the two groups regarding age, gender, task, and the departments they worked in. Comorbidities were present in 25.9% of the group with a history of COVID-19; the most common disease was asthma (5.6%). Allergy history was 4.3% in the group with COVID-19 and 7.8% in the other group (p=0.070). The incidence of post-vaccine adverse events (62.9%) was higher in those with a history of COVID-19 than in those without (57.1%). The most common adverse event was a headache, and it was significantly higher in the group who had COVID-19 compared to those who had not (36.6% vs. 27.7%; p=0.01).Conclusion: In our study, we observed that the rates of undesirable effects after vaccination were high in individuals with a history of COVID-19. Although it is thought that this situation may be related to the developing antibody response rates, the insufficient number of cases and the lack of determination of the antibody response after infection and vaccination are a disadvantage of the study.
目的:疫苗是控制疫情的一种有前景的方法。这项研究针对之前感染或未感染新冠肺炎的医护人员进行,目的是评估CoronaVac(科兴生命科学,中国北京)后产生的不良影响。方法:在2021年1月14日至24日期间接种第一剂灭活CoronaVac疫苗的志愿者被纳入这项回顾性研究。人口统计信息是从问卷调查结果和因副作用而提出的申请的数据中获得的。结果:911名医护人员被纳入研究,其中232人有新冠肺炎病史。有新冠肺炎病史的人的平均年龄为36岁(20-66岁),33.6%为男性。26.7%是医生,34.9%是护士,155人(66.8%)在内科工作,62人(26.7%)在外科工作。在年龄、性别、任务和工作部门方面,两组之间没有显著差异。有新冠肺炎病史的组中有25.9%患有合并症;最常见的疾病是哮喘(5.6%)。新冠肺炎组的过敏史为4.3%,另一组为7.8%(p=0.070)。有新冠肺炎史者的疫苗接种后不良事件发生率(62.9%)高于无新冠肺炎史者(57.1%)。最常见的不良事件是头痛,新冠肺炎患者的不良反应发生率显著高于未感染者(36.6%对27.7%;p=0.01)。结论:在我们的研究中,我们观察到有新冠肺炎病史的患者接种疫苗后不良反应的发生率很高。尽管人们认为这种情况可能与抗体反应率的发展有关,但病例数量不足以及缺乏对感染和接种疫苗后抗体反应的确定是该研究的一个缺点。
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引用次数: 0
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Klimik Journal
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