Przeglad epidemiologiczny最新文献

The exact cause of encephalitis is still unclear in many cases, although the common etiological factors of this process are viruses such as herpes simplex virus and rabies virus, and also bacteria, fungi, parasites, several medicines and autoimmune diseases. Herein, we report a case of a 56-year-old man with a history of amnestic syndrome, impaired consciousness, somnolence throughout the day, headache, dizziness and hypertension, who was admitted to hospital with suspected neurological disease, and imaging features that were consistent with encephalitis of unknown etiology. Methods which were used to examine patient: cerebrospinal fluid testing, PCR examinations for viruses, testing of antibodies against surface antigens, magnetic resonance imaging of the head, psychiatric consultation, oncology consultation. The objective of this study is to demonstrate a case about an uncommon neurologic condition, which every clinician might meet in clinical practice. In this type of cases, the use of steroids such as dexamethasone and methylprednisolone might lead to a full recovery.

Introduction: The SARS-CoV-2 pandemic is described as a global health crisis. The most typical symptoms of infection prompt most patients to visit a primary care clinic (PCC). From December 2020, COVID-19 can be diagnosed in European Union countries on the basis of a positive antigen test result. These tests are widely used at the primary care level.

Material and methods: The analysis covered the period from 01.09.2021 to 28.02.2022. Statistical analysis was performed on the results of a study of 1,849 patients who underwent antigen testing in primary care clinics at the Kashubian Medical Centre (KCM) in Sierakowice and data published by the Ministry of Health on the results of tests performed from the whole country, Pomeranian Voivodeship and Kartuzy County.

Results: Statistical analysis showed that the results of studies conducted in KCM in Sierakowice (antigen-only tests) were consistent with the results of studies conducted in Kartuzy County, Pomeranian Voivodeship and nationwide (molecular PCR - Polymerase Chain Reaction and antigen tests).

Conclusions: Rapid antigen tests are a useful diagnostic tool in the fight against the SARS-CoV-2 pandemic because of their easy availability and simplicity of performance, and their widespread dissemination, especially in primary care settings, could contribute to multibillion-dollar savings in the health care system.

Introduction: In children, SARS-CoV-2 infection may manifest with symptoms of fever, cough, muscle pain, diarrhea or waste smell and taste. However, in most cases it is mild or asymptomatic. Determination of the level of anti-SARS CoV-2 IgG antibodies in children enables to assess retrospectively the incidence of the SARS-CoV-2 infection among children.

Aim of the study: The aim of the research was to analyze the results of anti-SARS-CoV-2 antibodies in the IgG class contained in children hospitalized in north-eastern Poland in 2021.

Material and methods: The material for the study was venous blood collected once from children hospitalized in Children's University Hospital in Białystok in 2021. The results obtained from 615 children aged from 1 month to 11 years were analyzed. Determination of the level of antibodies was performed using the automated SARS-COV-2 IgG II test on the VIDAS® analyzer.

Results: The analysis of the results of the anti-SARS-CoV-2 IgG value showed that half of children (52%, n=319) had contact with SARS-CoV-2 virus of which approximately 15% (n=47) had documented infection with this virus. There was no difference in the frequency of infections among boys and girls, antibodies were detected in 51% and 53%, respectively. The highest percentage of positive results was observed in children aged 7 to 10 years, 62% (91/147). The least children with a positive result were in the group below 1 year of age, 24% (4/17). High values of the antibody index (>15.00) were most often found among younger children, aged 1-2 years.

Conclusions: The presented results showed that infection with the SARS-CoV-2 virus does not depend on the sex of children but the value of anti-SARS-CoV-2 IgG antibodies decreased with the age of the child.

Introduction: Amidst the growing epidemic of obesity and diabetes, metabolic syndrome (MetS) is one of the greatest health problems. Lifestyle factors and bad habits are responsible for the emergence and development of MetS.

Objective: The aim of the study was to compare and check whether women with MetS adhered to a healthy diet and had a healthier lifestyle than women without MetS, and to compare the impact of women's lifestyles on their nutritional status.

Material and methods: The study included 167 women aged 20-78. As per guidelines, all tests required fasting. Comparisons of individual quantitative variables between groups were made using the Student's t-test for independent variables or the Mann-Whitney U-test. The relationship between quantitative variables was verified with the Spearman correlation coefficient. All statistical tests were based on a significance level of p<0.05.

Results: Women with MetS were more likely to have bad habits such as smoking, adding sugar to beverages and adding salt to food on the plate, while alcohol consumption was more common in women without MetS, but there was a statistically significant positive correlation between alcohol consumption and HDL-cholesterol levels in both groups. Women with MetS showed statistically significantly higher body weight, BMI, waist and hip circumferences (p<0.001), a statistically significant positive relationship between adding sugar to beverages and triglyceride levels (r=0.2699, p=0.015). In women without MetS, there was a statistically significant negative correlation between HDL-cholesterol levels and cigarette smoking (r= 0.2709, p=0.014). Women with MetS had statistically significantly higher mean systolic and diastolic blood pressure and mean serum levels of total cholesterol (p<0.001), LDL-cholesterol (p=0.007), triglycerides (p<0.001) and glucose (p<0.001) than women without MetS.

Conclusions: Nutritional errors were shown in both groups, including deficiencies in calcium, folates, iron, vitamin D and excessive sodium and phosphorus intake. Therefore, it is important to prevent the onset of MetS components and to educate and assist professionals in setting realistic goals individually adapted to each patient.

COVID-19 is a disease caused by the SARS-CoV-2 virus, which, after entering a living organism, uses the ACE-2 protein as a receptor and several other proteins as cofactors of infection. Disease symptomatology is extensive, involving mostly predominant respiratory symptoms, as well as those of the nervous, gastrointestinal, circulatory and other systems. Incidence of COVID-19 also results in markedly different laboratory findings on the hemostatic system with the predominant feature of increased D-dimer levels. In the pathogenesis of thromboembolic complications in COVID-19, all elements of Virchow's triad are involved: endothelial damage, coagulation disorders and blood flow disorders. Coagulopathy increases with the severity of the clinical course of COVID-19. One of the causes of mortality associated with COVID-19 is pulmonary embolism. SARS-CoV-2 infection increases the risk of thromboembolic complications not only in the acute period of the disease. Also in the period of about a month after recovery, there is an increased risk of venous thrombosis and consequently, life-threatening pulmonary embolism. The classic biomarker of pulmonary embolism in the general population is D-dimers. Among imaging studies, the gold standard for diagnosing this disease is computed tomography of the pulmonary arteries (CTPA). Other useful diagnostic tests are ventilation-perfusion lung scintigraphy (VQ Scans) or echocardiography. Currently reviewed guidelines and recommendations recommend extens ive thromboprophylaxis in COVID-19 patients in both acute and chronic phases of the disease. Keywords: COVID-19, pulmonary embolism, laboratory and imaging diagnostics, thromboprophylaxis.

Introduction: Urinary tract infections (UTIs) caused by multi-drug resistant strains are a serious and growing problem in organ transplant (TX) recipients.

Aim of the study: The aim of the study was to assess the prevalence and risk factors of UTIs caused by multi-drug resistant strains in hospitalized patients after kidney or liver transplantation in a large transplant center.

Material and methods: 392 cases of UTIs in patients after kidney or liver TX hospitalized in 2014, 2015 and 2016 were analyzed. Among the assessed cases of UTIs, 66.07% occurred in women, 33.93% - in men, 80.1% - in kidney TX recipients and 19.9% - in liver TX recipients. The median age of the patients was 57.51 years and the median time since TX was 41.44 months.

Results: Most episodes of UTIs were observed during the first year after TX - 121 (30.78%) of cases. A total of 506 pathogens were cultured: 345 Gram-negative bacteria (68.182%), 146 Gram-positive bacteria (28.854%) and 15 fungi (2.964%). More than one pathogen was found in 25.51% of urine cultures. Among bacteria (n=491), a resistance mechanism was detected in 166 (33.81%) pathogens (133 Gram-negative and 33 Gram-positive). The most common etiological agents were: E. coli ESBL- (23.72%), K. pneumoniae ESBL+ (17.19%), E. faecalis (11.27%) and E. faecium (7.71%). Diabetes was present in 129 (35.46%) of patients, and the number of UTI cases was similar in the group with and without diabetes.

Conclusions: Compared to the general population, in hospitalized patients after kidney or liver transplantation UTIs occur more often in men and are more often caused by Gram-positive bacteria. In 33.81% of cases UTIs are caused by multi-drug resistant strains, predominantly Gram-negative bacteria.

Introduction: Diabetes mellitus is a metabolic disease that affects millions of people worldwide. The complications caused by this disease in many cases lead to a deterioration of the quality of life of patients. An additional factor that negatively affects the quality of life of respondents is disability, which in many cases is diagnosed due to diabetes.

Objective: The aim of the study was to quantify the impact of disability on the declared quality of life in patients with diabetes and to compare the percentage of people with declared disability with the degree of disability among people with type 1 and type 2 diabetes.

Material and methods: The study was based on an internet survey posted on social groups related to diabetes on Facebook. The shortened version of the questionnaire measuring quality of life created by the World Health Organization (WHOQOL-Bref) and some self-created questions were used. The survey was completed by 139 respondents. 113 (81.3%) of them were diagnosed with type 1 diabetes mellitus, and 26 (18.7%) with type 2 diabetes mellitus.

Results: The subjective assessment of the quality of life in the entire group was moderate and totalled 3.5 ± 0.9 (on a scale from 1 to 5). The mean score of the physical domain of the WHOQOL-Bref was 48.9 ± 13.1, of the psychological domain was 55.2 ± 13.5, of the social domain was 60.8 ± 22.1, and of the environmental domain was 54.6 ± 14.5. 56.8% (79) of respondents were diagnosed with disability. 46 (58.2%) of them declared moderate disability. Disability was more frequently diagnosed in patients with type 1 diabetes compared to the group of patients with type 2 diabetes (67.3% vs. 11.5%; p<0.001). Very weak correlation was found between the duration of diabetes and particular domains of the WHOQOL-Bref questionnaire (r ranging from -0.107 to -0.017; p>0.05). The subjective quality of life and the level of satisfaction with health were moderate in the group of patients with type 1 diabetes and declared disability (3.5 ± 0.9), without disability (3.4 ± 0.9) and in the group of patients with type 2 diabetes without disability (3.7 ± 0.8). The mean scores of particular domains of the WHOQOL-Bref questionnaire were very similar in patients with type 1 diabetes, both with a disability certificate (physical domain 49.0 ± 13.6; psychological domain 55.3 ± 13.7; social domain 61.1 ± 22 .8; environmental domain 54.0 ± 14.7) and without (physical domain 48.8 ± 14.0; psychological domain 55.4 ± 13.9; social domain 63.1 ± 23.3; environmental domain 55 .4 ± 14.9), and in people with type 2 diabetes (physical domain 49.8 ± 10.4; psychological domain 56.3 ± 12.1; social domain 59.8 ± 19.1; environmental domain 57, 7 ± 11.4).

Conclusions: Disability was diagnosed more often in patients with type 1 than type 2 diabetes. The disability certificate in the group of patients with type 1 diabetes doe

Introduction: Improper maintenance of the cleanliness of sand in sandboxes can be a source of human pathogenic helminths, including Toxocara spp., Enterobius vermicularis, Ascaris lumbricoides, leading to parasitic infections.

Aim of the study: The purpose of this study was to evaluate the sanitary condition of sandboxes in playgrounds and recreational areas in Warsaw for the presence of Human roundworm (Ascaris lumbricoides) and Toxocara spp. in sand.

Material and methods: 450 sand samples from 90 sandboxes in the city of Warsaw were analyzed. The flotation method was used for the study, and the material was evaluated using a light microscope. RESULTS. The conducted examinations did not reveal the presence of parasite eggs, indicating that hygiene rules were observed and appropriate recommendations were followed.

Conclusions: The analyzed sand samples are free of the tested parasites.

Objectives: The aim of this study is to compare the epidemiological situation of legionellosis in Poland in 2018-2021 to prior years, taking into account the impact of the COVID-19 pandemic in 2020-2021.

Material and methods: The assessment is based on national surveillance data published in the annual bulletin "Infectious Diseases and Poisons in Poland" from 2013 to 2021, as well as data from Legionnaires' disease case reports collected and sent to the Department of Epidemiology of Infectious Diseases and Surveillance NIPH NIH - NRI by sanitary and epidemiological stations or submitted to EpiBase.

Results: In Poland, both Legionnaires' disease (an acute infection that progresses to pneumonia) and Pontiac fever (a mild, flu-like sickness) are reported. In 2018-2021, a total of 255 cases of legionellosis were registered, including 236 cases of Legionnaires' disease and 19 cases of Pontiac fever. Each year, there was an increase in the number of notifications compared to the annual median number of cases from 2013-2017. The annual incidence rate in 2019 (0.23 per 100,000 population) was the highest since the start of legionellosis case registration in Poland. It declined again during the years of the COVID-19 pandemic. The notifications occurred throughout the country, but the highest notification rate was observed in the western belt of voivodeships. Pomorskie reported the highest incidence, accounting for more than 20% of all registered cases. The median incidence of Legionnaires' disease in men (0.23 per 100,000) was more than twice that of women (0.10), with the highest incidence (0.58) recorded in men 65 years of age or older. All indigenous cases of Legionnaires' disease were sporadic; all but three patients were hospitalized. State Sanitary Inspection reported 26 fatal cases of Legionnaires' disease (mortality = 11%). Twenty-four cases were linked to contaminated water systems in health-care settings, and 21 cases were likely associated with travel abroad.

Summary and conclusions: Although the number of notifications has increased in recent years, Legionnaires' disease is still an infrequently diagnosed respiratory infection in Poland, and the reported incidence remains one of the lowest in the entire EU. The most affected demographic group is men aged 65 and older. Improving the early diagnosis of Legionnaires' disease in healthcare settings remains a priority.

Objective: Evaluation of the epidemiological situation of hepatitis B in Poland in 2021 compared to previous years, considering the impact of the COVID-19 pandemic.

Material and methods: Data from individual reports on hepatitis B cases and HBV infections registered by local sanitary and epidemiological stations in the EpiBaza system were analyzed. Aggregate data published in the annual bulletins: "Infectious diseases and poisonings in Poland", "Vaccinations in Poland" and data on deaths provided by the Demographic Surveys Department of Statistics Poland (GUS) were also used.

Results: In 2021, a total of 1,547 cases of hepatitis B were registered, including 10 cases of acute hepatitis B, with an incidence of acute hepB 0.03/100,000 population. The incidence of acute hepB was lower by 25% than in 2020 and lower by 75% than the median incidence for 2015-2019. Acute cases occurred only in 6 voivodeships, all in people over 28 years of age. Two out of 10 acute cases were classified as imported. In 2021, 1,537 chronic or unknown-phase cases (UNK) were reported and registered, the diagnosis rate was 4.03/100,000 and was higher by 58% than the rate in 2020 and lower by 53% than the median for 2015-2019. The distribution of cases by gender, age and place of residence was similar to that observed previously - chronic cases or UNK were diagnosed more often in men (male-to female ratio 1.5:1) and people living in cities. Two chronic infections have been reported in infants born to HBV-infected women. 2.5% of chronic and UNK cases were considered imported. According to Statistics Poland (GUS), 20 people died in 2021, including 3 due to acute hepatitis B. The vaccination coverage of 1-year-olds with 3 doses of hepatitis B vaccine (HepB3) decreased slightly compared to 2020 and amounted to 89.3%.

Conclusions: In the second year of the COVID-19 pandemic, a gradual levelling of the sharp decline in the number of diagnosed chronic and UNK cases that occurred in 2020 was observed. In acute cases, a further decline in incidence was noted compared to 2020, but a smaller number of acute cases was most likely due to the lower effectiveness of surveillance during the COVID-19 pandemic, rather than from an improvement in the epidemiological situation. The vaccination coverage of children in the second year of life (born in 2020) with the third dose of HepB vaccine continued to decline, although slightly.