Przegla̧d epidemiologiczny
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Historical Article
[National Institute of Hygiene--as I saw it before nearly half-century ago].
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Analysis of clinical picture in children hospitalized because of suspicion of neuroborreliosis and evaluation of usefulness of testing serum and cerebrospinal fluid (CSF) for specific antibodies. ⋯ Meningitis in the course of neuroborreliosis is not always accompanied by meningeal signs. Positive serology is not an unequivocal confirmation of neuroborreliosis especially if symptoms are nonspecific (e.g. headache).
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Measles is still one of the leading causes of children mortality, despite of availability of a cheap, effective and safe vaccine for more than 40 years. Effective global eradication of smallpox and the success of polio eradication have provided an incentive to achieve the measles eradication all over the world. Elimination is achieved when no endemic measles cases has been observed in given area. ⋯ The National Laboratory in Poland is based at the Department of Virology in National Institute of Hygiene, Warsaw. Following the implementation of 2-dose measles vaccine schedule the epidemiologic situation of measles has improved. In 2006 results of genotyping indicate that recent outbreaks were caused by local strains of the virus (D4 and D5).
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Currently, the Polish Society of Hospital Infections is coordinating a national program of active surveillance of nosocomial infections. One of its elements is the control of hospital acquired pneumonia (PNEU) on Intensive Care Units. This paper analyzes the epidemiology and etiology of hospital acquired pneumonia (PNEU) at the Intensive Care Units (ICU). ⋯ The average cumulative incidence of PNEU was 5.6% (median 4.9%), incidence density of Ventilator Associated Pneumonia (VAP) on average reached 17.9 per thousand (median 18.8 per thousand); mortality of patients with PNEU totaled 12.6% and for patients on ventilator and with coexisting infections 15.0% and 20%, respectively--it wasn't high enough to be statistically significant. Dominant etiologic factors of hospital acquired pneumonia in patients with a risk factor were Pseudomonas aeruginosa and Escherichia coli Methicillin-resistant Staphylococcus aureus(MRSA) comprised 21.1% of isolated S. aureus strains. The analyzes in this paper show that it's possible to effectively implement uniform methods of detection, qualification and analysis in relatively new settings at Polish hospitals, where tools of modern hospital epidemiology are only used since the mid 90-ties.
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The paper presents contemporary definitions and guidelines for management of severe sepsis and septic shock in neonates. We discuss main directions of hemodynamic resuscitation, antibacterial and supportive treatment. Pathophysiological differences of septic shock in this group of patients were described.