"A Comparative Analysis of the Number of Organ Retrievals in Relation to Potential Donation Qualifications in Populations of Patients From a Single Anesthesiology and Intensive Care Unit in 2017-2018".

The population of patients declared as brain dead and qualified for organ donation is relatively low in Poland. The main causes of brain death include cerebral vascular diseases and brain trauma (54 and 34%, respectively, according to Poltransplant registry data). The number of organ procurements in Poland is constantly recorded on average at 14 donations per 1 million citizens (14/mln) in 2017 and 12 donations per one million in 2018. It is difficult to precisely define the number of patients who meet the criteria for brain death certification. The authors have retrospectively analyzed the medical data of 229 patients from 2017 and 2018 records with the aim of identifying potential organ donors among patients of the Intensive Care Unit (ICU) in the University Hospital in Western Poland. Brain death was suspected in 53 patients (23.14%). Brain imaging to confirm no cerebral flow (which is consistent with brain death) was performed in 17 patients (7.45%) and this, as a result, led to organ donation in 9 cases (3.93%). The factors identified as having a positive influence on organ donation included: daily thorough physical examination, (Glasgow Coma Scale) GCS assessment, depth and duration of sedation, ICU length of stay and early performance of a CT-angiogram.

Systemic Inflammatory Predictors of In-Hospital Mortality in COVID-19 Patients: A Retrospective Study.

The purpose of this study was to investigate whether routine blood tests and clinical characteristics can predict in-hospital mortality in COVID-19. Clinical data of 285 patients aged 59.7 ± 10.3 yrs. (males n = 189, females n = 96) were retrospectively collected from December 2020 to June 2021. Routine blood tests were recorded within the 1st hour of admission to hospital. The inflammatory variables, such as C-reactive protein (CRP), procalcitonin (PCT), neutrophils−lymphocyte ratio (NLR) and the systemic inflammatory index (SII), exceeded the reference values in all patients and were significantly higher in deceased patients (n = 108) compared to survivors (n = 177). The log-rank test for comparing two survival curves showed that patients aged ≥60.5 years, with PCT ≥ 0.188 ng/mL or NLR ≥ 11.57 103/µL were at a greater risk of death. NLR demonstrated a high impact on the COVID-19 mortality (HR 1.317; 95%CI 1.004−1.728; p < 0.05), whereas CRP and SII showed no effect (HR 1.000; 95%CI 1.000−1.004; p = 0.085 and HR 1.078; 95%CI 0.865−1.344; p = 0.503, respectively). In the first Polish study including COVID-19 patients, we demonstrated that age in relation to simple parameters derived from complete blood cell count has prognostic implications in the course of COVID-19 and can identify the patients at a higher risk of in-hospital mortality.

Management practices and their relation to success of Polish SMEs: The empirical verification.

PURPOSE: The aim of the paper is to identify management practices that are characteristic for SMEs that achieve market success measured by their business performance in last their years of their operation analyze the relationships between management practices applied in small and medium-sized enterprises and their success measured by their business performance drawing on the data from 2710 SMEs operating on the Polish market. APPROACH/METHODOLOGY/DESIGN: A cluster analysis was used to distinguish homogenous SME groups in view of their management practices. We examined differences between groups in terms of their business performance. The HINoV algorithm allowed six variables to be selected out of 32 management practices chosen initially for testing, with these variables providing the basis for grouping. Modal values and medians were calculated for 17 business performance measures in the three clusters produced. The subsequent analysis of those findings was focused on capturing significant differences. FINDINGS: In the group of 2710 Polish SMEs, it was possible to verify that there existed an association between management practices in the field of modern HRM, computer systems supporting management and the company's economic performance, as measured by an increase in net revenue and number of customers over the last three years. In clusters where the above mentioned practices were appreciated, modal and median values of the increase reported in net revenue and number of customers were significantly higher. PRACTICAL IMPLICATIONS: The research has shown that at a time marked by a shortage of highly skilled personnel one should pay particular attention to building an integrated and committed team of workers and to employee empowerment. The research has also shown that SME managers monitor only a fraction of basic business performance measures, which may prove to be a major risk to SMEs. ORIGINALITY/VALUE: Previous studies have been largely conducted in a fragmentary manner, i.e. they were concerned with the relationships between the application of some practices (strategic management, BPR, entrepreneurial orientation, monitoring, etc.) and selected business effectiveness measures. In this paper, the research covered SME management practices from a variety of areas which were then compared with the entrepreneurs' assessment as to whether the company's economic condition changed over the last three years. It is also the first attempt in post-socialist economies to identify those SME management practices that are related to better economic results.

Endourology Methods in Pediatric Population for Kidney Stones Located in Lower Calyx: FlexURS vs. Micro PCNL (MicroPERC®).

Kidney stone disease in children is always a therapeutic challenge. It is a multifactorial condition and it should be approached, diagnosed and treated as such. One of the biggest challenges is kidney stones located in the lower renal calyx. There are currently three main surgical techniques to treat this condition: ESWL-Extracorporeal Shock Wave Lithotripsy, RIRS-Retrograde IntraRenal Surgery, and PCNL-PerCutaneous Nephro-Lithotripsy. In pediatric population, the most frequently used method is ESWL, and in the event of failure, endoscopic procedures are the second-best choice. In this article, a sample of 53 children admitted to a tertiary medical center was examined. Thirty-eight of those children underwent flexible URS, while the remaining 15-micro PCNL. The average size of the deposit in the former group was 12.2 mm, against 13.5 mm in the latter. The full Stone Free Rate (SFR) was achieved in RIRS at 84.21 and 86.7% in percutaneous nephrolithotripsy. Flexible ureterorenoscopy and MicroPERC are two comparably effective methods for treating lower calyx stones of any size. However, according to our data, flexible ureterorenoscopy carries a lower risk of complications and inpatient care (with the mean of 3 days). The learning curve for these procedures in pediatric urology is long and relies on a limited number of patients. The number of pediatric patients qualifying for these procedures is restricted also due to the high efficacy of extracorporeal shock wave lithotripsy in pediatric population. Radiation exposure is an important factor in every endoscopy procedure and should never exceed the limits set in the ALARA protocol. ESWL remains to this day the treatment of choice for stone disease in children and can be performed under ultrasound control. For many parents, it is a first-choice treatment preference for their child due to its greater apparent safety, although data on this remains insufficient. Prospective, randomized, multicenter trials are definitely needed.

Extended Phylogeny and Extraintestinal Virulence Potential of Commensal Escherichia coli from Piglets and Sows.

Commensal Escherichia coli, naturally occurring in the intestinal tract, can be the origin of extraintestinal pathogenic E. coli (ExPEC) strains. ExPEC causes high mortality and significant economic losses in the swine industry in several countries and poses a serious threat to public health worldwide. The aim of this study was to analyze the extended phylogenetic structure and extraintestinal virulence potential in two groups of commensal E. coli isolates from post-weaning piglets and sows. The phylogenetic assignment to eight groups was determined using the revised Clermont phylogenetic typing method in quadruplex PCR. Identification of extraintestinal virulence genes (VGs) and adhesin operon genes was performed using multiplex or simplex PCR. The revised phylogenetic assignment allowed us to distinguish E. coli with significantly higher (groups C and F) or lower (group E) virulence potential in isolates from piglets. The majority of the tested VGs occurred more frequently in isolates from piglets than from sows, with statistically significant differences for seven genes: fimH, papAH, iutA, iroN, ompT, traT, and iss. Complete operons for type I and P fimbriae significantly prevailed among E. coli from piglets. This study provides insight into the extended phylogenetic structure of porcine commensal E. coli and showed that these strains, particularly from piglets, constitute a considerable reservoir of extraintestinal VGs and may increase the potential risk of extraintestinal infections.

Comparison of Commensal Escherichia coli Isolates from Adults and Young Children in Lubuskie Province, Poland: Virulence Potential, Phylogeny and Antimicrobial Resistance.

Commensal Escherichia coli population is a dynamic structure which may be important in the pathogenesis of extraintestinal infections. The aim of this study was the comparison of genetic diversity of commensal E. coli isolates from two age group-adults and young children. E. coli strains were isolated on MacConkey agar and identified by biochemical tests. Determination of four major phylogenetic groups, identification of virulence genes and antimicrobial resistance determinants were performed by using multiplex or simplex PCR. Phenotypic analysis of resistance was based on disc-diffusion method. The prevalence of virulence genes was significantly higher among isolates from adults than from young children. Phylogroup B2 predominated among E. coli from adults, whereas phylogroup A was the most common in isolates from young children. The analyses of antimicrobial resistance revealed that resistance to at least one antimicrobial agent and multidrug-resistance were detected significantly more frequent in the isolates from adults than from young children. This study documented that the commensal E. coli isolates from adults showed greater genetic diversity than from young children and constitutes a substantial reservoir of the virulence genes typical for extraintestinal pathogenic E. coli.

Prevalence of virulence determinants and antimicrobial resistance among commensal Escherichia coli derived from dairy and beef cattle.

Cattle is a reservoir of potentially pathogenic E. coli, bacteria that can represent a significant threat to public health, hence it is crucial to monitor the prevalence of the genetic determinants of virulence and antimicrobial resistance among the E. coli population. The aim of this study was the analysis of the phylogenetic structure, distribution of virulence factors (VFs) and prevalence of antimicrobial resistance among E. coli isolated from two groups of healthy cattle: 50 cows housed in the conventional barn (147 isolates) and 42 cows living on the ecological pasture (118 isolates). The phylogenetic analysis, identification of VFs and antimicrobial resistance genes were based on either multiplex or simplex PCR. The antimicrobial susceptibilities of E. coli were examined using the broth microdilution method. Two statistical approaches were used to analyse the results obtained for two groups of cattle. The relations between the dependent (VFs profiles, antibiotics) and the independent variables were described using the two models. The mixed logit model was used to characterise the prevalence of the analysed factors in the sets of isolates. The univariate logistic regression model was used to characterise the prevalence of these factors in particular animals. Given each model, the odds ratio (OR) and the 95% confidence interval for the population were estimated. The phylogroup B1 was predominant among isolates from beef cattle, while the phylogroups A, B1 and D occurred with equal frequency among isolates from dairy cattle. The frequency of VFs-positive isolates was significantly higher among isolates from beef cattle. E. coli from dairy cattle revealed significantly higher resistance to antibiotics. Some of the tested resistance genes were present among isolates from dairy cattle. Our study showed that the habitat and diet may affect the genetic diversity of commensal E. coli in the cattle. The results suggest that the ecological pasture habitat is related to the increased spreading rate of the VFs, while the barn habitat is characterised by the higher levels of antimicrobial resistance among E. coli.