Neurogenic Pulmonary Edema in Aneurysmal Subarachnoid Hemorrhage.

Neurogenic pulmonary edema (NPE) is observed in cerebral injuries and has an impact on treatment results, being a predictor of fatal prognosis. In this study we retrospectively reviewed medical records of 250 consecutive patients with aneurysmal subarachnoid hemorrhage (SAH) for the frequency and treatment results of NPE. The following factors were taken under consideration: clinical status, aneurysm location, presence of NPE, intracranial pressure (ICP), and mortality. All patients had plain- and angio-computer tomography performed. NPE developed most frequently in case of the aneurysm located in the anterior communicating artery. The patients with grades I-III of SAH, according to the World Federation of Neurosurgeons staging, were immediately operated on, while those with poor grades IV and V had only an ICP sensor's implantation procedure performed. A hundred and eighty five patients (74.4 %) were admitted with grades I to III and 32 patients (12.8 %) were with grade IV and V each. NPE was not observed in SAH patients with grade I to III, but it developed in nine patients with grade IV and 11 patients with grade V. Of the 20 patients with NPE, 19 died. Of the 44 poor grade patients (grades IV-V) without NPE, 20 died. All poor grade patients had elevated ICP in a range of 24-56 mmHg. The patients with NPE had a greater ICP than those without NPE. Gender and age had no influence on the occurrence of NPE. We conclude that the development of neurogenic pulmonary edema in SAH patients with poor grades is a fatal prognostic as it about doubles the death rate to almost hundred percent.

Vaccination status and perception of influenza vaccination in the Polish population.

Influenza is still considered to be the most dangerous infectious disease of the twenty-first century. Outbreaks of influenza occur worldwide and affect all ages. The disease is severe, often with threatening complications and can lead to death, albeit many people have it in disregard. One of the main ways of preventing the disease is vaccination. The most effective method of prevention against influenza illness and its complications are annual vaccinations. Vaccinations, although recommended by the Ministry of Health in Poland, are not subject to refund. This paper presents the results of research conducted with the use of an anonymous questionnaire containing 18 questions to be completed by parents of school children, students of technical and medical universities, patients, medical staff, and people over 65 years of age. The study was conducted in the season of 2012/2013 in Poland. The survey involved 1,203 people in various age groups with different educational background. The analysis of the study shows that respondents very rarely use this form of prevention. Even if the vaccination were refunded, the percentage of people vaccinated against influenza would not increase significantly. Among the respondents, those who are in favor of influenza vaccination are in the minority.