Enteritis and Severe Abdominal Pain as the First Presentation of Covid-19.

Presentation A male patient with no significant past medical history presented to emergency department with progressive in severity abdominal pain, associated with mild nausea and diarrhea. No other significant symptoms were reported. Diagnosis On investigation with CT, duodenojejunitis was diagnosed as the cause of abdominal pain. Lung basal changes were also visualized and subsequently proven to be secondary to Covid-19 infection. Treatment After few days of hospitalization and supportive treatment, the patient improved clinically and was discharged. Conclusion Covid-19 infection typically presents with respiratory symptoms associated with fever and myalgia. Anorexia, diarrhea and nausea have been reported. Severe abdominal pain is rare, particularly as the initial presenting compliant. It is important to be aware of the varied clinical presentations that may occur in Covid-19, including isolated gastrointestinal symptoms. This will allow to increase the timely detectability of infected patients and more effective contact control measures.

Current status of fungal cell wall components in the immunodiagnostics of invasive fungal infections in humans: galactomannan, mannan and (1-->3)-beta-D-glucan antigens.

Early diagnosis of fungal infections and the implementation of appropriate treatment represent major issues for clinicians, nowadays. Histopathological demonstration of microorganisms in tissue specimens or growth of fungal agents in culture media is still considered the "gold standard", but obtaining such specimens may be difficult. Several groups have investigated serological assays for cell wall elements unique to fungal organisms in serum or other body fluids to improve diagnostics in patients with haematological malignancies or undergoing haematopoietic stem-cell transplantation. In this review we have concentrated on the currently available assays allowing for detection of highly immunogenic components of fungal cell wall: galactomannan, mannan, and also (1-->3)-beta-D-glucan. Rapid serological tests appear to be useful for screening high-risk haematological patients, since they allow for the early diagnosis of invasive fungal infections, including infections with the most common pathogens such as Aspergillus and Candida. Based on current literature, factors increasing the probability of obtaining false-positive or false-negative results detected by each test were also analysed and tabulated.

[Compliance to treatment recommendations in patients with obstructive sleep apnea at least one year after diagnosis]. / Stosowanie sie do zalecen leczniczych chorych na obturacyjny bezdech senny (OBS) w co najmniej rok po ustaleniu rozpoznania.

UNLABELLED: 102 OSA patients, qualified for nCPAP treatment at least one year ago were investigated by questionnaire and direct examination. CPAP device has been used by 76 patients (75%). Other subjects (26 persons) did not use it for various reasons. Subjects treated (Group L) and not treated (Group NL) were compared. Before qualifying for nCPAP treatment, Group L compared to Group NL, had significantly higher apnoea/hyponoea index, AHI (p < 0.001) and more severe hypoxaemia during sleep (p < 0.01). Subjects of Group L were more obese (p < 0.01) and smoked more cigarettes per day (p < 0.05) than Group NL. Group L patients have been using nCPAP for 6.3 +/- 0.2 nights per week and 6.4 +/- 0.2 hours per night. From variables characterizing OSA and obesity, the intensity of nCPAP usage positively correlated with AHI (p < 0.05) and negatively with severity of daytime sleepiness (p < 0.001). Among Group L patients, 93% reported general improvement, 84% woke up refreshed and rested in the morning and 70% did not feel sleepy during the daytime. Concentration improved in 66% of treated patients. Main complaints were associated with rhinitis (38%), uncomfortable mask (34%) or air leaks around the mask (26%), dryness in throat and nose (33%), shallow, unquiet sleep with frequent awakenings (about 31%), chest pain (23%) or headache (22%). 33% of subjects complained of machine noise, troubling sleep partner. CONCLUSIONS: The acceptance of nCPAP treatment was 75% and depended on the OSA severity. nCPAP device was effective in OSA treatment, mild side effects were reported by around one third of studied patients.

[Hospital acquired pneumonia--analysis of frequency and etiology in Polish hospitals in 1998]. / Szpitalne zapalenia pluc--analiza czestosci wystepowania oraz czynników etiologicznych tego zakazenia w Polskich szpitalach w 1998 roku.

Hospital-acquired pneumonia (HAP) is one of the most frequently occurring hospital infections in the world. This study describes the incidence of HAP in Poland, as well as the specific risk factors leading to this type of infection in Polish hospitals; including those of patient age, length of hospitalization, and use of mechanical ventilation. The epidemiology of HAP as well as treatment resistance of various causal organisms was studied. Data for this study was acquired from the Registry of Hospital-acquired Infectious Diseases for the year 1998. Out of 329,608 hospital-acquired infections in all patients except newborns, 920 were found to be HAP. This study showed that of every 1000 hospital admissions three patients developed HAP (0.3%). Death occurred in 260 of 920 HAP cases or 30%; and HAP found to be the direct cause of death in 66 of the 260 cases (25%). The greatest incidence of HAP was found to occur in patients older than 75 years, was directly related to the length of hospital stay, and was higher in patients on mechanical ventilation longer than 10 days. The most frequently isolated causal agents were the Gram-negative rods (Pseudomonas aeruginosa, Acinetobacter sp., Klebsiella sp., Enterobacter sp.), and Staphylococcus aureus. Streptococcus pneumoniae and Haemophilus influenzae were found in only 2% and 4% of cases, respectively, and thus were the least likely causes of HAP in this population. It was found that the percentage of methicillin-resistant strains of Staphylococcus aureus was very high (55% to 60%); vancomycin-resistant enterococci were only found in patients who did not undergo surgery. The isolated strains of Pseudomonas aeruginosa showed marked resistance to chinolones (58-76%) and to imipen (approximately 20%). In the Enterobacteriaceae family, Klebsiella sp. was found to be resistant to third-generation cephalosporins (56-73%) and Enterobacter sp. resistant in 55% to 81% of the isolates.

[The effect of long-term therapy of obstructive sleep apnea syndrome with CPAP for symptoms of daytime sleepiness]. / Wplyw dlugotrwalego leczenia obturacyjnego bezdechu sennego za pomoca CPAP na objawy sennosci dziennej.

The study was undertaken to investigate whether a long-term CPAP therapy improves the symptoms of daytime sleepiness in patients with the obstructive sleep apnoea syndrome. Seventy six patients (72 men and 4 women) with AHI = 53(+/- SE = 3), BMI 35 (+/- SE = 0.8), mean age 46.3 (+/- SE = 11.4) have undergone CPAP therapy for at least one year (mean: 2.48 +/- SE = 0.33). The aggravation of alterations of the daytime sleepiness was estimated using the questionnaire from Sleep Laboratory at the Marburg University and the Epworth Sleepiness Scale (ESS). After the CPAP therapy, we have observed the decrease of the symptoms of the excessive daytime sleepiness (p < 0.001). Negative correlation between CPAP compliance and ESS outcome was observed (r = 0.4; p < 0.001). There was not correlation between the term of using CPAP and the degree of the complaints decrease.

Direct analysis of lead in fruit juice by anodic stripping voltammetry with no prior sample preparation.

A method is presented for determining lead in fruit juice in less than 3 min after instrument calibration. The range examined is 0.01 to 1.3 ppm lead. The method is compared with 3 other methods in general use. Standard error of estimates between the methods compared range from 0.023 to 0.051 ppm for a set of 50 samples and from 0.037 to 0.091 ppm for a set of 9 samples. Regression correlation coefficients between methods range from 0.968 to 0.995. Judged by the comparisons, the direct method is precise and accurate over greater than a 100-fold range of lead concentrations.