Comparative Analysis of Symptomatology in Hospitalized Children with RSV, COVID-19, and Influenza Infections.

BACKGROUND The clinical course of respiratory syncytial virus (RSV), SARS-CoV-2, and influenza infections comprises many non-specific symptoms, which makes diagnosis difficult. The aim of this study was to retrospectively analyze the symptomatology of these infections in children and to search for correlations between them. MATERIAL AND METHODS A total of 121 children with a positive RSV (n=61), influenza (n=31), or SARS-CoV-2 (n=29) antigen test were enrolled in this retrospective analysis. Children were aged up to 71 months (median, 8 months). The collected data were collated by performing statistical analysis using the chi-square test and comparing the results using OR (odds ratio) and 95%CI (confidence interval). RESULTS There was a higher risk of fever in children with influenza than in those with RSV. Patients infected with RSV had a higher risk of nasal blockage than those with SARS-CoV-2. Dyspnea was more common in RSV infection than in influenza. Severe, sleep-awakening cough was more frequent in children with RSV than in those with COVID-19. Influenza was more prevalent in children aged >24 months than in those aged 7-24 months. RSV-infected children had a higher risk of numerous auscultatory changes compared to those with SARS-CoV-2. In the case of RSV infection, symptoms requiring hospitalization occurred later than in SARS-CoV-2 infection. CONCLUSIONS Children aged >24 months were at higher risk of contracting influenza. Numerous auscultatory changes, nasal blockage, and dyspnea were more common in children with RSV. There was a higher risk of dyspnea in children with RSV. Fever was more frequent in children with influenza. However, none of the symptoms clearly indicated the etiology of the infection.

An Analysis of the Incidence and Cost of Intracranial Aneurysm and Subarachnoid Haemorrhage Treatment between 2013 and 2021.

The incidence of unruptured intracranial aneurysms (UIAs) amounts to 3.2% among adults. The annual risk of aneurysm rupture is 2-10% and it results in subarachnoid haemorrhage (SAH). The aim of this study is to assess changes in the incidence of unruptured intracranial aneurysms and subarachnoid haemorrhages in Poland between 2013 and 2021 and the cost associated with their in-hospital treatment in the acute phase. The analysis was based on the National Health Fund database. Patients diagnosed with UIA and SAH and hospitalised between 2013 and 2021 were chosen. The statistical analysis was performed with an assumed significance level of α = 0.05. The ratio between the prevalence of SAH and UIA diagnoses was 4:6. The proportion of women in relation to men was higher in both diagnoses. The highest proportions of patients with diagnoses SAH and UIA were found in highly urbanised provinces. The value of medical services in 2021 compared to 2013 increased by 81.8%. The highest values in this period were recorded in Mazowieckie province, and the lowest were recorded in Opolskie province. The overall number of patients hospitalised with diagnosis of UIA or SAH did not decrease, but the risk of aneurysm rupture probably decreased, which resulted in lower incidence of SAH in subsequent years of observation. The recorded changes in the dynamics of the value of medical services per patient or per hospitalisation largely coincided. However, it is difficult to speculate on expected value levels as not all provinces showed linear changes in the value of services provided.

The COVID-19 Pandemic as an Impulse for the Development of Telemedicine in Primary Care in Poland.

Telemedicine gives a safe and effective way of providing healthcare. During the COVID-19 pandemic, it was possible to offer teleconsultations in primary care (Primary Care Teleconsultation-PCT). The study aimed to present an analysis of the PCTs served in the years 2020-2021 in the field of primary care in Poland to determine how the COVID-19 pandemic contributed to the development of telemedicine in primary care in Poland. The database, containing a list of medical services provided remotely obtained from the National Health Fund, was analyzed. Economic and tax indicators obtained from the Ministry of Finance were also analyzed. Personal Income Tax (PIT) value was used as an indicator of household wealth, and the Corporate Income Tax (CIT) was used as an indicator of economic activity in individual counties for 2019. Along with the COVID-19 pandemic, patients as healthcare beneficiaries can take advantage of previously unserved telemedicine services as part of primary care. The data analysis showed that, along with the introduced recommendations and restrictions in connection with the pandemic, the number of teleconsultations in 2021 increased compared to 2020. In response to the pandemic, an educational campaign targeted older patients. These indicate the most significant percentage of PCTs among patients aged 70 and older. The study shows that the awareness barrier in implementing services for the elderly population decreased significantly. There was a clear correlation between the increase in PCTs and patient age.

The impact of selected educational and information interventions on the coverage rate and attitudes to influenza vaccination in nursing staff.

BACKGROUND: Influenza vaccinations are recommended for medical staff as an effective and safe form of preventing influenza and its complications. The aim of the study was to assess the impact of selected educational and information interventions on the influenza vaccination coverage (IVC) in nursing personnel and their attitude towards this procedure. MATERIAL AND METHODS: The study participants (N = 320) were randomly divided into 4 groups. Group 1 participated in stationary training, whereas group 2 participated in distance learning. Additionally, 2 subgroups were established in each of the groups above: 1 subgroup received a reminder about the vaccination in the form of a short text message, and the other group did not receive any such reminder. The IVC rate in each group was determined; the attitude towards influenza vaccination was measured using the health belief model. RESULTS: The highest IVC was obtained after stationary training followed by a reminder in the form of a short test message (36%). The reminder significantly affected IVC in the group attending stationary training (p < 0.05, OR = 2.5, 95% CI: 1.16-5.58); however, it had no impact on the IVC in the group participating in distance learning (p > 0.05, OR = 1.2, 95% CI: 0.51-2.83). Both stationary training and distance learning positively influenced the attitude towards influenza vaccinations. A major change in attitudes towards influenza vaccinations was observed only in the case of stationary training followed by a reminder in the form of a short text message (positive changes in perceived susceptibility and severity took place, perceived vaccination benefits increased, and perceived barriers were reduced). CONCLUSIONS: Stationary training followed by a reminder in the form of a short text message is more effective in increasing the IVC rate compared to distance learning. It also promotes positive changes in attitudes to this prophylactic procedure, which is why it should be recommended for wider implementation. Med Pr. 2020;71(6):665-85.

[Influenza vaccine coverage rates in Polish nurses]. / Wykonawstwo szczepien przeciw grypie u personelu pielegniarskiego w Polsce.

Medical personnel, including nursing staff, can become a source of influenza virus infections for their patients and co-workers. However, patients can infect the personnel, too. Therefore, influenza vaccinations are recommended for medical staff as an effective and safe form of preventing influenza and its complications. AIM: The aim of the study was to evaluate the current influenza vaccine coverage rate in nursing personnel and identify of incentives and disincentives for the performance of influenza vaccinations in nursing staff. MATERIALS AND METHODS: The cross sectional study was carried out a group of 770 nurses, using the research questionnaire, previously validated. RESULTS: The influenza vaccine coverage rate in the study group was 15%. The probability of having a vaccination this season and in the previous seasons was higher in medical staff working in out-patient health care (p <0.05, OR 5.15, 95% CI 3.33-7.96), with work experience >40 years (p <0 , 05, OR 6.93, 95% CI 2.04-23.78), dealing with chronic diseases (p <0.05, OR 1.57, 95% CI 1.00-2.46). The most important encouraging factor for influenza vaccination was that the employer paid for the vaccine available in the workplace, the desire to protect oneself from the disease, the belief in the safety and efficacy of the vaccine. The most important factor discouraging vaccination against influenza was the lack of reimbursement of the vaccine and the inconvenience of its implementation in the workplace, as well as doubts related to the safety and effectiveness of the vaccine. CONCLUSIONS: The influenza vaccine coverage rate is very low and certain activities should be undertaken to increase it. Measures taken to increase the influenza vaccine coverage rate for nursing staff should be targeted and include identified disincentives and incentives for vaccination.

Evaluation of the Implementation of Hospital Antibiotic Policy in Oncosurgery Ward: A Six-Year Experience.

The hospital antibiotic policy should be implemented to rationalize the antibiotic use and to decrease the risk of spread of resistant bacteria. The aim of this study was to describe the antibiotic consumption patterns in a single oncosurgery ward before and after the implementation of hospital antibiotic policy. We conducted a retrospective analysis of the antibiotic use at the oncosurgery ward in Warsaw, Poland, in the years 2011-2016. Calculations were based on daily defined doses (DDD), DDD/100 hospitalizations, and DDD/100 person-days. Drug utilization rates (DU 90% and DU 100%) were also analyzed. After the implementation of hospital antibiotic policy, a total antibiotic consumption increased (365.35 DDD in 2011 vs. 1359.22 DDD in 2016). A significant change was observed in the antibiotic consumption patterns: the use of amoxicillin clavulanate and carbapenems or glycopeptides decreased significantly (p < 0.05), while the use of ciprofloxacin and aminoglycosides increased (p < 0.05). The DU100% rate varied from 6 in 2011 to 12 in 2016; while DU 90% rate varied from 2 in 2011 to 3-5 in 2013-2016. Although the implementation of hospital antibiotic policy did not result in a decrease in the antibiotic consumption, it seems to provide a favorable change into the antibiotic consumption pattern.

Rapid Influenza Diagnostic Tests Improve Suitability of Antiviral Treatment in Hospitalized Children.

Influenza may have a complicated course in young children. The aim of the study was to analyze the suitability of influenza treatment among children younger than 5 years hospitalized due to an influenza-like illness. We conducted a comparison of the treatment among children hospitalized in two consecutive years: 2015, when no rapid influenza diagnostic tests (RIDT) were in use, and 2016, when RIDT were implemented into a routine practice in the pediatric ward. In both seasons, nasopharyngeal swabs were collected and examined with real time qRT-PCR. In the 2015 season, influenza was diagnosed in 15/52 (28 %) children and none of them received oseltamivir, while 14/15 (93 %) patients received antibiotics. In the 2016 season, influenza was diagnosed in 11/63 (17 %) children, 7/11 (64 %) of them received oseltamivir and another 7/11 (64 %) received antibiotics. In four cases antibiotics overlapped oseltamivir. These differences in the use of oseltamivir and antibiotics were statistically significant (p < 0.05). We conclude that the implementation of RIDT improves the suitability of influenza treatment and decreases the frequency of antibiotic therapy. RIDT should be available in pediatric departments to optimize influenza treatment.