OBJECTIVE: Reporting epidemiological data on prehospital cardiac arrest in the Pilsen Region in 2022. Expression of cardiopulmonary resuscitation success using the Cerebral Performance Category (CPC) score. MATERIALS AND METHODS: The study looked at the survival rate of out-of-hospital sudden cardiac arrest in all patients in whom emergency medical services performed cardiopulmonary resuscitation (CPR). The study covered the period from 1 January 2022 to 31 December 2022. Both electronic and paper medical records were used to obtain data. All cases were evaluated according to Utstein-style guidelines. RESULTS: During the studied period, emergency response teams in the Pilsen Region carried out CPR in 499 cases. The incidence of prehospital CPR was 88.43 cases per 100,000 population. A total of 146 patients (29.26%) were referred to the hospital with spontaneous circulation, and results indicating survival with a good neurological outcome of CPC 1 or 2 were recorded in 48 cases (9.62%). The first monitored rhythm was shockable in 119 cases (23.85%). In this subgroup, ROSC was achieved in 71 cases (59.66%) and 61 of them (51.26%) were referred to hospital. In this study subgroup, a total of 36 patients (30.25%) achieved a good neurological outcome with a CPC score of 1 or 2. CONCLUSION: The study presented epidemiological data on OHCA and prehospital CPR in the Pilsen region in 2022. The data obtained shows a survival rate with good neurological outcome in 9.62% of cases.
Bacterial meningitis is a serious infectious disease of the cerebral meninges, which occurs worldwide and threatens the lives of people of all ages. The largest number of cases in developed countries is caused by the gram-positive bacterium Streptococcus pneumoniae. Other more common agents are Neisseria meningitidis serotype B and Listeria monocytogenes. Fever is the most commonly reported symptom in paediatric patients, occurring in up to 93% of cases. Further, it is possible to observe headache, vomiting and positive meningeal phenomena. The most common symptoms in adults are fever, headache, positive meningeal symptoms and impaired consciousness. Examination of cerebrospinal fluid is essential for the diagnosis of bacterial meningitis. The basis of treatment is the earliest possible administration of antibiotics, initially empirically and then purposefully according to the results. Corticosteroids, traditionally dexamethasone, are also used in therapy.
- MeSH
- antibakteriální látky terapeutické užití MeSH
- bolesti hlavy farmakoterapie MeSH
- dítě MeSH
- dospělí MeSH
- horečka MeSH
- lidé MeSH
- Listeria monocytogenes * MeSH
- meningitida bakteriální * diagnóza farmakoterapie mikrobiologie MeSH
- Streptococcus pneumoniae MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: We present a rare case of status epilepticus in a 56-year-old man which arose as a complication after vaccination with the coronavirus disease 2019 (COVID-19) mRNA-1273 vaccine. The patient's history included well-compensated secondary epilepsy. The root cause of the situation was a fever which had developed as a side effect of the vaccination. CASE SUMMARY: A 56-year-old man received the first dose of mRNA-1273 vaccine against the severe acute respiratory syndrome-coronavirus-2. The vaccine was administered intramuscularly (100 mg, 0.5 mL). The next morning the man was found to be suffering from fever and headaches while at the same time experiencing general weakness. He lost consciousness suddenly and experienced generalized clonic seizures which turned into status epilepticus. When the Emergency Medical Service arrived the patient was unconscious with spontaneous breathing and generalized clonic seizures. It was necessary to administer diazepam repeatedly. It was also necessary to administer high doses of levetiracetam and temporary propofol. The status epilepticus was brought under control approximately 90 min after the patient's transport to the Emergency Department. A follow-up electroencephalogram no longer revealed abnormal indications of epileptic fit. The patient was temporarily hospitalized in the Intensive Care Unit and after seven days care was discharged without any further apparent effects. CONCLUSION: There is currently no specific treatment against COVID-19. Therefore, the benefits of COVID-19 vaccine protection outweigh the risks.
- Publikační typ
- kazuistiky MeSH
AIMS: To acquire epidemiological data on pre-hospital cardiac arrest incidents occurring in the Pilsen Region of the Czech Republic in 2018, and the results of subsequent cardiopulmonary resuscitation Methods. A prospective observational study of the survival rate of out-of-hospital cardiac arrest (OHCA) in patients undergoing CPR carried out by emergency medical service personnel. The observed time period was from January 1st, 2018 until December 31st, 2018. The data were acquired from patients' records in paper and electronic forms. RESULTS: In the monitored period 707 patients with signs of cardiac arrest were recorded in the Pilsen Region with an incidence rate of 128.9 per 100,000 inhabitants. Emergency medical units performed CPR in 484 cases. The incidence rate of pre-hospital CPR was 88.2 cases per 100,000 inhabitants. Spontaneous blood circulation was temporarily or permanently restored in 276 patients (57.0%), 203 (41.9%) patients were transferred to a hospital, and there were 61 (12.6%) cases of survival with Cerebral Performance Category (CPC) score of 1 or 2. The first monitored rhythm was a shockable in 134 (27.7%) cases. In this sub-group ROSC was achieved in 94 (70.1%) cases and 58 (43.3%) of those were subsequently transferred to a hospital. A good CPC result was achieved in 41 (30.6%) patients of this sub group. CONCLUSION: The study has provided valuable epidemiological data on OHCA and prehospital CPR in the area of the Pilsen Region in 2018. The collected data, compared to international results, show a higher survival rate with good neurological score in 12.6% of cases.
- MeSH
- dítě MeSH
- dospělí MeSH
- kardiopulmonální resuscitace * MeSH
- kojenec MeSH
- lidé středního věku MeSH
- lidé MeSH
- míra přežití MeSH
- mladiství MeSH
- mladý dospělý MeSH
- předškolní dítě MeSH
- prospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- zástava srdce mimo nemocnici epidemiologie terapie MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- kojenec MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
- Geografické názvy
- Česká republika MeSH
COVID-19 je infekční onemocnění způsobené novým koronavirem SARS-CoV-2. Poprvé bylo prokázáno v poslední čtvrtině roku 2019 v Číně. U příznakových pacientů v klinickém obrazu většinou dominují horečka, kašel, dušnost, celková slabost a únava. U pacientů s těžším průběhem se na podkladě virové pneumonie může rozvinout akutní respirační selhání a stav může progredovat až do obrazu ARDS (Acute respiratory distress syndrome). Mezi rizikové skupiny patří senioři, diabetici, hypertonici. Závažným faktorem je také obezita nebo přítomnost imunodeficitu. U pacientů se vyskytují i mnohé další příznaky mimo respirační trakt, jak ukazují námi představené kazuistiky. Je možné se setkat s gastrointestinálními obtížemi, různě lokalizovanými bolestmi, neurologickými příznaky nebo třeba exantémem. O to složitější je pro lékaře diagnostika onemocnění COVID-19 jen podle klinického obrazu.
COVID-19 is an infectious disease caused by the new coronavirus SARS-CoV-2. It was demonstrated in the last quarter of 2019 in China at first. In the clinical picture by symptomatic patients dominate fever, cough, shortness of breath, total weakness and tiredness. Acute respiratory failure on the basis of viral pneumonia can develop in patients with more severe course and the condition can progress up to ARDS (Acute respiratory distress syndrome). Risk groups include the elderly and patients with diabetes and hypertension. Obesity or the presence of immunodeficiency is also a serious factor. There are many other symptoms in patients outside the respiratory tract, as shown by our presented case reports. It is possible to encounter gastrointestinal problems, variously localized pains or even an exanthema. It is even more complicated for doctors to diagnose COVID-19 disease just according to clinical picture.
COVID-19 je infekční onemocnění způsobené novým koronavirem SARS-CoV-2. Poprvé bylo prokázáno v poslední čtvrtině roku 2019 v Číně. U příznakových pacientů v klinickém obrazu většinou dominují horečka, kašel, dušnost, celková slabost a únava. U pacientů s těžším průběhem se na podkladě virové pneumonie může rozvinout akutní respirační selhání a stav může progredovat až do obrazu ARDS (Acute respiratory distress syndrome). Mezi rizikové skupiny patří senioři, diabetici, hypertonici. Závažným faktorem je také obezita nebo přítomnost imunodeficitu. U pacientů se vyskytují i mnohé další příznaky mimo respirační trakt, jak ukazují námi představené kazuistiky. Je možné se setkat s gastrointestinálními obtížemi, různě lokalizovanými bolestmi, neurologickými příznaky nebo třeba exantémem. O to složitější je pro lékaře diagnostika onemocnění COVID-19 jen podle klinického obrazu.
COVID-19 is an infectious disease caused by the new coronavirus SARS-CoV-2. It was demonstrated in the last quarter of 2019 in China at first. In the clinical picture by symptomatic patients dominate fever, cough, shortness of breath, total weakness and tiredness. Acute respiratory failure on the basis of viral pneumonia can develop in patients with more severe course and the condition can progress up to ARDS (Acute respiratory distress syndrome). Risk groups include the elderly and patients with diabetes and hypertension. Obesity or the presence of immunodeficiency is also a serious factor. There are many other symptoms in patients outside the respiratory tract, as shown by our presented case reports. It is possible to encounter gastrointestinal problems, variously localized pains or even an exanthema. It is even more complicated for doctors to diagnose COVID-19 disease just according to clinical picture.
Femorální kýly tvoří pouze 0,7 % všech operovaných kýl, u mužů jsou spíše vzácností. Oproti tomu akutní apendicitida je jednou z nejčastějších chirurgických diagnóz vyžadujících někdy neodkladnou operaci. Autoři v této práci prezentují jeden z raritních případů, kdy obě tyto diagnózy jdou ruku v ruce – De Garengeotovu hernii a apendicitidu. Inkarcerovaná femorální kýla s nálezem akutní apendicitidy je předoperačně stanovena velmi výjimečně. V diagnostice mohou pomoci zobrazovací metody, avšak často konečnou diagnózu a především konečné řešení přináší jen chirurgický zákrok.
Femoral hernias account for only about 0.7% of all operated hernias and are rather infrequent among male patients. By contrast, acute appendicitis is one of the most frequent diagnoses in surgery requiring urgent operation. The authors present one of the rare cases in which both these diagnoses occur together – De Garengeot's hernia. Incarcerated femoral hernia with acute appendicitis is diagnosed preoperatively only sporadically. Imaging methods can help in the diagnosis, but often the final diagnosis, and especially the final solution, is brought about only by surgical intervention.
- MeSH
- apendektomie MeSH
- apendicitida * diagnóza chirurgie MeSH
- chirurgie operační MeSH
- diferenciální diagnóza MeSH
- femorální hernie * diagnóza chirurgie terapie MeSH
- gangréna MeSH
- lidé středního věku MeSH
- lidé MeSH
- počítačová rentgenová tomografie MeSH
- příznaky a symptomy MeSH
- retrospektivní studie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
