Cieľ: Hlavným cieľom práce bolo posúdiť prípady peripartálnych hysterektómií v súvislosti s morbídne adherentnou placentou v Slovenskej republike. Súbor a metodika: Retrospektívne boli analyzované prípady morbídne adherentnej placenty riešené peripartálnou hysterektómiou v Slovenskej republike od 1. januára 2012 do 31. decembra 2020. Údaje boli získané zo štandardizovaných anonymných dotazníkov. Výsledky: Incidencia morbídne adherentnej placenty bola 0,39 na 1 000 pôrodov. Peripartálna hysterektómia bola vykonaná u 151 (89,9 %) žien s morbídne adherentnou placentou (38,0 % všetkých peripartálnych hysterektómií). Placenta accreta bola zastúpená v 56,3 %, increta v 28,5 % a percreta v 15,2 %. V 60 (39,7 %) prípadoch išlo o kombináciu s placentou praeviou. V 112 (74,2 %) prípadoch bola morbídne adherentná placenta diagnostikovaná až v čase pôrodu. Neúspešný výkon na záchranu uteru predchádzal hysterektómiu v 23 (15,2 %) prípadoch. Medián odhadovanej straty krvi bol 1 500 ml. Transfúzia erytrocytov bola podaná u 138 (91,4 %), čerstvá mrazená plazma u 118 (78,2 %), koncentrát fibrinogénu u 39 (25,8 %) a kyselina tranexámová u 25 (16,6 %) pacientok. Prijatie na jednotku intenzívnej starostlivosti potrebovalo 58 (38,4 %) žien. Úmrtnosť pacientok bola 1,3 %. Záver: V posledných rokoch na Slovensku stúpol výskyt morbídne adherentnej placenty, peripartálnej hysterektómie, ale aj cisárskych rezov. Analýza prípadov poukazuje na potrebu zlepšenia prenatálnej diagnostiky a manažmentu morbídne adherentnej placenty.
Objective: The main aim of this study was to analyze the cases of peripartum hysterectomy associated with morbidly adherent placenta in the Slovak Republic. Materials and methods: Cases of morbidly adherent placenta managed by peripartum hysterectomy in the Slovak Republic between January 2012 and December 2020 were retrospectively analyzed. Data were obtained from the standardized anonymous questionnaires. Results: The incidence of morbidly adherent placenta was 0.39 per 1,000 births. A total of 151 (89.9%) women with morbidly adherent placenta were managed by peripartum hysterectomy (38.0% of all peripartum hysterectomies). Placenta accreta, increta and percreta were present in 56.3%, 28.5% and 15.2%, respectively. Placenta previa was present in 60 (39.7%) cases. Up to 112 (74.2%) cases of morbidly adherent placenta were diagnosed at the time of delivery. Hysterectomy was preceded by unsuccessful uterus-saving procedure in 23 (15.2%) of cases. The median of estimated blood loss was 1,500 mL. A packed red blood cells transfusion was used in 138 (91.4%), fresh frozen plasma in 118 (78.2%), fibrinogen concentrate in 39 (25.8%) and tranexamic acid in 25 (16.6%) women. A total of 58 (38.4%) women required admission to an intensive care unit. The mortality rate was 1.3%. Conclusion: In recent years, there was an increase in the incidence of morbidly adherent placenta, peripartum hysterectomy in the Slovak Republic, along with an increase in caesarean section rates, too. Case analysis highlights the need to improve the prenatal diagnosis and management of morbidly adherent placenta.
- Klíčová slova
- morbidně adherentní placenta,
- MeSH
- dospělí MeSH
- hysterektomie * mortalita statistika a číselné údaje MeSH
- komplikace porodu chirurgie epidemiologie mortalita MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- nemoci placenty * chirurgie epidemiologie mortalita MeSH
- průzkumy a dotazníky MeSH
- retrospektivní studie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- ženské pohlaví MeSH
- Geografické názvy
- Slovenská republika MeSH
This study aimed to assess the ability of adhesion, detachment, and biofilm formation of the reference strain Staphylococcus aureus CCM 4223 on a stainless steel surface, and the efficacy of three disinfectants: preparation A (based on peracetic acid, 20 mg/l), preparation B (newly developed disinfectant with a combination of two active ingredients, caprylic acid and hydrogen peroxide, 25 mg/l), and preparation C (based on sodium hypochlorite, 200 mg/l) in removing S. aureus cells adhered onto this surface. Cell detachment was around 5 log CFU/cm2 (colony forming units) over the first 6 h and around 6 log CFU/cm2 over 48 h characterizing a high persistence of cells on the tested surface. The number of cells (5–7 log CFU/cm2) needed for biofilm formation was noted already after 6 h of incubation. The decrease in cell counts caused by preparation A was 1.12–2.07 log CFU/cm2 (P < 0.0001), whereas for preparation C and preparation B, the decrease was 1.13–2.08 log CFU/cm2 and 1.61–2.16 log CFU/cm2, respectively (P < 0.0001). Preparation A was found to be the most effective (80.9%) in reducing the adhered cell count in the biofilm matrix. From these results, the assayed S. aureus strain revealed high capacities to adhere and form biofilms on stainless steel surfaces, and the cells in biofilm matrixes were resistant to total removal when exposed to the evaluated disinfectants.
Cieľ: Analýza život ohrozujúcich materských morbidít, ktorých stav si vyžadoval následnú liečbu na jednotkách intenzívnej starostlivosti (JIS) v Slovenskej republike v rokoch 2012–2020. Metodika: Retrospektívna analýza prípadov 655 rodičiek transportovaných na JIS z počtu 436 136 pôrodov. Dôvody transportu boli rozdelené do deviatich kategórií: peripartálne krvácanie, hypertenzné ochorenia, tromboembólia, kardiovaskulárne ochorenia, sepsa/ťažké infekcie, metabolické ochorenia, anestéziologické komplikácie, gastroenterologické problémy a iné. Výsledky: Celková incidencia transportu na jednotky intenzívnej starostlivosti v sledovanom období bola 1,5 na 1 000 pôrodov, ale u rodičiek rómskej národnosti 8,8 na 1 000 pôrodov. Priemerný vek rodičiek bol 30,7 rokov, pričom vo veku nad 35 rokov bolo 29,7 %. Nadhmotnosť a obezitu malo 70,4 % rodičiek. Najčastejšou príčinou transportu na JIS (49,3 %) bolo závažné popôrodné krvácanie. Druhou najčastejšou príčinou (26,0 %) boli hypertenzné ochorenia (preeklampsia, eklampsia a HELLP syndróm). Treťou najčastejšou príčinou (4,9 %) bola sepsa a závažné infekcie matky (pôrodníckej aj nepôrodníckej genézy). Úmrtnosť matiek prijatých na JIS bola 2,3 % a úmrtnosť ich novorodencov 8,7 %. Záver: Incidencia transportu rodičiek na JIS v sledovaných rokoch bola 1,5 na 1 000 pôrodov, čo v medzinárodnom porovnaní radí Slovenskú republiku ku krajinám s nižšou incidenciou.
Objective: Analysis of life-threatening maternal morbidities, the condition of which required subsequent treatment in Intensive Care Units (ICU) in the Slovak Republic in the years 2012–2020. Methodology: Retrospective analysis of 655 identified cases of mothers admitted to the intensive care units out of 436,136 births. The reasons for the transport were divided into nine categories: peripartum bleeding, hypertensive diseases, thromboembolism, cardiovascular diseases, sepsis/severe infections, metabolic diseases, complications of anaesthesiology, gastroenterological problems and others. Results: The total incidence of admission to the intensive care units in the observed period was 1.5 per 1,000 births, but for mothers of Roma nationality it was 8.8 per 1,000 births. The average age of mothers was 30.7 years, while 29.7% were over 35 years old. Overweight and obesity was present by 70.4% of mothers. The most common reason for transport to the ICU (49.3%) was severe postpartum hemorrhage. The second most common cause (26.0%) was hypertensive diseases (preeclampsia, eclampsia and HELLP syndrome). The third most common cause (4.9%) was sepsis and severe maternal infections. The mortality rate of mothers admitted to the ICU was 2.3% and infant mortality of these mothers was 8.7%. Conclusion: The incidence of admission of mothers to the ICU in the monitored years was 1.5 per 1,000 births, which in international comparison ranks Slovakia among countries with a lower incidence.
- Klíčová slova
- závažná akutní mateřská morbidita, transport rodičky na jednotku intenzivní péče,
- MeSH
- epidemiologické studie MeSH
- komplikace porodu * MeSH
- komplikace těhotenství * MeSH
- lidé MeSH
- mateřská mortalita MeSH
- péče o pacienty v kritickém stavu MeSH
- poporodní krvácení MeSH
- puerperální infekce MeSH
- retrospektivní studie MeSH
- těhotenství MeSH
- transport pacientů MeSH
- Check Tag
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Geografické názvy
- Slovenská republika MeSH
OBJECTIVES: Acrylamide is a toxic compound that can be found it both occupational and non-occupational environments. This study focuses on its sources and health effects of its exposure. METHODS: Adverse effects of acrylamide, especially carcinogenic, genotoxic, and teratogenic were reported in many studies conducted on animals. Neurotoxicity was reported in workers exposed to acrylamide in the occupational environment. Another important source of populations' exposure to acrylamide is their nutrition. RESULTS: This study focuses on humans' exposure to acrylamide from various sources and its harmful effects on their health. CONCLUSIONS: Dietary intake of acrylamide, as well as occupational exposure, cigarette smoking, cosmetics usage and other environmental sources could have a significant effect on human health.
- MeSH
- akrylamid * toxicita MeSH
- karcinogeny toxicita MeSH
- lidé MeSH
- nutriční stav účinky léků MeSH
- poškození DNA účinky léků MeSH
- pracovní expozice * škodlivé účinky MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
The aim of the article is to monitor the total numbers microorganisms, coliform bacteria and fungi located on the surface and in the air before, during and after disinfection with P3 Topax 66 in selected areas. Statistical analysis confirmed the efficacy of the P3 Topax 66 disinfectant in all of the three analyzed groups of microorganisms present on the surfaces and in the air with the exception of disinfection efficacy on air coliforms, which could not be shown due to the low detection sensitivity during monitoring.
- MeSH
- chemie MeSH
- látky znečišťující životní prostředí analýza chemie škodlivé účinky MeSH
- toxikologie MeSH
- Geografické názvy
- Slovenská republika MeSH
