Tuberkulózni pacienti vyžadujúci akútnu intenzívnu starostlivosť tvoria asi 1–3 % zo všetkých pacientov s tuberkulózou. Respiračné zlyhanie bola najčastejšia príčina príjmu pacientov na intenzívne oddelenie v našej retrospektívnej analýze súboru pacientov (n = 36). Vstupná leukocytóza, hypoalbuminémia a SOFA skóre predstavujú významné prediktívne faktory určujúce prežívanie pacientov. Protektívna ventilačná stratégia pacientov s nehomogénnym pľúcnym parenchýmom pri rozvinutej infekcii tuberkulózy je podobná ako pri manažmente ARDS. Cielená terapia býva častokrát oneskorená pre netypický priebeh tuberkulózneho ochorenia a jeho foriem. Intravenózna antituberkulózna terapia na intenzívnej jednotke vykazuje lepšie prežívanie pacientov. Svetovo narastajúci počet pacientov s multirezistentnou tuberkulózou (MDR-TB) a extenzívne rezistentnou tuberkulózou (XDR-TB) predstavuje zvýšené riziko aj pre nemocničný personál.
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- MeSH
- antituberkulotika terapeutické užití MeSH
- hypoalbuminemie krev MeSH
- leukocytóza krev MeSH
- lidé MeSH
- Mycobacterium tuberculosis patogenita MeSH
- péče o pacienty v kritickém stavu * MeSH
- přenos infekce z pacienta na zdravotnického pracovníka prevence a kontrola MeSH
- respirační insuficience etiologie terapie MeSH
- tuberkulóza * diagnóza farmakoterapie mikrobiologie mortalita MeSH
- vyhodnocení orgánové dysfunkce MeSH
- Check Tag
- lidé MeSH
The COVID-19 pandemic highlighted some potential limitations of transmission-based precautions. The distinction between transmission through large droplets vs aerosols, which have been fundamental concepts guiding infection control measures, has been questioned, leading to considerable variation in expert recommendations on transmission-based precautions for COVID-19. Furthermore, the application of elements of contact precautions, such as the use of gloves and gowns, is based on low-quality and inconclusive evidence and may have unintended consequences, such as increased incidence of healthcare-associated infections and spread of multidrug-resistant organisms. These observations indicate a need for high-quality studies to address the knowledge gaps and a need to revisit the theoretical background regarding various modes of transmission and the definitions of terms related to transmission. Further, we should examine the implications these definitions have on the following components of transmission-based precautions: (i) respiratory protection, (ii) use of gloves and gowns for the prevention of respiratory virus infections, (iii) aerosol-generating procedures and (iv) universal masking in healthcare settings as a control measure especially during seasonal epidemics. Such a review would ensure that transmission-based precautions are consistent and rationally based on available evidence, which would facilitate decision-making, guidance development and training, as well as their application in practice.
- MeSH
- COVID-19 * prevence a kontrola MeSH
- kontrola infekce * metody MeSH
- lidé MeSH
- osobní ochranné prostředky * MeSH
- pandemie prevence a kontrola MeSH
- přenos infekce z pacienta na zdravotnického pracovníka prevence a kontrola MeSH
- respirační aerosoly a kapénky MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- MeSH
- HIV infekce * prevence a kontrola MeSH
- lidé MeSH
- ochrana veřejného zdraví metody MeSH
- osoby s přechodným pobytem a migranti MeSH
- přenos infekce z pacienta na zdravotnického pracovníka prevence a kontrola statistika a číselné údaje MeSH
- vztahy mezi lékařem a pacientem etika MeSH
- zákonodárství lékařské trendy MeSH
- zdraví - znalosti, postoje, praxe MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- novinové články MeSH
OBJECTIVES: The aim of the analysis was to determine the probable places of coronavirus transmission in association with the work and compare the situation between 2020 and 2021. METHODS: The work analysed data from the Information System of Infectious Diseases managed by the Institute of Health Information and Statistics of the Czech Republic in the period from March 2020 - December 2021. RESULTS: 2,483,219 COVID-19 cases were officially confirmed (732,202 during 2020 and 1,338,790 in 2021), from them 140,368 (6%) represented work-related disease, 520,830 cases (21%) work-related contact, and 1,822,021 (73%) out-of-work contact. There were identified 13 occupations with the highest incidence of COVID-19 in the observed period (458,341 cases), in descending order - clerk, machinist, teacher, craftsman, worker/agency worker, driver, sales worker/cashier, warehouse worker/expediter, nurse, manager, food worker, paramedic, and social worker. Comparing 2020 and 2021, there was a difference in the ranking of occupations by incidence of disease. In 2021, the risk of infection acquiring increased for the occupations clerk, machinist, craftsman, worker/agency worker, manager, and food worker, while it decreased for the health professions (nurse, other paramedic, physician) and for social worker; 5,514 cases of COVID-19 were recognized as an occupational disease in 2020 and 2021, from them 5,483 cases (99.4%) in the health and social care economic activity sector. CONCLUSION: The available data show probable exposures to an infectious agent (without proof of specific contact with the source of the infection), of which 27% cases of COVID-19 are related to work (cases of work-related disease and work-related contact represented together the closest relationship to work). Different relevant anti-epidemic measures in the workplace have considerable practical importance for epidemic control. The use of personal protection of the mouth and nose with respirators/muffs is essential to reduce the risk of airborne transmission.
- MeSH
- COVID-19 * epidemiologie MeSH
- lidé MeSH
- nemoci z povolání * epidemiologie MeSH
- přenos infekce z pacienta na zdravotnického pracovníka prevence a kontrola MeSH
- SARS-CoV-2 MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
OBJECTIVE: To identify the available evidence on aerosol viral transmission risk during minimally invasive surgery (MIS) and evaluate its impact on guidelines development and clinical activity worldwide during the coronavirus disease 2019 (COVID-19) pandemic. METHODS: We performed a scoping review on PubMed, Cochrane, the Excerpta Medica dataBASE (EMBASE), Clinical Trial Register, and the Grey Literature Repository databases, to identify reports on viral transmission via surgical smoke or aerosolisation. A systematic review of all available national and international guidelines was also performed to report their recommendations. Additionally, a worldwide transdisciplinary survey was performed to capture the actual compliance to dedicated guidelines and their impact on MIS activity. RESULTS: Based on a selection of 17 studies, there was no evidence to support the concerns of an intraoperative viral transmission via pneumoperitoneum aerosolisation. Most national surgical and urological societies either did address this topic or referred to international guidelines. The guidelines of the American College of Surgery, the Royal College of Surgeons, and the European Association of Urology Robotic Urology Section, recommended an avoidance of MIS due to an increased risk of intraoperative aerosol-enhanced transmission. The results of the survey completed by 334 respondents, from different surgical abdominal specialties, suggested a lack of compliance with the guidelines. CONCLUSION: There seems to be a dissonance between contemporary guidelines and ongoing surgical activity, possibly due to the perceived lack of evidence. Recommendations regarding changes in clinical practice should be based on the best available research evidence and experience. A scoping review of the evidence and an assessment of the benefits and harms together with a survey showed that laparoscopic procedures do not seem to increase the risk of viral transmission. Nevertheless, the few publications and low quality of existing evidence limits the validity of the review.
- MeSH
- aerosoly * MeSH
- COVID-19 epidemiologie přenos MeSH
- dodržování směrnic * MeSH
- kontrola infekce * MeSH
- lékařská praxe - způsoby provádění MeSH
- lidé MeSH
- miniinvazivní chirurgické výkony škodlivé účinky MeSH
- pandemie MeSH
- peroperační doba MeSH
- přenos infekce z pacienta na zdravotnického pracovníka prevence a kontrola MeSH
- rizikové faktory MeSH
- SARS-CoV-2 MeSH
- směrnice pro lékařskou praxi jako téma * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
BACKGROUND AND AIMS: SARS-CoV-2 is a worldwide serious health problem. The aim of this study was to demonstrate the number of potentially infectious particles present during endoscopic procedures and find effective tools to eliminate the risks of SARS-CoV-2 infection while performing them. METHODS: An experimental model which focused on aerosol problematics was made in a specialized laboratory. This model simulated conditions present during endoscopic procedures and monitored the formation of potentially infectious fluid particles from the patient's body, which pass through the endoscope and are then released into the environment. For this reason, we designed and tested a prototype of a protective cover for the endoscope's control body to prevent the release and spread of these fluid particles from its working channel. We performed measurements with and without the protective cover of the endoscope's control body. RESULTS: It was found that liquid coming through the working channel of the endoscope with forceps or other instruments inside generates droplets with a diameter in the range of 0.1-1.1 mm and an initial velocity of up to 0.9 m/s. The average number of particles per measurement per whole measured area without a protective cover on the endoscope control body was 51.1; with this protective cover on, the measurement was 0.0, p<0.0001. CONCLUSIONS: Our measurements proved that fluid particles are released from the working channel of an endoscope when forceps are inserted. A special protective cover for the endoscope control body, made out of breathable material (surgical cap) and designed by our team, was found to eliminate this release of potentially infectious fluid particles.
- MeSH
- COVID-19 * prevence a kontrola přenos MeSH
- gastrointestinální endoskopie * MeSH
- lidé MeSH
- ochranné oděvy * MeSH
- přenos infekce z pacienta na zdravotnického pracovníka prevence a kontrola MeSH
- SARS-CoV-2 * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- MeSH
- absces diagnostické zobrazování MeSH
- děložní krvácení diagnostické zobrazování MeSH
- gynekologická onemocnění diagnostické zobrazování MeSH
- gynekologie MeSH
- koronavirové infekce prevence a kontrola přenos MeSH
- lidé MeSH
- nádory ženských pohlavních orgánů diagnostické zobrazování MeSH
- nemoci ovaria diagnostické zobrazování MeSH
- ovariální cysty diagnostické zobrazování MeSH
- ovariální hyperstimulační syndrom diagnostické zobrazování MeSH
- pandemie prevence a kontrola MeSH
- pánevní zánět diagnostické zobrazování MeSH
- poskytování zdravotní péče metody organizace a řízení MeSH
- přenos infekce z pacienta na zdravotnického pracovníka prevence a kontrola MeSH
- přenos infekce ze zdravotnického pracovníka na pacienta prevence a kontrola MeSH
- spontánní ruptura diagnostické zobrazování MeSH
- torzní deformity diagnostické zobrazování MeSH
- třídění pacientů metody MeSH
- ultrasonografie metody MeSH
- virová pneumonie prevence a kontrola přenos MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- konsensus - konference MeSH
Coronavirus disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), has spread worldwide triggering a pandemic during the year 2020. The proportion of persons infected with SARS-CoV-2 whose infection remained subclinical is not known. However, such information is important to determine whether the control measures currently employed are sufficient to halt the spread of the virus. Current study has examined the seroprevalence of anti-SARS-CoV-2 antibodies in a population of 92 healthcare professionals working with patients with inflammatory bowel disease (IBD). The enzyme-linked immunosorbent assay (ELISA) test system for SARS-CoV-2 IgG from EUROIMMUN Medizinische Labordiagnostika AG (Germany) was used. Very low herd antibody-mediated immunity was proven, less than 2%, although we have been faced with the COVID-19 pandemic for several months. Anti-SARS-CoV-2 IgG antibody testing is currently unable to provide sufficient information about our anti-infectious immunity.
- MeSH
- ambulantní zařízení organizace a řízení MeSH
- ELISA MeSH
- epidemický výskyt choroby prevence a kontrola MeSH
- hodnocení rizik MeSH
- hygiena práce * MeSH
- idiopatické střevní záněty epidemiologie imunologie terapie MeSH
- imunoglobulin G analýza imunologie MeSH
- klinické laboratorní techniky metody statistika a číselné údaje MeSH
- kolektivní imunita MeSH
- koronavirové infekce diagnóza epidemiologie prevence a kontrola MeSH
- lidé MeSH
- odhad potřeb MeSH
- pandemie prevence a kontrola statistika a číselné údaje MeSH
- přenos infekce z pacienta na zdravotnického pracovníka prevence a kontrola MeSH
- protilátky virové imunologie MeSH
- séroepidemiologické studie MeSH
- virová pneumonie epidemiologie prevence a kontrola MeSH
- zdravotnický personál MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Německo MeSH
Covid-19 has reached almost all the nations in the world. More and more people are dying from it and in some countries, even the army has been called upon to help dispose of the dead as there is a shortage of coffins, and undertakers are overwhelmed. Therefore, it is essential to have measures in place to contain the spread of infection while handling dead bodies. In view of this, different guidelines and protocols have been proposed bearing in mind the limited information we have about the virus. This review article sets them out for better reference.
- MeSH
- Betacoronavirus * MeSH
- kontrola infekce MeSH
- kontrola infekčních nemocí MeSH
- koronavirové infekce mortalita MeSH
- kremace MeSH
- lidé MeSH
- mrtvola * MeSH
- odstraňování zdravotnického odpadu MeSH
- osobní ochranné prostředky MeSH
- pandemie MeSH
- pitva MeSH
- pohřbívání MeSH
- pracovní expozice prevence a kontrola MeSH
- přenos infekce z pacienta na zdravotnického pracovníka prevence a kontrola MeSH
- soudní lékařství metody MeSH
- Světová zdravotnická organizace MeSH
- virová pneumonie mortalita MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
Ohrozenie koronavírusom SARS-CoV-2 mobilizoval kompetentné inštitúcie Slovenskej republiky na prevenciu a boj proti ochoreniu COVID-19. Myšlienka ochrany verejného zdravia sa stala témou číslo jedna v celom spektre života. Hľadajú sa najvhodnejšie spôsoby, ako vyvážiť potrebné opatrenia bez psychickej ujmy obyvateľstva a zároveň natoľko efektívne, aby splnili svoj účel. Cieľom tohto článku je priblížiť zriedkavo používané pojmy, ktoré sú témou diskusií pre zdravotníckych pracovníkov.
- Klíčová slova
- koronavirus COVID-19, protiepidemiolocká opatření, nouzový stav,
- MeSH
- dezinfekce rukou MeSH
- koronavirové infekce imunologie klasifikace MeSH
- ochranné oděvy MeSH
- pandemie MeSH
- přenos infekce z pacienta na zdravotnického pracovníka klasifikace prevence a kontrola MeSH
- přenos infekční nemoci klasifikace prevence a kontrola MeSH
- viry imunologie klasifikace MeSH
- Geografické názvy
- Slovenská republika MeSH
