A clinical case of prolonged CPAP ventilation in a patient with COVID-19-associated pneumonia

Non-invasive ventilation (NIV) via a mask to maintain a constant positive airway pressure (CPAP mask) is the method of choice for the treatment of pulmonary disorders in severe COVID-19-associated pneumonia. Nowadays, there are no studies which had shown the effectiveness of the ROX-index in predicting the efficacy of NIV in patients with acute hypoxic respiratory failure (AHRF). This clinical case describes our experience of effective use of ROX-index in patients with AHRF because of coronavirus dis-ease, SARS-CoV-2-associated, who underwent non-invasive lung ventilation through CPAP mask. © 2022. The Authors.

Impact of the COVID-19 pandemic on the quality of customer service in the local government units

Maintaining an adequate level of services becomes a particularly difficult challenge in the current conditions of the COVID-19 pandemic, which greatly complicates the organization and implementation of tasks assigned to public entities. Therefore, it was deemed important to determine the impact of the COVID-19 pandemic, considered in the context of global risk, on the quality of customer service in the local government units. In the theoretical part, the investigations presented in this study contain a discussion of public service provision by local government units. The publication includes a study of the concepts of quality and satisfaction. The article also draws attention to the aspect of risk as an indispensable element of business entities in relation to the global risk caused by the SARS-CoV-2 virus. The empirical part presents the results of surveys conducted using the Servqual method and the Kruskal-Wallis test. In conclusion, providing high-quality services is a challenge for many local government units. The COVID-19 pandemic has negatively affected the dimensions of reliability and trust that make up the quality of customer service in local government units. This is evidenced by the results which show the deterioration of the quality of customer service during the pandemic. The current situation exacerbates the negative trend resulting from the gap between the perception of the services provided and the actual requirements of the respondents. © 2022, Bucharest University of Economic Studies Publishing House. All rights reserved.

Approach to a child with pediatric inflammatory multisystem syndrome with COVID-19 recommendations by the Polish pediatric society expert group and the national consultant in the field of pediatrics

Pediatric inflammatory multisystem syndrome associated with COVID-19 (PIMS) is a new entity, occurring in children and young adults, associated with the SARS-CoV-2 infection. The first cases of PIMS were found in Poland in May 2020. Since October 2020, a significant increase in the incidence of this new disease has been observed in Poland, which reflects the increased incidence of COVID-19 in adults. PIMS development results from dysregulation of the immune system occurring after 2-4 weeks after the SARS-CoV-2 in-fection. Diagnosis is based on a set of clinical features (including fever and features of mul-tiple organ damage) and laboratory abnormalities, with the exclusion of other causes. Most common complications involve cardiovascular system: myocarditis with decreased left ven-tricular ejection fraction, shock and/or coronary artery aneurysms. Mortality is around 2%. Appropriate management, including vital functions support and immunomodulating treat-ment, allows for a quick recovery of the vast majority of patients. The following document is a proposal for diagnostic and therapeutic management of children with suspected PIMS in Poland. Copyright © 2020, Wydawnictwo Czelej Sp. z o.o.. All rights reserved.

Impact of Epidemiological Situation on Respect for Human Rights and Freedoms: Informational Aspect

OBJECTIVE: The aim: To study an impact of the epidemiological situation on enforcement of the rights and freedoms in global informational space at international, regional, and national levels (by the example of the Republic of Poland and Ukraine). PATIENTS AND METHODS: Materials and methods: This research is based on empirical and analytical data of WHO, conventional norms on protection of rights and freedoms, anti-epidemic legislation of Ukraine and the Republic of Poland, reports of European and international institutions on human rights. Over 100 sources of information have been discovered, including regulatory legal acts, academic papers. Dialectical, comparative, analytical, synthesis, system analysis methods have been applied. CONCLUSION: Conclusion: The priority of human rights and freedoms over the public interest in the fight against the previously unknown and rapidly spreading coronavirus while delivering medical care - is a paradigm that seems to be reconsidered under "syndemic" conditions in connection with "infodemic". Epidemiological situation and human rights are interdependent in a globalized world. Channels of formal and informal informing, as well as objective, current, full enough information content, make a "person-state" communication effective. During a pandemic, regional and international communication must be complete and regular.

Diabetic ketoacidosis in children with new onset diabetes in Poland during COVID-19 pandemic

Introduction: The COVID-19 pandemic imposed a heavy burden on the healthcare systems worldwide, especially during initial outbreaks. The strain on medical systems, including human resources, as well as shift to telemedicine and pro-isolation policy may have delayed diagnosis and aggravated the outcomes of type 1 diabetes (T1D) in children, possibly increasing the incidence of diabetic ketoacidosis (DKA) at diabetes onset. Objectives: Compare the incidence of T1D in children and fraction of new T1D cases presenting with DKA among multiple pediatric diabetes care centres in Poland between a year before COVID-19 pandemic outbreak and after. Methods: We contacted 14 reference pediatric diabetes centres in Poland, which collectively provide diabetes care for a population of 6.2 MLN children. They were asked to provide a case-by case data concerning new cases of T1D diagnosed between 15th March 2019 and 15th Match 2021 in children <18 y.o., together with available clinical information. Collected data were divided into two year-long periods - before COVID-19 pandemic outbreak and after, with the division made on March 15 2020, when policy changes and lockdown was imposed. In addition, demographic data for each studied region was downloaded from central statistical office for years 2019 and 2020. Results: In the assessed period, we noted 2942 new cases of T1D (overall incidence rate 23.6 per 100000 patient-years) amongst 12 Poland regions (19.9 - 27.1), with a significant increase between pre-COVID- 19 and COVID-19 period across all regions (mean increase 4.8±4.2 per 100000, p=0.0002). Among new T1D cases, 1409 (47.9%) presented with DKA (38.8 to 72.1%). The first wave of COVID-19 was associated with a significant increase in fraction of DKA at T1D diagnosis across all regions (mean +8.4±10.5%, p=0.0175). Greatest increase was noted during the first 3 months after lockdown. Conclusions: In a multicentre national perspective, COVID-19 outbreak and related restrictions were associated with increased incidence of DKA at T1D presentation.

Approach to a child with pediatric inflammatory multisystem syndrome with covid-19 recommendations by the Polish pediatric society expert group update february 2021

Pediatric inflammatory multisystem syndrome associated with COVID-19 (PIMS) is a new entity, occurring in children and young adults, associated with the SARS-CoV-2 infection. The first cases of PIMS were found in Poland in May 2020. Since October 2020, a signi-ficant increase in this new disease incidence has been observed in Poland, reflecting the increased incidence of COVID-19 in the pediatric population. PIMS development results from dysregulation of the immune system occurring after ca. 4 weeks after the SARS-CoV-2 infection. Diagnosis is based on criteria: a set of clinical features (including fever and features of multiple organ damage) and elevated inflammatory markers, excluding other cau-ses. The most common complications involve the cardiovascular system: heart damage with decreased left ventricular ejection fraction, shock, and coronary artery abnormalities. Mortality is around 2%. Appropriate management, including vital functions support and immunomodulating treatment, allows for a quick recovery of the vast majority of patients. The following document is a guideline for the diagnostic and therapeutic management of children with suspected PIMS in Poland. © 2021, Wydawnictwo Czelej Sp. z o.o.. All rights reserved.

Advancement of SARS-CoV-2 infection in children

Novel coronavirus disease 2019 (COVID-19) is a disease characterized by respiratory symptoms caused by novel coronavirus (SARS-CoV-2). Its pathogenesis is suggested to be related with ACE2 receptors, present in various organs. Children, as a special group of patients with COVID-19, have their own unique characteristics in terms of the disease's course. The majority of children present with asymptomatic course or have mild symptoms. In severe cases COVID-19 may manifest as a multisystem inflammatory syndrome;thus, correct identification of children at risk is particularly important in the diagnostic process. The treatment options for this disease are still based on general therapy, and related drug therapy is still at the clinical trial stage.

Approach to a child with Multisystem Inflammatory Syndrome associated with COVID-19. Recommendations by the Polish Paediatric Society Expert Group. Update - February 2021

Multisystem Inflammatory Syndrome in Children (MIS-C) is a new clinical entity occurring in children and young adults, which is associated with the SARS-CoV-2 infection. The first cases of MIS-C were diagnosed in Poland in May 2020. Since October 2020, a significant increase in the incidence of this new disease has been observed in Poland, reflecting the increased incidence of COVID-19 in the paediatric population. MIS-C develops as a result of dysregulation of the immune system occurring 4 weeks after the SARS-CoV-2 infection. Diagnosis is based on the following criteria: a set of clinical features (including fever and signs of multiple organ damage) and elevated inflammatory markers, with exclusion of other causes. The most common complications involve the cardiovascular system: acute myocardial damage with reduced left ventricular ejection fraction, shock, and coronary artery abnormalities and arrhythmias. Mortality in Western Europe and the United States is around 1-2%. Appropriate management, including vital function support and immunomodulatory treatment, allows for a quick recovery in the vast majority of patients. This document is an updated guideline for the diagnostic and therapeutic management of children with suspected MIS-C in Poland. The most important changes concern treatment, steroid therapy, and antiplatelet therapy in particular.

Use of the brief observation of symptoms of autism (bosa) as a new clinical approach to assessing patients with suspected spectrum disorder during the COVID-19 pandemic

COVID-19 has imposed major changes to the delivery of healthcare worldwide. In many settings, healthcare is now predominantly transitioned to telehealth, creating challenges and unique benefits. In 2020, the Centers for Disease Control and Prevention has reported that 1 in 54 children in the U.S. are diagnosed with autism spectrum disorder (ASD). The Brief Observation of Symptoms of Autism (BOSA) is a new clinical approach that has been developed to ensure that patients suspected of ASD can receive valid diagnostic assessments during the pandemic. BOSA is offered when a diagnostician is unable to administer the Autism Diagnostic Observation Schedule-Second Edition (ADOS-2) either because it is not appropriate to administer the ADOS-2 via telehealth or, in person, face coverings confound ASD assessment. Only trained ADOS-2 diagnosticians can administer BOSA, because BOSA relies on ADOS-2 codes. The article describes BOSA to prepare the field for future research during the COVID-19 crisis.