ABSTRACT
Results of treatment of 22 adults hospitalized for sepsis in Intensive Care Unit of Department of Infectious Diseases, Medical University of Lódz, are presented. Etiology, confirmation of diagnosis according to common microbiological criteria, source of sepsis and final results of treatment were analysed. There were 14 death among these patients (63.6%). In 50% of cases methycillin-resistant Staphylococcus aureus (MRSA) was the infectious agent.
Subject(s)
Sepsis/diagnosis , Sepsis/microbiology , Adolescent , Adult , Aged , Anti-Bacterial Agents/therapeutic use , Candida albicans/isolation & purification , Escherichia coli/isolation & purification , Female , Humans , Intensive Care Units , Klebsiella pneumoniae/isolation & purification , Male , Middle Aged , Poland/epidemiology , Pseudomonas aeruginosa/isolation & purification , Sepsis/epidemiology , Sepsis/therapy , Staphylococcus aureus/isolation & purification , Time FactorsABSTRACT
Authors have presented 81 cases of bacterial meningitis in adult patients (pts) treated in the Clinic for Infectious Diseases in the years 1990-1991. The aim of the study was the clinical and epidemiological analysis of the bacterial meningitis. Clinical symptoms, time between first symptoms and onset of hospitalisation and treatment, coexisting diseases and their influence on the course of the disease were considered in the analysis. The aetiological agent was found in 21% of cases. In the study group 75.3% were pts 26-65 years old. 77.8% were male pts. In 65.4% pts delay in hospitalisation and therapy exceeded 24 hours, 41.9% was longer than 48 hours. 18% of pts were afebrile. In the study group only 34.6% of pts were free of coexisting diseases.
Subject(s)
Meningitis, Bacterial/epidemiology , Adolescent , Adult , Aged , Female , Humans , Length of Stay , Male , Meningitis, Bacterial/complications , Meningitis, Bacterial/microbiology , Middle Aged , PolandABSTRACT
81 patients (pts) with bacterial meningitis hospitalised in the Clinic for Infectious Diseases in the years 1990-1991 were treated according to two therapeutic schedules. First: young pts (under 40 years), without coexisting diseases obtained Penicillin G and aminoglycoside and/or synthetic penicillin. Second: pts over 40 years old with coexisting diseases or cases of recurrent meningitis were treated with third-generation cephalosporins and aminoglycoside and/or synthetic penicillin. The mortality was 16% in the study group. 11 of 13 pts with coexisting diseases died. Neurologic sequelae were found in 23% of pts. The complete recovery was obtained in 34% of pts, more often (35.9%) in a group treated with third--generation cephalosporins comparing to 29.4% with other antibiotic therapy.
Subject(s)
Meningitis, Bacterial/drug therapy , Adolescent , Adult , Aged , Aminoglycosides , Anti-Bacterial Agents/therapeutic use , Cephalosporins/therapeutic use , Female , Humans , Male , Meningitis, Bacterial/complications , Meningitis, Bacterial/mortality , Middle Aged , Nervous System Diseases/etiology , Penicillins/therapeutic use , Recurrence , Survival Rate , Treatment OutcomeABSTRACT
40 adult patients were examined: 24 with purulent meningitis and 16 with lymphocytic meningitis. The control group consisted of 100 healthy people. In purulent meningitis patients in the 1st, 3rd, 5th, 7th, 14th and 28th day of the disease, concentrations of the following acute phase proteins were measured in serum: C-reactive protein, alpha 1-antitripsin, alpha 1-orosomucoid, alpha 2-ceruloplasmin, alpha 2-macroglobulin and alpha 2-haptoglobin. In lymphocytic meningitis patients concentrations of the above mentioned acute phase proteins were measured only in the 1st day of the disease. Usefulness of establishing alpha 2-haptoglobin, alpha 1-antitripsin, alpha 2-ceruloplasmin and particularly C-reactive protein concentrations for differential diagnosis of purulent and lymphatic meningitis was proved. Evaluation of C-reactive protein and alpha 1-antitripsin concentration kinetics proved to be fully useful for monitoring of seriousness of the course of purulent meningitis, and together with evaluation of the clinical condition of the patient it can constitute a valuable marker of effectiveness of the disease treatment.
Subject(s)
Ceruloplasmin/cerebrospinal fluid , Haptoglobins/cerebrospinal fluid , Macroglobulins/cerebrospinal fluid , Meningitis/blood , Meningitis/cerebrospinal fluid , Orosomucoid/cerebrospinal fluid , Protein C/cerebrospinal fluid , alpha 1-Antitrypsin/cerebrospinal fluid , Adult , Aged , Diagnosis, Differential , Female , Humans , Male , Meningitis/etiology , Middle Aged , Neisseria meningitidis/pathogenicity , Streptococcus pneumoniae/pathogenicityABSTRACT
40 adult patients were examined: 24 with purulent meningitis and 16 with lymphocytic meningitis. In the course of purulent meningitis concentrations of the following acute phase proteins were measured in the cerebrospinal fluid: C-reactive protein, alpha 1-antitripsin, alpha 1-orosomucoid, alpha 2-ceruloplasmin, alpha 2-macroglobulin and alpha 2-haptoglobin in the 1st, 3rd, 5th, 7th, 14th and 28th day of the disease. In lymphocytic meningitis patients concentrations of the above mentioned acute phase proteins were measured only in the 1st day of the disease. Full usefulness of establishing concentrations of all the above mentioned acute phase proteins within the first five days of the purulent meningitis for differential diagnosis of purulent and lymphatic meningitis was proved. Evaluation of concentration kinetics of acute phase proteins in cerebrospinal fluid for monitoring of the course of purulent meningitis is of a limited value.
Subject(s)
Ceruloplasmin/cerebrospinal fluid , Macroglobulins/cerebrospinal fluid , Meningitis/cerebrospinal fluid , Orosomucoid/cerebrospinal fluid , Protein C/cerebrospinal fluid , alpha 1-Antitrypsin/cerebrospinal fluid , Adult , Aged , Diagnosis, Differential , Female , Humans , Male , Middle AgedABSTRACT
We have evaluated the results of the first action of voluntary vaccination against hepatitis B in the students of Medical University of Lódz using Energix-B vaccine (20 micrograms) in schedule 0, 1, 6 months. Few students applied for the vaccination: only 48.4% of persons planned for vaccination completed the schedule. Seroconversion rate (anti-HBs > 10u/l) in this group was 93.9%. Three doses of vaccine applied inconsistently with schedule resulted in the immunological response in 3 out of 4 students observed. Two doses of vaccine resulted in the effective response in 13 out of 16 students observed. One doses of vaccine proved to be ineffective. The blood tests performed prior to vaccination showed the presence of the HBV markers in 9.6% of students (HBsAg in 2.1% of persons and anti-HBs in 5.3/of persons).
