Benign Acute Childhood Myositis During Influenza B Outbreak.

Benign acute childhood myositis (BACM) is a syndrome classically occurring in children during the convalescent phase from a febrile upper respiratory tract infection, most commonly after influenza B. BACM can cause difficulty walking due to severe calf pain. Laboratory results show increased serum creatinine kinase and AST. Although alarming, BACM is self-limiting with symptoms disappearing within a week. Herein, we described a case series of BCAM in children in two cities in Poland during the influenza outbreaks in 2012/2013 and 2014/2015. We discussed the presentation and the clinical workup and examinations of the myositic syndrome. In addition, we evaluated the association of BACM with influenza B. We detected specific IgG against influenza B virus in 83% of the children diagnosed with BCAM. Reports from the National Institute of Public Health - National Institute of Hygiene in Warsaw, Poland confirmed a high rate of influenza B cases during both epidemic seasons in question.

Usage of Over-the-Counter and Herbal Products in Common Cold in Poland: Findings from Consumer Survey.

Upper respiratory tract infections are usually self-treated with synthetic and herbal over-the-counter products. The aim of the study was to assess the reasons for the purchase of those medications in Poland. We examined 413 adults, aged 18 and over (70.5% of them were women) using a questionnaire. The findings demonstrate that oral synthetic products were used by 76% of respondents, while herbal products by 30%. Synthetic products were used mainly by educated people under 65 years of age, students, and the employed. Herbal products were used mainly by older people. In conclusion, synthetic products against common cold are perceived as more effective. Such medications are used by people who probably would like to recover and return to professional activity as quickly as possible. As they generally use more medications, they are at increased risk of adverse effects resulting from drug interactions, and they should be a target group for health education programs.

Implementation of Hospital's Antibiotic Policy Decreases Antimicrobial Use in the General Pediatric Ward.

Hospitalized children are often treated with antibiotics. However, 30-75% of antibiotic treatment in pediatric hospitals is administrated incorrectly or unreasonably. Implementation of Hospital's Antibiotic Policy (HAP) should improve antibiotic consumption patterns in pediatric wards. The objective of this study was to determine the effectiveness of HAP by assessing antibiotic consumption in the General Pediatric Ward of an academic hospital in the city of Warsaw, Poland before and after this policy was introduced in the years 2012 and 2013, respectively. Antibiotic use was calculated in daily-defined doses (DDDs) per 100 patient-days and DDDs per 100 admissions. Antibiotics were ranked by the volume of DDDs and the number of antibiotics which accounted for 90% and 100% of the total volume: DU90% and DU100% (where DU stands for drug use). The total antibiotic consumption and significantly decreased after the implementation of HAP; DDDs were 2,177.5 before and 1,335.4 after implementation of HAP. The number of DDDs/100 patient-days was also lower; 36.3 vs. 24.9 before and after HAP, respectively. After implementation of HAP a decreased use of ceftriaxone and cefuroxime was observed. The most commonly used antibiotic was amoxicillin with clavulanic acid. The DU100% rates remained the same (8 antibiotics) and DU90% increased (from 3 in 2012 to 5 in 2013). We conclude that implementation of HAP resulted a decreased consumption of antibiotics in the General Pediatric Ward, despite the hardly changed number of children treated with antibiotics.

The Incidence of Respiratory Tract Infections in Vertically HIV-Infected Children in Lower Silesia in Poland and the Approach to Infection Prevention.

Human immunodeficiency virus (HIV) is a risk factor associated with respiratory tract infections. However little is known about the prevalence of these infections in HIV-infected children in Poland. We investigated the incidence of respiratory tract infections in 26 HIV-infected children (aged 4-18, mean 10.3 years, including 17 girls) treated in our center and compared it with the age-matched control group of 70 children. The prevalence of chronic diseases and other factors such as cigarette smoking by household members or attending educational institutions were also taken into consideration. Among the HIV-infected children, 48 respiratory infections were observed, including 4 cases of pneumonia and 44 other respiratory infections for 312 person-month observations vs. 256 infections including 13 cases of pneumonia and 243 other respiratory infections for 840 person-month observations in the control group. Thus, incidence of respiratory infections per month was lower in HIV-infected children (14%) compared with the control group (29%), i.e., 0.14 95% CI (0.10-0.18) infections per month vs. 0.29 95% CI (0.26-0.32). There was no difference in the incidence of pneumonia. The lower incidence of respiratory infections in HIV-infected children may be explained by their avoiding sick people, taking influenza vaccination on the annual basis, and possibly antiviral medication. We conclude that the influence of modifiable environmental factors that reduce the risk of respiratory tract infections is more significant than the HIV infection itself.

Pathophysiology of Clinical Symptoms in Acute Viral Respiratory Tract Infections.

In this article we discuss the pathophysiology of common symptoms of acute viral respiratory infections (e.g., sneezing, nasal discharge, sore throat, cough, muscle pains, malaise, and mood changes). Since clinical symptoms are not sufficient to determine the etiology of viral respiratory tract infections, we believe that the host defense mechanisms are critical for the symptomatology. Consequently, this review of literature is focused on the pathophysiology of respiratory symptoms regardless of their etiology. We assume that despite a high prevalence of symptoms of respiratory infection, their pathogenesis is not widely known. A better understanding of the symptoms' pathogenesis could improve the quality of care for patients with respiratory tract infections.

Immunizations against respiratory infections in children in primary health care in poland: coverage and delays.

Pneumococcal infections, pertussis, and influenza are vaccine-preventable diseases. The aim of this study was to determine vaccine coverage and compliance with the dosage regimen among children in Poland. We performed a retrospective chart analysis of 1,356 children in a large primary healthcare establishment. The complete primary pertussis vaccination, 3 doses in the first year of life, was administered to 1,310/1,356 patients (96.6 %). The self-paid combined acellular vaccine was given in 55.2 % of children. The first dose of the pertussis vaccine was administered in a timely manner to 67.1 % of children. The self-paid pneumococcal vaccine was administered in 499/1,356 (36.8 %) children. In 46.1 % of them immunization started within the first 6 months of life; in 12.6 % aged 7-11 months, in 12.6 % aged 12-23 months, and in 28.7 % aged over 24 months. The dosage regimen was compliant in 49.2 % of patients. Only 3.5 % of patients were immunized against both pneumococci and influenza. Compliance with the Polish immunization program should be increased by reducing the number of injections and the cost of vaccines. Education is essential to facilitate simultaneous administration of vaccines during one visit and to prepare the parents for judicious decision-making when it comes to vaccinations.

Respiratory tract infections in children in primary healthcare in Poland.

Respiratory tract infections are the most common diseases in children. The aim of the study was to assess their frequency and antibiotic treatment in Poland. We retrospectively analyzed 91 randomly-selected children aged 0-17 years receiving care from birth in a large primary healthcare establishment in the city of Wroclaw in Poland. Respiratory tract infections were responsible for 25-40 % of all primary healthcare visits. The median of visits due to upper respiratory tract infections was 1.8 per year in all children and 2.0 per year in children 0-3 years old. Antibiotics were overused; the majority (57.4 %) of the respiratory infections were treated with antibiotics: acute tonsillitis in 90.7 %, bronchitis in 67.5 %, otitis media in 65.9 %, pneumonia in 60.9 %, non-specific upper respiratory tract infections in 25.8 %, laryngitis in 22.2 %, and sinusitis in 12.5 %. The higher the number of antibiotic therapies, the higher the total number of visits including visits due to respiratory tract infections. In conclusion, implementation of careful and responsible management of a rational use of antibiotics is urgently needed since a reduction in their use may lead to a decrease in the number of visits due to upper respiratory tract infections and a total number of primary care visits.

Clinical studies on the protective effects of Ketotifen and Intal in atopic asthmatic patients.

The study was undertaken to compare the protective action of HC 20-511 (Ketotifen) and disodium cromoglycate (Intal) in patients with the atopic form of asthma. A total of 50 asthmatics, 26 men and 24 women, aged 14 to 45 were examined by a double-blind controlled method. In the group examined, both Ketotifen and Intal were administered in 25 patients during 12 weeks. Ketotifen was highly effective in 14 patients (56.0 percent) while the results of treatment by Intal were highly effective in 19 patients (76.0 per cent). The tolerance to Ketotifen and Intal was excellent or good, respectively in 88 per cent and 100 per cent of treated persons. In the authors opinion, Ketotifen and Intal have a valuable protective effect in atopic asthma cases, but both are less effective in patients with recurrent infections of the respiratory tract.

Allergy to cockroach antigens in asthmatic patients.

Cockroach allergy was investigated in a group of 56 patients with atopic bronchial asthma (37 men and 19 women with ages ranging from 16 to 65) all allergic to house dust antigen. In all patients, both intracutaneous tests and bronchial provocation tests were performed with cockroach antigen prepared from the species most common in Poland, Blattella germanica and Blatta orientalis. Positive skin reactions to cockroach antigen were found in 17 patients while an immediate bronchoconstrictive response was noted in 11. In the authors opinion, cockroach antigens may be partly responsible for the antigenic properties of house dust and may play a causative role in some cases of atopic asthma.