Results of diagnostics and treatment of amanita phalloides poisoning in Slovakia (2004-2020).

The paper presents results of AI diagnostics and treatment across the period of 2004-2020 pointing to the efficacy of two particular protocols. METHOD: Quantitative determination of amanitins in blood (ATOs) and urine (ATOu) performed by the original ELISA kit, indicated upon mycological history and clinical symptoms of poisoning. ATOu positive cases were recommended our protocol; ATOu negative results excluded amanitin poisoning. RESULTS: out of 2876 fungal poisonings registered in Slovakia during the subjected period, were 698 AI suspected cases. In 557 of them, was AI reliably excluded, in 141 confirmed. Urinary ATOu correlated with the severity of poisoning in the range of 6-47 h after mushroom ingestion, without false negativity. Serum ATOs had no diagnostic value. 129 patients with confirmed AI received full treatment protocol with antidotes of penicillin plus silibinin. In this group died two patients of acute kidney injury in the early stages of poisoning and 127 patients were recovered. Silibinin without penicillin was used in 12 patients. One of them undergone liver transplantation and four patients died of fulminant liver failure, respectively intracranial hemorrhage. Treatment failure in the PNC + silibinin protocol was 1.5 % (2 of 127 patients), silibinin alone being 41.7 % (5 of 12 patients, p = 0.00058). CONCLUSION: Early diagnostics of amanitin intoxication based on mycological and clinical history and subsequent determination of urinary amanitin levels (ATOu) allows early initiation of treatment. The use of treatment protocol with antidotes of PNC and silibinin is of high therapeutic efficacy. The omission of PNC from the treatment protocol significantly worsens patients' prognosis.

Potential problem of the co-occurrence of pandemic COVID-19 and seasonal influenza.

In times of COVID-19 pandemics, the upcoming period of the year when influenza activity usually increases in the Northern Hemisphere brings new medical and public health challenges. These challenges include the risk of mixed infections and/or a possible collision of the two epidemics (“twindemia”) with a potentially serious impact on individual health and public health. In this report, we discuss the results of the published stu-dies and conclude that the catastrophic collision of the seasonal influenza and COVID-19 epidemics is unlikely when efficient non-pharmaceutical public health measures are applied to control or mitigate the spread of the COVID-19 epidemic. This conclusion is supported by several lines of evidence, including the extremely low seasonal influenza activity registered in the Southern Hemisphere in 2020. On the other hand, the existence of mixed SARS-CoV-2 and influenza virus infections has been demonstrated in humans. The continuing uncertainty about the occurrence and potential severity of these mixed infections emphasizes the importance of seasonal influenza vaccination in the current epidemiological situation and raises the need to: (i) ensure vaccine availability, (ii) facilitate access to safe seasonal influenza vaccination under the conditions of the ongoing COVID-19 epidemic, and (iii) promote the vaccine to the public.

Magnetic resonance imaging in children receiving quinolones: no evidence of quinolone-induced arthropathy. A multicenter survey.

Twenty-nine children with cystic fibrosis (CF) were investigated for quinolone-induced arthropathy. Magnetic resonance imaging (MRI) was performed in 14/14 children treated with ofloxacin or ciprofloxacin and in 10/15 of those never treated with quinolones. The frequency of pathologic MRI findings, concerning cartilage thickness, careful analysis of the cartilage structure, presence of edema, cartilage-bone borderline and the presence of fluid in joints did not show any difference between both groups. Thus the presence of quinolone-induced arthrotoxicity cannot be confirmed in this study.

[Personal experience with the use of Rulid (roxithromycin) in children less than 1 year of age]. / Nase skúsenosti s pouzitím Rulidu (roxithromycinu) u detí do 1 roku zivota.

The authors give an account of the use of Roxithromycin (preparation Rulide) in children of the youngest age group, i.e. in infants. From January 1989 to April 1992 they treated 24 children under 5 weeks to 12 months of age with Roxithromycin. Roxithromycin was administered in amounts from 5 to 10 mg/kg after 12-hour intervals in the course of 4 to 12 days. In 22 children a favourable clinical effect was observed, in two children antibiotic treatment had to be changes because there was no clinical response. Undesirable effects, i.e. vomiting, during Roxithromycin were observed only in two children. In no instance was it necessary to discontinue treatment.

[Results of treatment of acute lymphoblastic leukemia over a 12-year period]. / Výsledky liecby akutnej lymfoblastickej leukémie za 12-rocné obdobie.

In the course of a 12-year period the authors treated at the Paediatric Department of the Regional Institute of National Health in Banská Bystrica 72 children with acute lymphoblastic leukaemia according to four protocols. Complete remission was achieved by 67 children, i.e. 93%. None of the children died from complications of treatment during complete remission. A relapse during treatment or soon after its termination occurred in 23 children, i.e. 31.9%. A second complete remission was achieved in 15 children, i.e. 65.2%. During the second complete remission seven children survive for 0.5-91.5 months. Twenty children died, i.e. 27.8%. All children had at the time of death signs of malignant disease. Fifty-two children survive at present for 1-132 months. The cumulative ratio of surviving children in the 12th year since the diagnosis is 0.57, the cumulative ratio of children in initial complete remission in the 12th year is 0.51.

[Claforan in the treatment of serious infections in children]. / Claforan v liecbe závazných infekcií u detí.

To 63 critically sick patients on account of serious infection Claforan was administered. Forty-six patients were hospitalized at the intensive care and resuscitation unit and 17 patients suffered from oncological conditions. Claforan treatment was successful in 69.56% of the patients treated at the intensive care and resuscitation unit and in 30.44% in the group of oncological patients.

[Hyperosmolar hyperglycemic coma in a 10-year-old patient]. / Hyperosmolárna hyperglykemická kóma u desat'rocného pacienta.

A ten-year-old patient referred to a child ambulatory for preoperative examination suddenly falls unconscious. The physical finding and laboratory results suggest hyperosmolar hyperglycaemic coma. The authors describe the clinical course and therapeutic procedure. They draw attention to adequate fluid and ion repletion, to the importance of their balancing and to possible complications of treatment.

Studies on congenital hypothyroidism and results of three and half years of compulsory screening program in Slovak Socialist Republic.

In the introduction the results of previous retrospective study (1975-79) including 312,259 newborns and of preliminary screening program including 31,780 newborns are briefly summarized. After January 1st, 1985 a compulsory screening of congenital hypothyroidism (CH) was started in the whole territory of Slovakia using the estimation of thyroxine in dry blood spot obtained from a heel prick on 5th day after birth. In suspected cases a complete clinical and laboratory examination was made including TSH estimation by RIA and after January 1st, 1988 by IRMA. The organization of screening program is described in detail. During three and half year period 286,469 newborns were examined which represented almost 100 percent of all newborns. A total of 44 cases of CH was found out of them 13 cases of athyreosis, 3 cases of ectopic thyroid and 28 cases of dyshormonogenesis (among them 5 cases with goiter and 23 cases without goiter). The average incidence of CH was 1:6874. Until January 1st, 1988 (when only T4 estimation was used as a first step) the recall rate was 2.32% and the treatment was started before 25th day after birth, while after the use of TSH by IRMA from dry blood spot in suspected cases (i.e. after January 1st, 1988) the recall rate decreased to 0.82% and the treatment was started before 14th day of life. In addition, the data on 39 cases of TBG deficiency and on regional differences in their incidence are reported. Some remarkable differences in the incidence of total CH and of its individual variants between West, Central and East Slovakia with different historical, cultural, economical and genetical background as well as in some ethnic groups (Gypsies) are also presented.