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EN
Influenza is an acute respiratory disease caused by the influenza virus which often occurs in outbreaks and epidemics worldwide. The World Health Organization recommends annual vaccination of healthcare workers (HCWs) against influenza, because most of them are involved in the direct care of patients with a high risk of influenza-related complications. Given the significance of the disease burden, a targeted literature review was conducted to assess issues related to influenza vaccination among HCWs. The primary aim of this review was to assess the incidence of influenza among medical personnel and healthcare-associated influenza, and to outline the benefits of influenza vaccination for patients and HCWs themselves. Vaccination of HCWs seems to be an important strategy for reducing the transmission of influenza from healthcare personnel to their patients and, therefore, for reducing patient morbidity and mortality, increasing patient safety, and reducing work absenteeism among HCWs. The benefits of influenza vaccination for their patients and for HCWs themselves are addressed in literature, but the evidence is mixed and often of low-quality.
EN
Background Some cardiac implantable electronic device (CIED) implantation procedures require the use of X-rays, which is reflected by such parameters as total fluoroscopy time (TFT) and dose-area product (DAP – defined as the absorbed dose multiplied by the area irradiated). Material and Methods This retrospective study evaluated 522 CIED implantation (424 de novo and 98 device upgrade and new lead placement) procedures in 176 women and 346 men (mean age 75±11 years) over the period 2012–2015. The recorded procedure-related parameters TFT and DAP were evaluated in the subgroups specified below. The group of 424 de novo procedures included 203 pacemaker (PM) and 171 implantable cardioverter-defibrillator (ICD) implantation procedures, separately stratified by single-chamber and dual-chamber systems. Another subgroup of de novo procedures involved 50 cardiac resynchronization therapy (CRT) devices. The evaluated parameters in the group of 98 upgrade procedures were compared between 2 subgroups: CRT only and combined PM and ICD implantation procedures. Results We observed differences in TFT and DAP values between procedure types, with PM-related procedures showing the lowest, ICD – intermediate (with values for single-chamber considerably lower than those for dual-chamber systems) and CRT implantation procedures – highest X-ray exposure. Upgrades to CRT were associated with 4 times higher TFT and DAP values in comparison to those during other upgrade procedures. Cardiac resynchronization therapy de novo implantation procedures and upgrades to CRT showed similar mean values of these evaluated parameters. Conclusions Total fluoroscopy time and DAP values correlated progressively with CIED implantation procedure complexity, with CRT-related procedures showing the highest values of both parameters. Med Pr 2017;68(3):363–374
PL
Wstęp Realizacja części procedur CIED (cardiac implantable electronic device – stałej elektroterapii serca) wymaga zastosowania promieniowania rentgenowskiego (rtg.), co znajduje odzwierciedlenie w czasie ekspozycji TFTs (total fluoroscopy times – łączny czas naświetlania) oraz wielkości dawki promieniowania rtg. wyemitowanej na skórę pacjenta (dose area product – DAP). Materiał i metody Badaniem retrospektywnym dotyczącym lat 2012–2015 objęto 522 procedury CIED (u 176 kobiet i 346 mężczyzn, średnia wieku: 75±11 lat), z których 424 były zabiegami pierwszorazowymi (de novo), a 98 powtórnymi (upgrade), wymagającymi wprowadzenia nowej elektrody i zmiany urządzenia. Zarejestrowane po ich realizacji parametry TFTs i DAP odniesiono do wymienionych poniżej grup. Grupę 424 zabiegów de novo tworzyły: 203 implantacje stymulatorów (pacemaker – PM), 171 implantacji kardiowerterów-defibrylatorów (implantable cardiowerter-defibrylator – ICD), w których obrębie niezależnie wyodrębniono układy 1- i 2-jamowe, oraz 50 implantacji układów resynchronizujących (cardiac resynchronization therapy – CRT). W przypadku grupy 98 procedur upgrade porównano parametry między 2 podgrupami zabiegów – tylko do CRT oraz tylko w obrębie PM i ICD. Wyniki Najniższe wartości TFTs i DAP towarzyszyły implantacjom PM, pośrednie – ICD, z wyraźnym wzrostem w przypadku układów 2-jamowych w stosunku do 1-jamowych. Najwyższe wartości TFTs i DAP cechowały zabiegi CRT. Zabiegom upgrade do CRT towarzyszyły 4-krotnie większe wartości TFTs i DAP w porównaniu z upgrade niezwiązanym z CRT. W przypadku zabiegów CRT de novo i CRT upgrade średnie wartości mierzonych parametrów były zbliżone. Wnioski Czas ekspozycji i wielkość DAP pozostawały dodatnio związane z zaawansowaniem procedury CIED, przy czym zabiegi z zakresu CRT wyróżniały się ich największymi wartościami. Med. Pr. 2017;68(3):363–374
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