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2. Perioperative antibiotic prophylaxis in a single tertiary hospital in Slovenia - the role of education in recommendation complianceMatej Žnidarič, Matjaž Vogrin, Andrej Moličnik, Faris Mujezinović, Niko Kavčič, Nina Gorišek Miksić, 2021, izvirni znanstveni članek Ključne besede: perioperative antibiotic prophylaxis, recommendations, compliance, surgery, educational intervention
Objavljeno v DKUM: 22.01.2023; Ogledov: 589; Prenosov: 62
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4. Forecasting COVID-19Matjaž Perc, Nina Gorišek Miksić, Mitja Slavinec, Andraž Stožer, 2020, drugi znanstveni članki Opis: The World Health Organization declared the coronavirus disease 2019 a pandemic on March 11th, pointing to the over 118,000 cases in over 110 countries and territories around the world at that time. At the time of writing this manuscript, the number of confirmed cases has been surging rapidly past the half-million mark, emphasizing the sustained risk of further global spread. Governments around the world are imposing various containment measures while the healthcare system is bracing itself for tsunamis of infected individuals that will seek treatment. It is therefore important to know what to expect in terms of the growth of the number of cases, and to understand what is needed to arrest the very worrying trends. To that effect, we here show forecasts obtained with a simple iteration method that needs only the daily values of confirmed cases as input. The method takes into account expected recoveries and deaths, and it determines maximally allowed daily growth rates that lead away from exponential increase toward stable and declining numbers. Forecasts show that daily growth rates should be kept at least below 5% if we wish to see plateaus any time soon - unfortunately far from reality in most countries to date. We provide an executable as well as the source code for a straightforward application of the method on data from other countries.
Ključne besede: COVID-19, pandemic, disease dynamics, exponential growth, virality
Objavljeno v DKUM: 06.11.2020; Ogledov: 1189; Prenosov: 232
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5. Viral respiratory infections in a nursing home : a six-month prospective studyTina Uršič, Nina Gorišek Miksić, Lara Lusa, Franc Strle, Miroslav Petrovec, 2016, izvirni znanstveni članek Opis: Background: The knowledge on viral respiratory infections in nursing home (NH) residents and their caregivers is limited. The purpose of the present study was to assess and compare the incidence of acute respiratory infections (ARI) in nursing home (NH) residents and staff, to identify viruses involved in ARI and to correlate viral etiology with clinical manifestations of ARI.
Methods: The prospective surveillance study was accomplished in a medium-sized NH in Slovenia (central Europe). Ninety NH residents and 42 NH staff were included. Nasopharyngeal swabs were collected from all participants at enrollment (December 5th, 2011) and at the end of the study (May 31st, 2012), and from each participant that developed ARI within this timeframe. Molecular detection of 15 respiratory viruses in nasopharyngeal swab samples was performed.
Results: The weekly incidence rate of ARI in NH residents and NH staff correlated; however, it was higher in staff members than in residents (5.9 versus 3.8/1,000 person-days, P=0.03), and was 2.5 (95 % CI: 1.36-4.72) times greater in residents without dementia than in residents with dementia. Staff members typically presented with upper respiratory tract involvement, whereas in residents lower respiratory tract infections predominated. Respiratory viruses were detected in 55/100 ARI episodes. In residents, influenza A virus, respiratory syncytial virus, and human metapneumovirus were detected most commonly, whereas in NH staff rhinovirus and influenza A virus prevailed. 38/100 ARI episodes (30/56 in residents, 8/44 in staff) belonged to one of three outbreaks (caused by human metapneumovirus, influenza A virus and respiratory syncytial virus, respectively). NH residents had higher chances for virus positivity within outbreak than HN staff (OR=7.4, 95 % CI: 1.73-31.48, P<0.01).
Conclusions: ARI are common among NH residents and staff, and viruses were detected in a majority of the episodes of ARI. Many ARI episodes among NH residents were outbreak cases and could be considered preventable. Trial registration The study was registered on the 1th of December 2011 at ClinicalTrials (NCT01486160).
Ključne besede: respiratory infections, nursing home, residents nursing home
Objavljeno v DKUM: 28.06.2017; Ogledov: 1210; Prenosov: 197
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6. Etiologija virusnih okužb dihal pri oskrbovancih in zaposlenih v domu starejših občanovNina Gorišek Miksić, 2016, doktorsko delo/naloga Opis: S staranjem prebivalstva se veča število oseb s kroničnimi obolenji, upadom mentalnih in motoričnih funkcij ter posledično potrebo po institucionaliziranem varstvu. V Sloveniji prebiva v domovih starejših občanov (DSO) okoli 5% prebivalcev. Zaradi starostnega upada imunskih zmožnosti, pridruženih obolenj in bivalnih posebnosti (bivanja večjega ranljivih števila oseb v skupnih prostorih) predstavljajo okužbe v DSO poseben problem. Okužbe dihal (AOD) so med najpogostejšimi okužbami v DSO, predstavljajo tretjino vseh okužb v DSO, povezane so z največjim številom bolnišničnih obravnav in tudi z najvišjo smrtnostjo. Vodijo lahko v trajni upad fizičnih zmogljivosti starostnikov. Četudi pogostost virusnih AOD s starostjo pada, lahko te potekajo s težjim kliničnim potekom - z znaki akutne okužbe spodnjih dihal (AOSD). Prepoznavanje AOD je lahko pri starostnikih v DSO, zaradi pogosto neznačilne klinične slike, težavno. Poznavanje virusne etiologije in incidence AOD v DSO je pomembno, saj omogoča smiselno na
rtovanje ukrepov za zmanjšanje obolevnosti oskrbovancev.
Bolniki in metode
V 6-mesečno prospektivno raziskavo smo vključili 90 oskrbovancev DSO ter 42 zaposlenih v enem izmed DSO-jev v mariborski regiji. Opazovali smo pojav AOD v obdobju od 5.decembra 2011 do 31. maja 2012 pri oskrbovancih DSO in osebju. AOD smo definirali po McGeer-ovih kriterijih. AOD so dnevno prepoznavale naučene medicinske sestre in potrdila zdravnica ob viziti pri obolelih oskrbovancih. Pridobili smo osnovne podatke, podatke o pridruženih obolenjih ter o cepljenju proti gripi pri vseh sodelujočih v raziskavi. Ob začetku in zaključku raziskave smo vsem sodelujočim odvzeli bris nosnega dela žrela za mikrobiološke preiskave, prav tako tudi ob vsaki epizodi AOD, kjer smo zabeležili tudi klinične simptome in znake obolenja.
V brisu nosnega dela žrela smo s pomočjo molekularne preiskave določili prisotnost genoma virusov gripe A in B, parainfleunce 1-3, rinovirusov, respiratomega sincicijskega virusa, človeškega metapnevmovirusa, koronavirusov, adenovirusov, človeškega bokavirusa in enterovirusov. Prav tako smo v 6 mesečnem obdobju raziskave beležili tedensko število obiskovalcev v sobah sodelujočih oskrbovancev DSO. V statistični analizi smo uporabljali naslednje metode: 6-mesečno incidenčno stopnjo AOD, akutnih okužb zgornjih dihal (AOZD) in AOSD smo podali kot število AOD (oz. AOSD in AOZD) na 1000 oskrbnih dni; kategorične spremenljivke smo primerjali s pomočjo hi-kvadrat testa ali Fisherjevega eksaktnega testa; korelacijo med spremenljivkama smo preučili s pomočjo korelacijskega koeficienta Kendall τ; s pomočjo multivariantne Poissonove analize smo preučili vpliv različnih neodvisnih spremenljivk na incidenčno stopnjo AOD pri posameznem oskrbovancu DSO. Povezanost med številom obiskovalcev pri posameznih oskrbovancih in pojavom AOD pri le-teh smo preučevali s pomočjo Poissonove regresije. Kot statistično značilne smo upoštevali rezultate, pri katerih je bil p < 0,05.
Rezultati
V 6-mesečnem opazovalnem obdobju je bila incidenčna stopnja AOD 3,8/1000 oskrbnih dni pri oskrbovancih in 5,9/1000 oskrbnih pri zaposlenih, razlika je statistično pomembna. Starostniki so pogosteje obolevali z AOSD (73%), kot z AOZD (27%), med tem ko so zaposleni obolevali skoraj izključno za AOZD (97%). S pomočjo multivariantne Poissonove analize smo ugotovili, da nobena od vključenih neodvisnih spremenljivk (starost, cepilni status - cepljenje proti gripi, pomičnost in pridružena kronična obolenja (sladkorna bolezen, srčno-žilna, možgansko-žilna obolenja, kronična pljučna obolenja, demenca) ne vpliva na pojav AOD pri oskrbovancih, z izjemo demence. Dementni bolniki so kar 2,5 krat redkeje obolevali z AOD. Prav tako število obiskovalcev ni vplivalo na pojav AOD pri oskrbovancih. Ugotovili smo korelacijo med tedensko incidenčno stopnjo AOD pri zaposlenih in oskrbovancih. Viruse smo dokazali pri 60,7 % epizod AOD pri oskrbovancih DSO in pri 47,7 % epizod AOD pri zaposlenih. Pri os
Ključne besede: akutna okužba dihal, dom starejših občanov, respiratorni virusi, gripa, incidenčna stopnja
Objavljeno v DKUM: 10.02.2016; Ogledov: 2792; Prenosov: 431
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7. Capnocytophaga canimorsus - neobičajna povzročiteljica septičnega šoka pri bolniku brez vraniceNina Gorišek Miksić, Andrej Trampuž, 2002, strokovni članek Opis: The paper describes the case of a 28-year-old patient without a spleen in whomhigh fever, vomiting, abdominal cramps, palpable purpura and peripheral cyanosis suddenly developed. Upon admission, he was in septic shock with multi-organ failure. He needed intubation, artificial ventilation and hemodynamic support. Blood culture samples grew gram-negative rods after four days of incubation, which were later identified as Capnocytophaga Canimorsus. In continuation, the differential diagnosis in patients without a spleen who suddenly develop a septic shock is discussed. The importance bf taking an exact exposure history to find the correct diagnosis is emphasized, including possible contacts with domestic animals.
Objavljeno v DKUM: 21.12.2015; Ogledov: 1079; Prenosov: 40
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