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pneumonia guideline

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https://www.readbyqxmd.com/read/28103536/evidence-based-guidelines-for-the-use-of-tracheostomy-in-critically-ill-patients
#1
Néstor Raimondi, Macarena R Vial, José Calleja, Agamenón Quintero, Albán Cortés, Edgar Celis, Clara Pacheco, Sebastián Ugarte, José M Añón, Gonzalo Hernández, Erick Vidal, Guillermo Chiappero, Fernando Ríos, Fernando Castilleja, Alfredo Matos, Enith Rodriguez, Paulo Antoniazzi, José Mario Teles, Carmelo Dueñas, Jorge Sinclair, Lorenzo Martínez, Ingrid von der Osten, José Vergara, Edgar Jiménez, Max Arroyo, Camilo Rodríguez, Javier Torres, Sebastián Fernandez-Bussy, Joseph L Nates
OBJECTIVES: To provide evidence-based guidelines for tracheostomy in critically ill adult patients and identify areas needing further research. METHODS: A taskforce composed of representatives of 10 member countries of the Pan-American and Iberic Federation of Societies of Critical and Intensive Therapy Medicine and of the Latin American Critical Care Trial Investigators Network developed recommendations based on the Grading of Recommendations Assessment, Development and Evaluation system...
October 20, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/28099038/an-exome-sequencing-study-to-assess-the-role-of-rare-genetic-variation-in-pulmonary-fibrosis
#2
Slavé Petrovski, Jamie L Todd, Michael T Durheim, Quanli Wang, Jason W Chien, Fran L Kelly, Courtney Frankel, Caroline M Mebane, Zhong Ren, Joshua Bridgers, Thomas J Urban, Colin D Malone, Ashley Finlen Copeland, Christie Brinkley, Andrew S Allen, Thomas O'Riordan, John G McHutchison, Scott M Palmer, David B Goldstein
RATIONALE: Idiopathic pulmonary fibrosis (IPF) is an increasingly recognized, often fatal lung disease of unknown etiology. OBJECTIVES: The aim of this study was to use whole-exome sequencing to improve our understanding of the genetic architecture of pulmonary fibrosis. METHODS: We performed a case-control exome-wide collapsing analysis including 262 unrelated individuals with pulmonary fibrosis; clinically classified as IPF according to ATS/ERS/JRS/ALAT guidelines (81...
January 18, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28098068/the-differential-diagnosis-of-dyspnea
#3
Dominik Berliner, Nils Schneider, Tobias Welte, Johann Bauersachs
BACKGROUND: Dyspnea is a common symptom affecting as many as 25% of patients seen in the ambulatory setting. It can arise from many different underlying conditions and is sometimes a manifestation of a life-threatening disease. METHODS: This review is based on pertinent articles retrieved by a selective search in PubMed, and on pertinent guidelines. RESULTS: The term dyspnea refers to a wide variety of subjective perceptions, some of which can be influenced by the patient's emotional state...
December 9, 2016: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28095824/community-based-health-care-is-an-essential-component-of-a-resilient-health-system-evidence-from-ebola-outbreak-in-liberia
#4
Kendra Siekmans, Salim Sohani, Tamba Boima, Florence Koffa, Luay Basil, Saïd Laaziz
BACKGROUND: Trained community health workers (CHW) enhance access to essential primary health care services in contexts where the health system lacks capacity to adequately deliver them. In Liberia, the Ebola outbreak further disrupted health system function. The objective of this study is to examine the value of a community-based health system in ensuring continued treatment of child illnesses during the outbreak and the role that CHWs had in Ebola prevention activities. METHODS: A descriptive observational study design used mixed methods to collect data from CHWs (structured survey, n = 60; focus group discussions, n = 16), government health facility workers and project staff...
January 17, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28092204/impact-of-combination-therapy-and-early-de-escalation-on-outcome-of-ventilator-associated-pneumonia-caused-by-pseudomonas-aeruginosa
#5
Laurène Deconinck, Agnès Meybeck, Pierre Patoz, Nicolas Van Grunderbeeck, Nicolas Boussekey, Arnaud Chiche, Pierre-Yves Delannoy, Hugues Georges, Olivier Leroy
BACKGROUND: Pseudomonas aeruginosa is a common cause of ventilator-associated pneumonia (VAP). Guidelines recommend dual coverage of P. aeruginosa, but the beneficial effect of combination therapy is controversial. We described antibiotic prescriptions and evaluated the clinical impact of initial combination antibiotic therapy and de-escalation strategy in patients with VAP caused by P. aeruginosa. METHODS: Between 1994 and 2014, all 100 patients with VAP caused by P...
January 16, 2017: Infectious Diseases
https://www.readbyqxmd.com/read/28092165/recommendations-for-best-disinfectant-practices-to-reduce-the-spread-of-infection-via-wrestling-mats
#6
Linda Mull Young, Vicki Abram Motz, Emily R Markey, Suzanne C Young, Ronald E Beaschler
CONTEXT:  At the request of the National Wrestling Coaches Association and the head wrestling coach at our university, we conducted a study of infection transmission in collegiate wrestlers. OBJECTIVE:  To examine disinfectant effectiveness and develop best-practice guidelines for minimizing the spread of skin infections via wrestling mats. DESIGN:  Controlled laboratory study and crossover study. SETTING:  Laboratory and two 15-college wrestling invitational meets...
January 16, 2017: Journal of Athletic Training
https://www.readbyqxmd.com/read/28089635/venetoclax-plus-rituximab-in-relapsed-or-refractory-chronic-lymphocytic-leukaemia-a-phase-1b-study
#7
John F Seymour, Shuo Ma, Danielle M Brander, Michael Y Choi, Jacqueline Barrientos, Matthew S Davids, Mary Ann Anderson, Anne W Beaven, Steven T Rosen, Constantine S Tam, Betty Prine, Suresh K Agarwal, Wijith Munasinghe, Ming Zhu, L Leanne Lash, Monali Desai, Elisa Cerri, Maria Verdugo, Su Young Kim, Rod A Humerickhouse, Gary B Gordon, Thomas J Kipps, Andrew W Roberts
BACKGROUND: Selective BCL2 inhibition with venetoclax has substantial activity in patients with relapsed or refractory chronic lymphocytic leukaemia. Combination therapy with rituximab enhanced activity in preclinical models. The aim of this study was to assess the safety, pharmacokinetics, and activity of venetoclax in combination with rituximab. METHODS: Adult patients with relapsed or refractory chronic lymphocytic leukaemia (according to the 2008 Modified International Workshop on CLL guidelines) or small lymphocytic lymphoma were eligible for this phase 1b, dose-escalation trial...
January 12, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28079487/adopting-universal-testing-for-hiv-in-intensive-care-for-patients-admitted-with-severe-pneumonia-results-from-our-change-in-practice
#8
Rory Sharvill, Arnold Fernandes, Kate Allen, Jeremy Astin
Early identification of HIV infection is of obvious benefit to patients' health, yet many remain unaware of their diagnosis, with detrimental consequences. Current guidelines suggest patients with pneumonia are offered an HIV test. Early diagnosis of HIV infection in critically ill patients within intensive care is vital in reducing mortality and morbidity. In 2015, we established automated HIV testing for patients with pneumonia admitted to our intensive care unit. Prior to our change in practice, our HIV testing rate in patients with pneumonia was 29% within two weeks of admission...
January 2017: International Journal of STD & AIDS
https://www.readbyqxmd.com/read/28077751/performance-of-health-workers-using-an-electronic-algorithm-for-the-management-of-childhood-illness-in-tanzania-a-pilot-implementation-study
#9
Clotilde Rambaud-Althaus, Amani Shao, Josephine Samaka, Ndeniria Swai, Seneca Perri, Judith Kahama-Maro, Marc Mitchell, Valérie D'Acremont, Blaise Genton
In low-resource settings, where qualified health workers (HWs) are scarce and childhood mortality high, rational antimicrobial prescription for childhood illnesses is a challenge. To assess whether smartphones running guidelines, as compared with paper support, improve consultation process and rational use of medicines for children, a pilot cluster-randomized controlled study was conducted in Tanzania. Nine primary health-care facilities (HFs) were randomized into three arms: 1) paper algorithm, 2) electronic algorithm on a smartphone, and 3) control...
January 11, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28073945/surgery-and-imatinib-therapy-for-liver-oligometastasis-of-gist-a-study-of-japanese-study-group-on-gist
#10
Tatsuo Kanda, Toru Masuzawa, Toshihiro Hirai, Osamu Ikawa, Akinori Takagane, Yasuhiro Hata, Hitoshi Ojima, Harutsugu Sodeyama, Izumi Mochizuki, Takashi Ishikawa, Tatsuo Kagimura, Toshirou Nishida
We conducted a multicenter prospective study to clarify the efficacy and safety of surgery and imatinib for liver oligometastasis of gastrointestinal stromal tumors. Eligible gastrointestinal stromal tumor patients were enrolled in the surgery trial or the imatinib trial. Primary endpoints were recurrence-free survival and progression-free survival, respectively. The trials were prematurely terminated due to amendment of guidelines for adjuvant imatinib therapy and low patient accrual. In the surgery trial, all the six patients showed hepatic recurrence: median recurrence-free survival was 145 days (range: 62-1366 days)...
January 9, 2017: Japanese Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28069071/sporadic-cases-of-adult-measles-a-research-article
#11
Ranjan Premaratna, Nathasha Luke, Harsha Perera, Mahesh Gunathilake, Pubudu Amarasena, T G A Nilmini Chandrasena
BACKGROUND: Measles caused by a paramyxovirus, characterized by fever, malaise, cough, coryza conjunctivitis, a maculopapular rash is known to result in pneumonia, encephalitis and death. Fatal cases of measles in Sri Lanka are rare after implementation of the National Immunization Programme in 1984. Thereafter 0.1% case fatality rate was observed during October 1999-June 2000 which is a very low figure compared to other regional countries. Immunization guidelines were further revised in 2001, 2011 and in 2012 when additional immunization was recommended to age group 4-21 years; who are likely to have inadequate immunization, in order to achieve elimination of Measles by 2020...
January 10, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28061505/effectiveness-of-the-23-valent-pneumococcal-polysaccharide-vaccine-ppv23-against-pneumococcal-disease-in-the-elderly-systematic-review-and-meta-analysis
#12
Gerhard Falkenhorst, Cornelius Remschmidt, Thomas Harder, Eva Hummers-Pradier, Ole Wichmann, Christian Bogdan
BACKGROUND: Routine vaccination of elderly people against pneumococcal diseases is recommended in many countries. National guidelines differ, recommending either the 23-valent polysaccharide vaccine (PPV23), the 13-valent conjugate vaccine (PCV13) or both. Considering the ongoing debate on the effectiveness of PPV23, we performed a systematic literature review and meta-analysis of the vaccine efficacy/effectiveness (VE) of PPV23 against invasive pneumococcal disease (IPD) and pneumococcal pneumonia in adults aged ≥60 years living in industrialized countries...
2017: PloS One
https://www.readbyqxmd.com/read/28052071/impact-of-the-13-valent-pneumococcal-conjugate-vaccine-on-clinical-and-hypoxemic-childhood-pneumonia-over-three-years-in-central-malawi-an-observational-study
#13
Eric D McCollum, Bejoy Nambiar, Rashid Deula, Beatiwel Zadutsa, Austin Bondo, Carina King, James Beard, Harry Liyaya, Limangeni Mankhambo, Marzia Lazzerini, Charles Makwenda, Gibson Masache, Naor Bar-Zeev, Peter N Kazembe, Charles Mwansambo, Norman Lufesi, Anthony Costello, Ben Armstrong, Tim Colbourn
BACKGROUND: The pneumococcal conjugate vaccine's (PCV) impact on childhood pneumonia during programmatic conditions in Africa is poorly understood. Following PCV13 introduction in Malawi in November 2011, we evaluated the case burden and rates of childhood pneumonia. METHODS AND FINDINGS: Between January 1, 2012-June 30, 2014 we conducted active pneumonia surveillance in children <5 years at seven hospitals, 18 health centres, and with 38 community health workers in two districts, central Malawi...
2017: PloS One
https://www.readbyqxmd.com/read/28049382/use-of-intracranial-pressure-monitoring-in-bacterial-meningitis-a-10-year-follow-up-on-outcome-and-intracranial-pressure-versus-head-ct-scans
#14
Lykke Larsen, Frantz R Poulsen, Troels H Nielsen, Carl-Henrik Nordström, Mette K Schulz, Åse B Andersen
BACKGROUND: The aim of this study was to evaluate the clinical outcome of patients with severe bacterial meningitis where intracranial pressure (ICP) monitoring has been performed. METHODS: A retrospective observational study including patients admitted 1st(.) January 2005 to 31st(.) December 2014. Thirty nine patients age 18-89 years were included. All the patients received intensive care with mechanical ventilation, ICP monitoring, sedation, antibiotics and corticosteroids according to current guidelines...
January 3, 2017: Infectious Diseases
https://www.readbyqxmd.com/read/28041838/ambient-fine-and-coarse-particulate-matter-pollution-and-respiratory-morbidity-in-dongguan-china
#15
Yiju Zhao, Shengyong Wang, Lingling Lang, Caiyan Huang, Wenjun Ma, Hualiang Lin
We estimated the short-term effects of particulate matter (PM) pollution with aerodynamic diameters ≤2.5 μm (PM2.5) and between 2.5 and 10 μm (PMc) on hospital outpatient visits due to overall and specific respiratory diseases, as well as the associated morbidity burden in Dongguan, a subtropical city in South China. A time-series model with quasi-Poisson link was used to examine the association between PM pollution and morbidities from respiratory diseases, COPD, asthma and pneumonia in Dongguan during 2013-2015...
December 29, 2016: Environmental Pollution
https://www.readbyqxmd.com/read/28036314/etiology-of-early-onset-septicemia-among-neonates-at-the-university-college-hospital-ibadan-nigeria
#16
Abimbola Ellen Akindolire, Olukemi Tongo, Hannah Dada-Adegbola, Olusegun Akinyinka
INTRODUCTION: Neonatal septicemia remains a major cause of newborn deaths in developing countries. Its burden is further compounded by the emergence of multidrug-resistant pathogens, which is related to a lack of antibiotic protocols resulting in unrestricted use of antibiotics. The absence of reliable antibiotic sensitivity testing makes the formulation of antibiotic guidelines and judicious use of antibiotics difficult. This study sought to identify the current bacterial agents associated with early onset septicemia (EOS; age <72 hours) and their antibiotic susceptibility patterns among neonates at the University College Hospital, Ibadan, Nigeria...
December 30, 2016: Journal of Infection in Developing Countries
https://www.readbyqxmd.com/read/28035717/the-role-of-cd4-cell-count-as-discriminatory-measure-to-guide-chemoprophylaxis-against-pneumocystis-jirovecii-pneumonia-in-human-immunodeficiency-virus-negative-immunocompromised-patients-a-systematic-review
#17
Peter E Messiaen, Senne Cuyx, Tom Dejagere, Jeroen C Van der Hilst
BACKGROUND: In recent years, the incidence of Pneumocystis jirovecii pneumonia (PJP) has increased in immunocompromised patients without human immunodeficiency virus (HIV) infection. Chemoprophylaxis with trimethoprim-sulfamethoxazole (TMP-SMX) is highly effective in preventing PJP in both HIV-positive and -seronegative patients. In HIV-positive patients, the risk of PJP is strongly correlated with decreased CD4 cell count. The role of CD4 cell count in the pathogenesis of PJP in non-HIV immunocompromised patients is less well studied...
December 30, 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28033143/probiotics-for-trauma-patients-should-we-be-taking-a-precautionary-approach
#18
Heather A Vitko, L Kathleen Sekula, Martin A Schreiber
The use of probiotics in the hospital setting is largely understudied and highly controversial. Probiotics are living organisms that, when taken internally, can produce an immunomodulating effect and improve the gastrointestinal (GI) mucosal barrier. Although used for centuries by healthy individuals for GI health, their use in the hospital setting is now gaining wide attention for the prevention of infectious complications such as antibiotic-associated diarrhea, Clostridium difficile infections, multiple-organ dysfunction syndrome, and ventilator-associated pneumonia...
January 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28030502/operative-fixation-of-rib-fractures-after-blunt-trauma-a-practice-management-guideline-from-the-eastern-association-for-the-surgery-of-trauma
#19
George Kasotakis, Erik A Hasenboehler, Erik W Streib, Nimitt Patel, Mayur B Patel, Louis Alarcon, Patrick L Bosarge, Joseph Love, Elliott R Haut, John J Como
BACKGROUND: Rib fractures are identified in 10% of all injury victims and are associated with significant morbidity (33%) and mortality (12%). Significant progress has been made in the management of rib fractures over the last few decades, including operative reduction and internal fixation (rib ORIF); however, the subset of patients that would benefit most from this procedure remains ill-defined. The aim of this project was to develop evidence-based recommendations. METHODS: Population, intervention, comparison and outcome (PICO) questions were formulated for patients with and without flail chest...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28030371/antibiotic-dosing-for-multidrug-resistant-pathogen-pneumonia
#20
Mohd H Abdul-Aziz, Jeffrey Lipman, Jason A Roberts
PURPOSE OF REVIEW: Nosocomial pneumonia caused by multidrug-resistant pathogens is increasing in the ICU, and these infections are negatively associated with patient outcomes. Optimization of antibiotic dosing has been suggested as a key intervention to improve clinical outcomes in patients with nosocomial pneumonia. This review describes the recent pharmacokinetic/pharmacodynamic data relevant to antibiotic dosing for nosocomial pneumonia caused by multidrug-resistant pathogens. RECENT FINDINGS: Optimal antibiotic treatment is challenging in critically ill patients with nosocomial pneumonia; most dosing guidelines do not consider the altered physiology and illness severity associated with severe lung infections...
December 24, 2016: Current Opinion in Infectious Diseases
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