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Ahmad A Abdul-Aziz, Rodney A Hayward, Keith D Aaronson, Scott L Hummel
Importance: US hospitals receive financial penalties for excess risk-standardized 30-day readmissions and mortality in Medicare patients. Under current policy, readmission prevention is incentivized over 10-fold more than mortality reduction. Objective: To determine how penalties for US hospitals would change if policy equally weighted 30-day readmissions and mortality. Design, Setting, and Participants: Publicly available hospital-level data for fiscal year 2014 was obtained, including excess readmission ratio (ERR; risk-standardized predicted over expected 30-day readmissions) and 30-day mortality rates for heart failure, pneumonia, and acute myocardial infarction, as well as readmission penalties (as percent of Medicare Diagnosis Group payments)...
October 26, 2016: JAMA Cardiology
Adrien Contejean, Virginie Lemiale, Matthieu Resche-Rigon, Djamel Mokart, Frédéric Pène, Achille Kouatchet, Julien Mayaux, François Vincent, Martine Nyunga, Fabrice Bruneel, Antoine Rabbat, Pierre Perez, Anne-Pascale Meert, Dominique Benoit, Rebecca Hamidfar, Michael Darmon, Mercé Jourdain, Anne Renault, Benoît Schlemmer, Elie Azoulay
BACKGROUND: Acute respiratory failure (ARF) is the most frequent complication in patients with hematological malignancies and is associated with high morbidity and mortality. ARF etiologies are numerous, and despite extensive diagnostic workflow, some patients remain with undetermined ARF etiology. METHODS: This is a post-hoc study of a prospective multicenter cohort performed on 1011 critically ill hematological patients. Relationship between ARF etiology and hospital mortality was assessed using a multivariable regression model adjusting for confounders...
December 2016: Annals of Intensive Care
Angela Chiereghin, Evangelia Petrisli, Matteo Ravaioli, Maria Cristina Morelli, Gabriele Turello, Diego Squarzoni, Giulia Piccirilli, Simone Ambretti, Liliana Gabrielli, Antonio Daniele Pinna, Maria Paola Landini, Tiziana Lazzarotto
Infections continue to be one of the leading causes of morbidity and mortality in liver transplant recipients. We retrospectively reviewed the symptomatic infectious episodes that occurred during the first year post-transplant to determine time of onset, causative pathogens and cell-mediated immunity response patterns. Ninety-eight of the 202 (48.5%) recipients enrolled developed at least one infectious episode. The total number of infectious episodes was 135: 77 (57.1%) bacterial, 45 (33.3%) viral and 13 (9...
October 25, 2016: Medical Microbiology and Immunology
Ronan F O'Toole, Shakti D Shukla, Eugene H Walters
Expression of the platelet-activating factor receptor is upregulated in the respiratory epithelium of smokers and chronic obstructive pulmonary disease patients. We have recently determined that increased expression of PAFr correlates with higher levels of adhesion to human bronchial epithelial cells by non-typable Haemophilus influenzae and Streptococcus pneumoniae which are major bacterial pathogens in acute exacerbations of COPD. In addition, we found that a PAFr antagonist decreased the adhesion of both respiratory bacterial pathogens to non-cigarette exposure control levels...
October 26, 2016: Journal of Translational Medicine
Si Guo, JingJing Xu, YanShuan Wei, JunHong Xu, Yi Li, Rui Xue
BACKGROUND: Klebsiella pneumoniae is a prominent nosocomial pathogen that accounts for up to 10 % of all hospital-acquired infections. It is a frequent cause of ventilator-associated pneumonia (VAP). The purpose of this study was to investigate the clinical characteristics of K. pneumoniae-associated VAP and the molecular characteristics of K. pneumoniae strains. METHODS: We retrospectively reviewed 70 mechanically ventilated patients with K. pneumoniae isolated...
October 26, 2016: BMC Infectious Diseases
Simone M C Spoorenberg, Stefan M T Vestjens, Ger T Rijkers, Bob Meek, Coline H M van Moorsel, Jan C Grutters, Willem Jan W Bos
BACKGROUND AND OBJECTIVE: The aim of this study was to investigate the prognostic value of four biomarkers, YKL-40, chemokine (C-C motif) ligand 18 (CCL18), surfactant protein-D (SP-D) and CA 15-3, in patients admitted with community-acquired pneumonia (CAP). These markers have been studied extensively in chronic pulmonary disease, but in acute pulmonary disease their prognostic value is unknown. METHODS: A total of 289 adult patients who were hospitalized with CAP and participated in a randomized controlled trial were enrolled...
October 26, 2016: Respirology: Official Journal of the Asian Pacific Society of Respirology
Tamera J Corte, Harold Collard, Athol U Wells
No abstract text is available yet for this article.
October 26, 2016: Respirology: Official Journal of the Asian Pacific Society of Respirology
E C F Wagenaar, P van Wijngaarden, C M Verduin, D Beelen, R W van Etten
Staphylococcus lugdunensis (SL) is a species belonging to the group of coagulase-negative staphylococci (CNS). It can cause severe infections such as endocarditis. Three cases of endocarditis caused by SL are presented. The first case describes a 71-year-old man with a fever and endogenous endophthalmitis. The second case describes delirium in an 87-year-old woman, thought to be due to pneumonia. The third case describes a 76-year-old man with an infection of unknown origin. In all cases, the first blood cultures drawn were positive for CNS and considered to be contaminated...
2016: Nederlands Tijdschrift Voor Geneeskunde
David N Ku, Sarah K Ku, Beth Helfman, Nael A McCarty, Bernard J Wolff, Jonas M Winchell, Larry J Anderson
Background: Identifying lung pathogens and acute spikes in lung counts remain a challenge in the treatment of patients with cystic fibrosis (CF). Bacteria from the deep lung may be sampled from aerosols produced during coughing. Methods: A new device was used to collect and measure bacteria levels from cough aerosols of patients with CF. Sputum and oral specimens were also collected and measured for comparison. Pseudomonas aeruginosa, Staphylococcus aureus, Klebsiella pneumoniae, and Streptococcus mitis were detected in specimens using Real-Time Polymerase Chain Reaction (RT-PCR) molecular assays...
2016: F1000Research
M K Win, A Chow, H J Ho, S Y Tay, Y S Leo
Since the emergence of Middle East respiratory syndrome coronavirus (MERS-CoV), Singapore has enhanced its national surveillance system to detect the potential importation of this novel pathogen. Using the guidelines from the Singapore Ministry of Health, a suspect case was defined as a person with clinical signs and symptoms suggestive of pneumonia or severe respiratory infection with breathlessness, and with an epidemiological link to countries where MERS-CoV cases had been reported within the preceding 14 days...
October 26, 2016: Epidemiology and Infection
Harri Hemilä
Analyses in nutritional epidemiology usually assume a uniform effect of a nutrient. Previously, four subgroups of the Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study of Finnish male smokers aged 50-69 years were identified in which vitamin E supplementation either significantly increased or decreased the risk of pneumonia. The purpose of this present study was to quantify the level of true heterogeneity in the effect of vitamin E on pneumonia incidence using the I 2 statistic. The I 2 value estimates the percentage of total variation across studies that is explained by true differences in the treatment effect rather than by chance, with a range from 0 to 100 %...
October 26, 2016: British Journal of Nutrition
Lital Meir-Gruber, Yossi Manor, Shiraz Gefen-Halevi, Musa Y Hindiyeh, Fernando Mileguir, Roberto Azar, Gill Smollan, Natasha Belausov, Galia Rahav, Ari Shamiss, Ella Mendelson, Nathan Keller
The presence of pan-resistant bacteria worldwide possesses a threat to global health. It is difficult to evaluate the extent of carriage of resistant bacteria in the population. Sewage sampling is a possible way to monitor populations. We evaluated the presence of pan-resistant bacteria in Israeli sewage collected from all over Israel, by modifying the pour plate method for heterotrophic plate count technique using commercial selective agar plates. This method enables convenient and fast sewage sampling and detection...
2016: PloS One
Marina C Pils, Karla Dreckmann, Katharina Jansson, Silke Glage, Nadine Held, Wiebke Sommer, Florian Länger, Murat Avsar, Gregor Warnecke, André Bleich
Porcine reproductive and respiratory syndrome virus (PRRSV) infection was diagnosed in 6 Göttingen minipigs (Sus scrofa domestica) with severe interstitial pneumonia. The virus was defined as a North American (NA) subtype virus, which is common in the commercial pig population and might be derived from a widely used attenuated live-virus vaccine in Europe. The ORF5 sequence of the isolated PRRSV was 98% identical to the vaccine virus. The affected pigs were part of a lung transplantation model and received tacrolimus and steroids as well as irradiation or CD8 antibody for immunosuppression...
2016: Comparative Medicine
Hanna Stypułkowska-Misiurewicz, Michał Czerwiński
OBJECTIVE: The aim of the study was to assess the epidemiological situation of legionellosis in Poland in 2014. MATERIAL AND METHODS: We reviewed data published in the annual bulletin: “Infectious diseases and poisonings in Poland in 2014” and its prior versions along with the legionellosis case reports sent to the Department of Epidemiology of NIPH - NIH. RESULTS: In Poland, both two forms of legionellosis - Legionnaires’ disease (a severe form of disease accompanied by pneumonia) and Pontiac fever (mild, influenza-like form of infection) - are routinely reported to the surveillance...
2016: Przegla̧d Epidemiologiczny
Małgorzata Sadkowska-Todys, Andrzej Zieliński, Mirosław P Czarkowski
PURPOSE of the STUDY: The aim of the study is to assess epidemiological situation of infectious and parasitic diseases in Poland in 2014, and an indication of the potential health risks from communicable diseases occurring in other areas of the globe. MATERIAL AND METHODS: This paper is a summary of the analysis and evaluation of the results of epidemiological surveillance of infectious diseases in Poland in 2014, and those elements of European and global epidemiological background, which in this period had an impact on the epidemiological situation in Poland or constituted a threat...
2016: Przegla̧d Epidemiologiczny
Gen Kano, Hisashi Tsujii, Kazuhiko Takeuchi, Kaname Nakatani, Makoto Ikejiri, Satoru Ogawa, Hisami Kubo, Mizuho Nagao, Takao Fujisawa
Primary ciliary dyskinesia (PCD) is a rare genetic disorder caused by structural and/or functional impairment of cilia throughout the whole body. Early diagnosis of PCD is important for the prevention of long‑term sequelae, however early diagnosis is a challenge due to the phenotypic heterogeneity of PCD. In the current study, the patient with PCD was diagnosed at nine years old following several efforts to control intractable airway symptoms. The patient experienced a chronic productive cough beginning in early childhood and had multiple episodes of pneumonia and otitis media with effusion and sinusitis...
October 21, 2016: Molecular Medicine Reports
Wei Lu, Jia-Lin Yu, Lu-Quan Li, Qi Lu, Zheng-Li Wang, Yun Pan
Bacterial infectious pneumonia is one of the major causes of mortality in neonates, particularly when the neonates suffer from ventilator‑associated pneumonia (VAP). However, the causes of pneumonia are difficult to define. Thus, the present study focused on understanding the diversity of microflora in the lower respiratory tract to elucidate the causes. The experimental groups comprised newborns who suffered from infectious pneumonia with or without VAP (IVAP and IP groups, respectively), whereas the control group comprised newborns who suffered from respiratory distress syndrome (RDS) without VAP (RDS group)...
October 25, 2016: Molecular Medicine Reports
Fang Hua, Huixu Xie, Helen V Worthington, Susan Furness, Qi Zhang, Chunjie Li
BACKGROUND: Ventilator-associated pneumonia (VAP) is defined as pneumonia developing in people who have received mechanical ventilation for at least 48 hours. VAP is a potentially serious complication in these patients who are already critically ill. Oral hygiene care (OHC), using either a mouthrinse, gel, toothbrush, or combination, together with aspiration of secretions, may reduce the risk of VAP in these patients. OBJECTIVES: To assess the effects of oral hygiene care on incidence of ventilator-associated pneumonia in critically ill patients receiving mechanical ventilation in hospital intensive care units (ICUs)...
October 25, 2016: Cochrane Database of Systematic Reviews
Rebekah M Martin, Jie Cao, Sylvain Brisse, Virginie Passet, Weisheng Wu, Lili Zhao, Preeti N Malani, Krishna Rao, Michael A Bachman
Klebsiella pneumoniae is among the most common causes of hospital-acquired infections and has emerged as an urgent threat to public health due to carbapenem antimicrobial resistance. K. pneumoniae commonly colonizes hospitalized patients and causes extraintestinal infections such as urinary tract infection, bloodstream infection (septicemia), and pneumonia. If colonization is an intermediate step before infection, then detection and characterization of colonizing isolates could enable strategies to prevent or empirically treat K...
September 2016: MSphere
Danielle Ahn, Hernán Peñaloza, Zheng Wang, Matthew Wickersham, Dane Parker, Purvi Patel, Antonius Koller, Emily I Chen, Susan M Bueno, Anne-Catrin Uhlemann, Alice Prince
Adaptive changes in the genome of a locally predominant clinical isolate of the multidrug-resistant Klebsiella pneumoniae ST258 (KP35) were identified and help to explain the selection of this strain as a successful pulmonary pathogen. The acquisition of 4 new ortholog groups, including an arginine transporter, enabled KP35 to outcompete related ST258 strains lacking these genes. KP35 infection elicited a monocytic response, dominated by Ly6C(hi) monocytic myeloid-derived suppressor cells that lacked phagocytic capabilities, expressed IL-10, arginase, and antiinflammatory surface markers...
October 20, 2016: JCI Insight
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