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Aspiration pneumonia

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https://www.readbyqxmd.com/read/28339769/incidence-and-potential-risk-factors-for-hospital-acquired-pneumonia-in-an-emergency-department-of-surgery
#1
Marie Stenlund, Rune Sjödahl, R N Pia Yngman-Uhlin
Objective: Hospital-acquired pneumonia (HAP) is associated with high mortality and is the second most common nosocomial infection. The aim of this study was to calculate the incidence and to identify potential risk factors for HAP in an emergency ward for surgical patients admitted because of acute abdomen or trauma. Design: A structured review of medical records was conducted. Patients diagnosed with pneumonia >48 h after admittance, were compared with a randomly chosen age-matched reference group...
February 23, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28338911/new-horizons-in-hospital-acquired-pneumonia-in-older-people
#2
Victoria Ewan, Thomas Hellyer, Julia Newton, John Simpson
Approximately 1.5% of hospital patients develop hospital acquired pneumonia. Aspiration is the major risk factor for pneumonia and is associated with reduced ability to mechanically clear respiratory pathogens into the stomach. Currently non-invasive methods of diagnosing hospital acquired pneumonia are less robust than invasive methods, and lead to over-diagnosis. Accurate diagnosis is key to surveillance, prevention and treatment of HAP, and also to improving outcomes; newer imaging modalities such as phase contrast X-ray imaging and nanoparticle enhanced magnetic resonance imaging may help...
February 27, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28336165/suspicious-outbreak-of-ventilator-associated-pneumonia-caused-by-burkholderia-cepacia-in-a-surgical-intensive-care-unit
#3
LiPing Guo, Gang Li, Jian Wang, Xia Zhao, Shupeng Wang, Li Zhai, Hongbin Jia, Bin Cao
BACKGROUND: We reviewed Burkholderia cepacia infections in a hospital from 2013-2016 to report a suspicious outbreak that occurred in a surgical intensive care unit in 2015, and to outline the infection control measures adopted thereafter. METHODS: Review of the health care-associated infection data regarding B cepacia via the surveillance system, hospital information system, electronic medical records, and laboratory information system together with the outbreak investigation was managed by the health care-associated infection control team...
March 20, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28323747/supporting-a-youth-with-cerebellar-ataxia-into-adolescence
#4
Veronica Meneses, Zurisadai Gonzalez-Castillo, Veronica B Edgar, Marilyn Augustyn
Zoe, a 13-year-old white girl, presents as a new patient to your pediatric clinic with complaints of frequent emesis, anxiety, and learning problems, and previous diagnosis of cerebellar ataxia. Parents accompany Zoe and state, "it is really hard for her to go out, she gets sick and falls easily." She was born full term by vaginal delivery without complications. Given globally delayed milestones, she received early intervention services. Feeding problems began at infancy, including gastroesophageal reflux and aspiration pneumonia...
March 17, 2017: Journal of Developmental and Behavioral Pediatrics: JDBP
https://www.readbyqxmd.com/read/28323732/bronchoscopic-removal-of-a-long-standing-aspirated-iron-pill
#5
Sandeep R Somalaraju, Katherine Patil, Anthony C Campagna
While patients have been known to aspirate pills, they virtually never persist long enough to lead to complications. A spectrum of events, however, may arise especially from iron pill aspiration. If not identified and removed early, cytotoxic damage from local free-radical generation may result in airway damage. We report a case of an aspirated iron pill, which did not disintegrate and presented with chronic cough. Imaging revealed a foreign body in the right bronchus, and bronchoscopic removal allowed resolution of an associated pneumonia, without any further symptoms on subsequent surveillance...
April 2017: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/28321261/diagnostic-performance-of-soluble-triggering-receptor-expressed-on-myeloid-cells-1-in-ventilator-associated-pneumonia-of-patients-with-ischemic-stroke
#6
Yuetian Yu, Cheng Zhu, Chunyan Liu, Yuan Gao, Rong Yin, Jianguo Cao
Objective. To investigate the effect of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) in serum, bronchoalveolar lavage fluid (BALF), endotracheal aspiration (ETA), and exhaled breath condensate (EBC) samples as early biomarkers for the diagnosis of ventilator-associated pneumonia (VAP) in patients with ischemic stroke. Methods. One hundred and thirty-two patients with clinically suspected VAP were enrolled in this study. Bronchoscopy was performed on the day of clinically suspected VAP...
2017: Canadian Journal of Infectious Diseases & Medical Microbiology
https://www.readbyqxmd.com/read/28317607/nutritional-aspects-of-dysphagia-management
#7
C Gallegos, E Brito-de la Fuente, P Clavé, A Costa, G Assegehegn
This chapter describes the nutritional aspects of dysphagia management by starting with the definition of these two conditions (dysphagia and malnutrition) that share three main clinical characteristics: (a) their prevalence is very high, (b) they can lead to severe complications, and (c) they are frequently underrecognized and neglected conditions. From an anatomical standpoint, dysphagia can result from oropharyngeal and/or esophageal causes; from a pathophysiological perspective, dysphagia can be caused by organic or structural diseases (either benign or malignant) or diseases causing impaired physiology (mainly motility and/or perception disorders)...
2017: Advances in Food and Nutrition Research
https://www.readbyqxmd.com/read/28304084/surgical-versus-non-surgical-management-for-pleural-empyema
#8
REVIEW
Mark D Redden, Tze Yang Chin, Mieke L van Driel
BACKGROUND: Empyema refers to pus in the pleural space, commonly due to adjacent pneumonia, chest wall injury, or a complication of thoracic surgery. A range of therapeutic options are available for its management, ranging from percutaneous aspiration and intercostal drainage to video-assisted thoracoscopic surgery (VATS) or thoracotomy drainage. Intrapleural fibrinolytics may also be administered following intercostal drain insertion to facilitate pleural drainage. There is currently a lack of consensus regarding optimal treatment...
March 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28303845/diagnostic-value-of-nasopharyngeal-aspirates-in-children-with-lower-respiratory-tract-infections
#9
Ai-Zhen Lu, Peng Shi, Li-Bo Wang, Li-Ling Qian, Xiao-Bo Zhang
BACKGROUND: The accuracy of nasopharyngeal aspirate (NPA) specimens in detecting lower respiratory pathogens remains controversial. The objective of this study was to evaluate the diagnostic accuracy of aspirates (NPAs) specimen in lower respiratory tract infections (LRTIs) in children. METHODS: The prospective study was designed to collect the data of paired NPAs and bronchoalveolar lavage fluids from children with acute LRTIs from January 2013 to December 2015...
March 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28303763/case-report-of-nivolumab-related-pneumonitis
#10
Kohei Tada, Yasuyuki Kurihara, Tomohiro Myojo, Fumitsugu Kojima, Yuya Ishikawa, Nobuyuki Yoshiyasu, Masaya Morimoto, Reiko Ito, Ryosuke Koyamada, Takuya Yamashita, Toru Bando, Shinichiro Mori, Yuji Heike
We report a case with suggestive antiprogrammed death-1 inhibitor-related pneumonitis in an endometrial cancer patient. This case presented with fever and cough after three dosages of nivolumab. Computed tomography initially showed centrilobular nodularities in a unilateral lung, which was compatible with aspiration pneumonia. However, diffuse ground-glass opacities (GGO) rapidly developed in the unilateral lung over 4 days despite the use of broad-spectrum antibiotics. Development of GGO was considered to be related to a nivolumab-mediated immune reaction...
March 2017: Immunotherapy
https://www.readbyqxmd.com/read/28303301/impact-of-tapered-cuff-tracheal-tube-on-microaspiration-of-gastric-contents-in-intubated-critically-ill-patients-a-multicenter-cluster-randomized-cross-over-controlled-trial
#11
Emmanuelle Jaillette, Christophe Girault, Guillaume Brunin, Farid Zerimech, Hélène Behal, Arnaud Chiche, Céline Broucqsault-Dedrie, Cyril Fayolle, Franck Minacori, Isabelle Alves, Stéphanie Barrailler, Julien Labreuche, Laurent Robriquet, Fabienne Tamion, Emmanuel Delaporte, Damien Thellier, Claire Delcourte, Alain Duhamel, Saad Nseir
PURPOSE: Studies on the impact of tapered-cuff tracheal tubes on rates of microaspiration and ventilator-associated pneumonia (VAP) in intubated patients have reported conflicting results. The aim of this study was to determine the influence of this shape of tracheal cuff on abundant microaspiration of gastric contents in critically ill patients. METHODS: All patients intubated in the intensive care unit (ICU) and requiring mechanical ventilation for at least 48 h were eligible for this multicenter cluster-randomized controlled cross-over open-label study...
March 16, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28296655/endoscopic-fundoplication-effectiveness-for-controlling-symptoms-of-gastroesophageal-reflux-disease
#12
Michael I Ebright, Praveen Sridhar, Virginia R Litle, Chaitan K Narsule, Benedict D Daly, Hiran C Fernando
OBJECTIVE: Transoral incisionless fundoplication (TIF) is a completely endoscopic approach to treat gastroesophageal reflux disease (GERD). We previously reported our initial results demonstrating safety and early effectiveness. We now present an updated experience describing outcomes with longer follow-up. METHODS: For a three-year period, TIF procedures were performed on 80 patients. Preoperative workup routinely consisted of contrast esophagram and manometry...
March 14, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28289630/recommendation-of-nasogastric-tube-removal-in-acute-stroke-patients-based-on-videofluoroscopic-swallow-study
#13
Jong-Moon Hwang, Youn-Soo Cheong, Min-Gu Kang, Seong Min Chun, Yu-Sun Min, Yang-Soo Lee, Tae-Du Jung
OBJECTIVE: To evaluate the safety of nasogastric tube (NGT) removal and change to oral feeding with a food thickener for acute stroke patients in whom a videofluoroscopic swallow study (VFSS) confirmed thin liquid aspiration. METHODS: We retrospectively examined data of 199 patients with first stroke who were diagnosed with dysphagia from 2011 to 2015. Swallowing function was evaluated using VFSS. Patients included in this study were monitored for 4 weeks to identify the occurrence of aspiration pneumonia...
February 2017: Annals of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28288860/epidemiology-of-multidrug-resistant-gram-negative-pathogens-isolated-from-ventilator-associated-pneumonia-in-icu-patients
#14
Richa Gupta, Abida Malik, Meher Rizvi, Moied Ahmed, Anuradha Singh
OBJECTIVES: Antibiotic resistance among Gram-negative pathogens isolated from ventilator-associated pneumonia (VAP) poses a grave threat in intensive care unit (ICU) patients. The aim of this study was to assess the prevalence of pathogens in ICU patients and their drug resistance profile. The prevalence of extended-spectrum β-lactamases (ESBLs), AmpC β-lactamases and metallo-β-lactamases (MBLs) was also assessed. METHODS: Tracheal aspirates were collected aseptically from 87 ICU patients between May 2012 and January 2014...
March 10, 2017: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/28272915/national-trends-in-admission-for-aspiration-pneumonia-in-the-united-states-in-2002-2012
#15
Chao-Ping Wu, Yu-Wei Chen, Min-Jung Wang, Evgeny Pinelis
RATIONALE: Aspiration pneumonia is a subset of pneumonias prevalent in elderly patients and patients with neurologic disorders. Previous studies mostly reported incidence and/or mortality rates from regional data or in specific subgroups of patients. There is paucity of nationwide data in contemporary United States population. OBJECTIVES: To describe United States national trends in acute care hospital admission for aspiration pneumonia from 2002 to 2012. METHODS: We used the US Nationwide Inpatient Sample (NIS) database to identify patients admitted with a primary diagnosis of aspiration pneumonia between 2002 and 2012...
March 8, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28269568/smartphone-based-swallowing-monitoring-and-feedback-device-for-mealtime-assistance-in-nursing-homes
#16
Naomi Kuramoto, Dushyantha Jayatilake, Kikue Hidaka, Kenji Suzuki
As many of the elderly are prone to dysphagia, preventing aspirations during mealtime assistance is a huge concern, especially for institutions operated with limited staff. Two of the main course of actions that are taken usually to prevent aspiration are the altering of bolus consistency and altering of the swallowing posture. To assist prevention of pneumonia, we have been developing a smartphone-based wearable technology that can evaluate swallowing ability in real-time. In this paper we will introduce modified version of Swallwoscope adding a posture detection system and a remote swallowing activity visualisation system to our previous work...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28261696/incidence-of-underlying-biliary-neoplasm-in-patients-after-major-hepatectomy-for-preoperative-benign-hepatolithiasis
#17
Hyeong Min Park, Young Hoe Hur, Chol Kyoon Cho, Yang Seok Koh, Hee Joon Kim, Eun Kyu Park
BACKGROUNDS/AIMS: Despite hepatolithiasis being a risk factor for biliary neoplasm including cholangiocarcinoma, the incidence of underlying biliary neoplasm is unknown in patients with preoperative benign hepatolithiasis. The aim of this study was to evaluate the incidence of underlying biliary neoplasm in patients who underwent major hepatectomy for preoperative benign hepatolithiasis. METHODS: Between March 2005 and December 2015, 73 patients who underwent major hepatectomy for preoperative benign hepatolithiasis were enrolled in this study...
November 2016: Ann Hepatobiliary Pancreat Surg
https://www.readbyqxmd.com/read/28259058/community-analysis-of-dental-plaque-and-endotracheal-tube-biofilms-from-mechanically-ventilated-patients
#18
Poala J Marino, Matt P Wise, Ann Smith, Julian R Marchesi, Marcello P Riggio, Michael A O Lewis, David W Williams
PURPOSE: Mechanically ventilated patients are at risk for developing ventilator-associated pneumonia, and it has been reported that dental plaque provides a reservoir of respiratory pathogens that may aspirate to the lungs and endotracheal tube (ETT) biofilms. For the first time, metataxonomics was used to simultaneously characterize the microbiome of dental plaque, ETTs, and non-directed bronchial lavages (NBLs) in mechanically ventilated patients to determine similarities in respective microbial communities and therefore likely associations...
February 16, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28257624/endotracheal-tubes-and-fluid-aspiration-an-in-vitro-evaluation-of-new-cuff-technologies
#19
Maryanne Z Mariyaselvam, Lucy L Marsh, Sarah Bamford, Ann Smith, Matt P Wise, David W Williams
BACKGROUND: Aspiration of subglottic secretions past the endotracheal tube (ETT) cuff is a prerequisite for developing ventilator-associated pneumonia (VAP). Subglottic secretion drainage (SSD) ETTs reduce aspiration of subglottic secretions and have demonstrated lower VAP rates. We compared the performance of seven SSD ETTs against a non-SSD ETT in preventing aspiration below inflated cuffs. METHODS: ETTs were positioned vertically in 2 cm diameter cylinders. Four ml of a standard microbial suspension was added above inflated cuffs...
March 4, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28257317/pulmonary-infections-in-critical-intensive-care-rapid-diagnosis-and-optimizing-antimicrobial-usage
#20
Ivor S Douglas
PURPOSE OF REVIEW: Diagnosis of pulmonary infection, including hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) in the critically ill patient remains a common and therapeutically challenging diagnosis with significant attributable morbidity, mortality, and cost. Current clinical approaches to surveillance, early detection and, conventional culture-based microbiology are inadequate for optimal targeted antibiotic treatment and stewardship. Efforts to enhance diagnosis of HAP and VAP and the impact of these novel approaches on rational antimicrobial selection and stewardship are the focus of recent studies reviewed here...
March 2, 2017: Current Opinion in Pulmonary Medicine
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