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https://www.readbyqxmd.com/read/29037960/effect-of-procalcitonin-guided-antibiotic-treatment-on-mortality-in-acute-respiratory-infections-a-patient-level-meta-analysis
#1
Philipp Schuetz, Yannick Wirz, Ramon Sager, Mirjam Christ-Crain, Daiana Stolz, Michael Tamm, Lila Bouadma, Charles E Luyt, Michel Wolff, Jean Chastre, Florence Tubach, Kristina B Kristoffersen, Olaf Burkhardt, Tobias Welte, Stefan Schroeder, Vandack Nobre, Long Wei, Heiner C Bucher, Djillali Annane, Konrad Reinhart, Ann R Falsey, Angela Branche, Pierre Damas, Maarten Nijsten, Dylan W de Lange, Rodrigo O Deliberato, Carolina F Oliveira, Vera Maravić-Stojković, Alessia Verduri, Bianca Beghé, Bin Cao, Yahya Shehabi, Jens-Ulrik S Jensen, Caspar Corti, Jos A H van Oers, Albertus Beishuizen, Armand R J Girbes, Evelien de Jong, Matthias Briel, Beat Mueller
BACKGROUND: In February, 2017, the US Food and Drug Administration approved the blood infection marker procalcitonin for guiding antibiotic therapy in patients with acute respiratory infections. This meta-analysis of patient data from 26 randomised controlled trials was designed to assess safety of procalcitonin-guided treatment in patients with acute respiratory infections from different clinical settings. METHODS: Based on a prespecified Cochrane protocol, we did a systematic literature search on the Cochrane Central Register of Controlled Trials, MEDLINE, and Embase, and pooled individual patient data from trials in which patients with respiratory infections were randomly assigned to receive antibiotics based on procalcitonin concentrations (procalcitonin-guided group) or control...
October 13, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/29018800/asthma-endotypes-and-an-overview-of-targeted-therapy-for-asthma
#2
REVIEW
Sarah Svenningsen, Parameswaran Nair
Guidelines for the management of severe asthma do not emphasize the measurement of the inflammatory component of airway disease to indicate appropriate treatments or to monitor response to treatment. Inflammation is a central component of asthma and contributes to symptoms, physiological, and structural abnormalities. It can be assessed by a number of endotyping strategies based on "omics" technology such as proteomics, transcriptomics, and metabolomics. It can also be assessed using simple cellular responses by quantitative cytometry in sputum...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28992906/renal-amyloidosis-associated-with-kartagener-syndrome-in-a-dog
#3
Bartolo Celona, Chiara Crinò, Carmelo Bruno, Simona Di Pietro, Elisabetta Giudice
A 4-year-old cocker spaniel, male, of 12kg body weight was presented because of the onset of polyuria or polydipsia. From the first months of its life, the dog had exhibited constant serous to mucopurulent nasal discharge, productive cough, sneezing, reverse sneezing, otitis, and recurrent episodes of fever. The respiratory signs had been treated several times with antibiotics, without ever achieving a complete resolution. Clinical examination revealed normal rectal temperature (38.3°C), increased respiratory rate (40breaths/min), a copious mucous nasal discharge and right deviation of the heart apex beat (ictus cordis)...
June 2017: Topics in Companion Animal Medicine
https://www.readbyqxmd.com/read/28985369/reducing-early-career-general-practitioners-antibiotic-prescribing-for-respiratory-tract-infections-a-pragmatic-prospective-non-randomised-controlled-trial
#4
Parker Magin, Amanda Tapley, Simon Morgan, Joshua S Davis, Patrick McElduff, Lucy Yardley, Kim Henderson, Anthea Dallas, Lawrie McArthur, Katie Mulquiney, Andrew Davey, Paul Little, Neil Spike, Mieke L van Driel
Background: Inappropriate antibiotic prescription and consequent antibacterial resistance is a major threat to healthcare. Objectives: To evaluate the efficacy of a multifaceted intervention in reducing early career general practitioners' (GPs') antibiotic prescribing for upper respiratory tract infections (URTIs) and acute bronchitis/bronchiolitis. Methods: A pragmatic non-randomized trial employing a non-equivalent control group design nested within an existing cohort study of GP registrars' (trainees') clinical practice...
July 17, 2017: Family Practice
https://www.readbyqxmd.com/read/28981235/-lower-respiratory-tract-infections-in-immunocompetent-adult
#5
F Jacobs
Lower respiratory tract infections represent one of the main causes of mortality in the world. They essentially consist of bronchitis, acute exacerbations of chronic obstructive bronchopulmonary diseases (COPD) and acute pneumonia. If acute bronchitis is mainly of viral origin, acute exacerbations of COPD and pneumonia are mainly due to a trio of bacteria (Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis). Other pathogens as many viruses and atypical bacteria such as Mycoplasma pneumoniae, Legionella, some Enterobacteriaceae and very rarely Pseudomonas aeruginosa are also implicated...
2017: Revue Médicale de Bruxelles
https://www.readbyqxmd.com/read/28961815/quality-of-antibiotic-prescribing-of-swiss-primary-care-physicians-with-high-prescription-rates-a-nationwide-survey
#6
Dominik Glinz, Selene Leon Reyes, Ramon Saccilotto, Andreas F Widmer, Andreas Zeller, Heiner C Bucher, Lars G Hemkens
Objectives: To assess the quality of antibiotic prescribing of Swiss primary care physicians with high prescription rates. Methods: In January 2015, we mailed a structured questionnaire to 2900 primary care physicians in Switzerland. They were included in a nationwide pragmatic randomized controlled trial on routine antibiotic prescription monitoring and feedback based on health insurance claims data. We asked them to record the diagnosis and antibiotic treatment for 44 consecutive patients with the most common conditions associated with antibiotic prescribing in primary care...
August 24, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28929236/-criteria-for-treating-mrsa-in-sputum
#7
REVIEW
J Lorenz, M Unnewehr, B Schaaf, S Gatermann
Methicillin-resistant strains of Staphylococcus aureus (MRSA) are of particular significance for the management of patients with airway infections, since the disease course is often complicated and treatment rendered difficult by multiple resistance. Their prevalence is now slowly declining, but still alarmingly high. Hospital-acquired infections are predominant, but hospital-associated and community-acquired infections do occur, as do rare infections with livestock-acquired strains. Non-nosocomial strains are characterized by different pathogenic factors and a different spectrum of antibacterial resistance; they often have a threatening disease course...
September 19, 2017: Der Internist
https://www.readbyqxmd.com/read/28922566/streptococcus-pneumoniae-and-chronic-endobronchial-infections-in-childhood
#8
Kim M Hare, Amanda J Leach, Heidi C Smith-Vaughan, Anne B Chang, Keith Grimwood
Streptococcus pneumoniae (pneumococcus) is the main cause of bacterial pneumonia worldwide and has been studied extensively in this context. However, its role in chronic endobronchial infections and accompanying lower airway neutrophilic infiltration has received little attention. Severe and recurrent pneumonia are risk factors for chronic suppurative lung disease (CSLD) and bronchiectasis; the latter causes considerable morbidity and, in some populations, premature death in children and adults. Protracted bacterial bronchitis (PBB) is another chronic endobronchial infection associated with substantial morbidity...
September 18, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28887201/reactive-oxygen-therapy-a-novel-antimicrobial
#9
REVIEW
Matthew Dryden
The main solution to the global antibiotic resistance crisis is reducing the volume of antibiotic use in medicine, agriculture and the environment. However there is also a pressing need for novel antimicrobials. Despite much rhetoric, there are few entirely novel agents in development. One such therapy to reach clinical use is an agent using Reactive Oxygen Species (ROS), oxygen radicals, as an antimicrobial mechanism. ROS can be delivered to the site of infection in various formats. ROS is highly antimicrobial against Gram positive and negative bacteria, viruses and fungi...
September 5, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28885339/role-of-chemotherapy-and-thrombolysis-in-treatment-of-choriocarcinoma-accompanied-with-pulmonary-embolism-a-case-report-with-literature-review
#10
Mei Yang, Li Peng
RATIONALE: Choriocarcinoma accompanied with pulmonary embolism (PE) is rare and difficult to diagnose and treat. There are about 25 cases reported in literature, which presented variable clinical characteristics and prognosis. PATIENT CONCERNS: We reported a case of choriocarcinoma presenting PE as the first manifestation in a 26-year-old Chinese female. DIAGNOSES: Four months before her admission to our hospital, she presented to a local hospital with respiratory manifestations, and was first diagnosed as bronchitis and treated with antibiotics without improvement, and subsequently suspected of having pulmonary tuberculosis and receive anti-tuberculosis therapy, with no response...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28859019/age-specific-antibiotic-prescribing-and-adherence-to-guidelines-in-pediatric-patients-in-primary-care
#11
Verica Ivanovska, Karin Hek, Aukje K Mantel-Teeuwisse, Hubert G M Leufkens, Liset van Dijk
BACKGROUND: Most antibiotics in children are used to treat viral and self-limiting conditions. This study aims to compare physicians' adherence to guidelines on antibiotic prescribing in fever and in ear and respiratory infections to children in different age groups in the Netherlands. METHODS: Data were used from the NIVEL Primary Care Database. For all pediatric episodes of fever, acute otitis media (AOM), streptococcal pharyngitis (strep throat), sinusitis, acute tonsillitis, acute bronchitis/bronchiolitis and pneumonia in 2012, we determined whether national guidelines were followed in regard to whether an antibiotic was prescribed, and the type of antibiotic...
August 28, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28819878/aspergillus-bronchitis-in-patients-with-cystic-fibrosis
#12
Claudia Brandt, Jobst Roehmel, Volker Rickerts, Volker Melichar, Nadja Niemann, Carsten Schwarz
Aspergillus fumigatus frequently colonizes the airways of patients with cystic fibrosis (CF) and may cause various severe infections, such as bronchitis. Serological data, sputum dependent markers and longitudinal data of treated cases of Aspergillus bronchitis were evaluated for further description of this infection. This study, which comprises three substudies, aimed to analyze epidemiological data of Aspergillus in CF and the entity of Aspergillus bronchitis. In a first step, data of the German Cystic Fibrosis Registry were used to evaluate the frequency of Aspergillus colonization in patients with CF (n = 2599)...
August 17, 2017: Mycopathologia
https://www.readbyqxmd.com/read/28811907/factors-associated-with-antibiotic-prescriptions-for-the-viral-origin-diseases-in-office-based-practices-2006-2012
#13
Sara Imanpour, Obioma Nwaiwu, Darcy K McMaughan, Bethany DeSalvo, Adnan Bashir
OBJECTIVE: To test the potential association between time spent with a doctor and antibiotic overprescriptions in case of the common cold, runny nose, bronchitis, chest colds, flu, sore throats, and fluid in the middle ear. DESIGN: Cross-sectional study. SETTING: Office-based physicians in the US. PARTICIPANTS: A total of 261,623 patient visits recorded to office-based physicians in the US. MAIN OUTCOME MEASURES: The interest outcome was unnecessary antibiotic prescription...
August 2017: JRSM Open
https://www.readbyqxmd.com/read/28810628/use-of-aerosol-inhalation-treatment-with-budesonide-and-terbutaline-sulfate-on-acute-pediatric-asthmatic-bronchitis
#14
Fangfang Bian, Yue-E Wu, Chong-Lin Zhang
The use of oxygen-driven aerosol inhalation therapy with budesonide (suspension) and terbutaline sulfate for the treatment of pediatric asthmatic bronchitis was studied. Sixty pediatric patients diagnosed with asthmatic bronchitis in Xuzhou Children's Hospital during the period comprising April 2013 to December 2015 were enrolled in the study. After randomly dividing the patients into a control (conventional dexamethasone drip) and a treatment group (inhalation of budesonide with terbutaline sulfate) of 30 patients each, the symptoms were treated using antibiotics when necessary...
August 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28805776/-diagnostic-and-curative-bronchoscopy-for-purulent-destructive-pulmonary-diseases
#15
T P Pinchuk, O O Yasnogorodsky, Yu V Guryanova, M V Taldykin, A S Kachikin, Yu A Catane
AIM: To assess an efficacy of diagnostic and curative bronchoscopy in patients with purulent-destructive pulmonary diseases. MATERIAL AND METHODS: Diagnosis and treatment of 34 patients with purulent-destructive pulmonary diseases including small-focal destruction (14) and lung abscesses (19) were analyzed. 33 patients underwent diagnostic fibrobronchoscopy (FBS) with brush and transbronchial biopsy. Curative endoscopy included bronchial tree sanation, peribronchial administration of antibiotics (5) and transbronchial drainage of abscess (14)...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28755066/two-sides-of-the-same-coin-pediatric-onset-and-adult-onset-common-variable-immune-deficiency
#16
Lauren A Sanchez, Solrun Melkorka Maggadottir, Matthew S Pantell, Patricia Lugar, Charlotte Cunningham Rundles, Kathleen E Sullivan
PURPOSE: Common variable immunodeficiency (CVID) is a complex, heterogeneous immunodeficiency characterized by hypogammaglobulinemia, recurrent infections, and poor antibody response to vaccination. While antibiotics and immunoglobulin prophylaxis have significantly reduced infectious complications, non-infectious complications of autoimmunity, inflammatory lung disease, enteropathy, and malignancy remain of great concern. Previous studies have suggested that CVID patients diagnosed in childhood are more severely affected by these complications than adults diagnosed later in life...
July 28, 2017: Journal of Clinical Immunology
https://www.readbyqxmd.com/read/28701117/antibiotics-for-acute-respiratory-infections-in-general-practice-comparison-of-prescribing-rates-with-guideline-recommendations
#17
COMPARATIVE STUDY
Amanda R McCullough, Allan J Pollack, Malene Plejdrup Hansen, Paul P Glasziou, David Fm Looke, Helena C Britt, Christopher B Del Mar
OBJECTIVE: To compare the current rate of antibiotic prescribing for acute respiratory infections (ARIs) in Australian general practice with the recommendations in the most widely consulted therapeutic guidelines in Australia (Therapeutic Guidelines). DESIGN AND SETTING: Comparison of general practice activity data for April 2010 - March 2015 (derived from Bettering the Evaluation and Care of Health [BEACH] study) with estimated rates of prescribing recommended by Therapeutic Guidelines...
July 17, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28671088/correlation-study-of-cough-variant-asthma-and-mycoplasma-pneumonia-infection-in-children
#18
Wen Li, Cunfang Ban, Junxia Zhang, Yingying Hu, Bingjuan Han, Bingchao Han
Cough variant asthma (CVA), as one of bronchitis diseases, features with repeated cough. In clinics, CAV does not show significant abnormal signs, therefore antibiotic therapy can hardly achieve satisfactory treatment effect. With the development of scientific technologies, the correlation between mycoplasma pneumoniae infection and CVA has become a hot research topic in clinics. In clinics, mycoplasma pneumoniae is extensively regarded as major cause for CVA, with complex pathogenic mechanism. The symptoms of CVA is characterized by chronic non abnormal inflammation, normally accompanied with bronchospasm and intestinal infection...
May 2017: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28644312/early-infections-and-the-risk-of-irritable-bowel-syndrome-a-case-control-study
#19
Edward J Krajicek, Ann E Almazar, Joseph J Larson, Elizabeth J Atkinson, Nicholas J Talley, Yuri A Saito
GOALS: The goal of this study is to evaluate the association between early life infections and subsequent adult onset irritable bowel syndrome (IBS). BACKGROUND: Infections during adulthood are a known risk factor for adult-onset IBS. This investigation examined the role of childhood infections and infection risk factors in the development of IBS symptoms. STUDY: In total, 1010 subjects (509 outpatients with IBS, 501 matched controls) were mailed questionnaires regarding early-life infections during infancy (0 to 12 mo), toddler years (1 to 3 y), and child years (4 to 18 y)...
June 21, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28626902/haemophilus-influenzae-oral-vaccination-for-preventing-acute-exacerbations-of-chronic-bronchitis-and-chronic-obstructive-pulmonary-disease
#20
REVIEW
Edward Teo, Kathleen Lockhart, Sai Navya Purchuri, Jennifer Pushparajah, Allan W Cripps, Mieke L van Driel
BACKGROUND: Chronic bronchitis and chronic obstructive pulmonary disease (COPD) are serious conditions in which patients are predisposed to viral and bacterial infections resulting in potentially fatal acute exacerbations. Chronic obstructive pulmonary disease is defined as a lung disease characterised by obstruction to lung airflow that interferes with normal breathing. Antibiotic therapy has not been particularly useful in eradicating bacteria such as non-typeable Haemophilus influenzae (NTHi) because they are naturally occurring flora of the upper respiratory tract in many people...
June 19, 2017: Cochrane Database of Systematic Reviews
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