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https://www.readbyqxmd.com/read/28719897/clinical-manifestations-and-prognostic-factors-of-pneumocystis-jirovecii-pneumonia-without-hiv
#1
Nobuhiro Asai, Shinji Motojima, Yoshihiro Ohkuni, Ryo Matsunuma, Takuya Iwasaki, Kei Nakashima, Keiji Sogawa, Tamao Nakashita, Norihiro Kaneko
INTRODUCTION: Pneumocystis jirovecii pneumonia (PCP) can occur in HIV patients but also in those without HIV (non-HIV PCP) but with other causes of immunodeficiency including malignancy or rheumatic diseases. OBJECTIVE AND METHODS: To evaluate the clinical presentation and prognostic factors of non-HIV PCP, we retrospectively reviewed all patients diagnosed as having PCP without HIV at Kameda Medical Center, Chiba, Japan, from January 2005 until June 2012. For the purpose of examining a prognostic factor for non-HIV PCP with 30-day mortality, we compared the characteristics of patients, clinical symptoms, radiological images, Eastern Cooperative Oncology Group performance status (PS), and the time from the onset of respiratory symptoms to the start of therapy, in both survival and fatality groups...
July 19, 2017: Chemotherapy
https://www.readbyqxmd.com/read/28719697/diagnosis-and-management-of-asthma-in-adults-a-review
#2
Jennifer L McCracken, Sreenivas P Veeranki, Bill T Ameredes, William J Calhoun
Importance: Asthma affects about 7.5% of the adult population. Evidence-based diagnosis, monitoring, and treatment can improve functioning and quality of life in adult patients with asthma. Observations: Asthma is a heterogeneous clinical syndrome primarily affecting the lower respiratory tract, characterized by episodic or persistent symptoms of wheezing, dyspnea, and cough. The diagnosis of asthma requires these symptoms and demonstration of reversible airway obstruction using spirometry...
July 18, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28718995/a-systematic-review-of-the-prevalence-and-impact-of-urinary-incontinence-in-cystic-fibrosis
#3
REVIEW
Katherine B Frayman, Traci M Kazmerski, Susan M Sawyer
This systematic review synthesizes published articles investigating the prevalence, severity and impact of urinary incontinence (UI), a condition associated with cystic fibrosis (CF). References were identified through searching Medline, Embase and PubMed using the medical subject headings 'cystic fibrosis' AND 'urinary incontinence'. Articles were included if UI prevalence was investigated as an outcome. Twelve studies met selection criteria. The prevalence of UI ranged from 5% to 76%. Age and gender contributed to this variability...
July 18, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28718275/-assessment-of-adherence-to-antibiotic-treatment-in-primary-care-by-determining-levels-of-the-drug-using-a-liquid-chromatography-technique
#4
P Navarro-Gómez, A Sorlózano-Puerto, M M Olmo-Navas, P Nieto-Guindo, R Dueñas-Alcalá, J Gutiérrez-Fernández, R Romero-González, M A Rodriguez-Maresca
OBJECTIVE: The lack of adherence to antibiotic treatments is a matter of special interest, which has important clinical implications, as it is associated with therapeutic failure and increased bacterial resistance causing a high sani-tary cost. The objective of our study was to assess the degree of adherence to prescribed antibiotic treatment in outpatients through the detection of these in blood, urine or sputum. METHODS: Concentrations of antibiotics prescribed in 39 patients (34 with clinical suspicion of urinary tract infection and 5 with clinical suspicion of low respiratory tract infection) treated in Primary Care consultations of the Sanitary District of Almería (Spain) were determined by ultra-high performance liquid chromatography coupled to tandem mass spectrometry...
July 18, 2017: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/28717779/impact-of-middle-east-respiratory-syndrome-outbreak-on-the-use-of-emergency-medical-resources-in-febrile-patients
#5
Hyunho Jeong, Sikyoung Jeong, Juseok Oh, Seon Hee Woo, Byung Hak So, Jeong Hee Wee, Ji Hoon Kim, Ji Yong Im, Seung Pill Choi, Kyoungnam Park, Byul Nim Hee Cho, Sungyoup Hong
OBJECTIVE: Outbreaks of transmissible respiratory infection are suspected to have significant effects on the health of pediatric and geriatric patients. The objective was to assess the impact of the Middle East respiratory syndrome (MERS) outbreak on the use of emergency resources. METHODS: An ecologic analysis of emergency department (ED) records between September and December 2015, was performed. Data was obtained from the National Emergency Department Information System database for Korea...
June 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/28717000/empathy-burnout-and-antibiotic-prescribing-for-acute-respiratory-infections-a-cross-sectional-primary-care-study-in-the-us
#6
Bob Z Sun, Alexander Chaitoff, Bo Hu, Kathleen Neuendorf, Mahesh Manne, Michael B Rothberg
BACKGROUND: The impact of physician-patient relationship factors, such as physician empathy and burnout, on antibiotic prescribing has not been characterised. AIM: To assess associations between physician empathy and burnout and antibiotic prescribing for acute respiratory infections (ARIs) in primary care. DESIGN AND SETTING: Cross-sectional study of primary care practices in the Cleveland Clinic Health System in the US. METHOD: Patient and prescribing data were obtained from the medical record...
July 17, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28716797/a-pragmatic-phase-iii-multisite-double-blind-placebo-controlled-parallel-arm-dose-increment-randomised-trial-of-regular-low-dose-extended-release-morphine-for-chronic-breathlessness-breathlessness-exertion-and-morphine-sulfate-beams-study-protocol
#7
David Currow, Gareth John Watts, Miriam Johnson, Christine F McDonald, John O Miners, Andrew A Somogyi, Linda Denehy, Nicola McCaffrey, Danny J Eckert, Philip McCloud, Sandra Louw, Lawrence Lam, Aine Greene, Belinda Fazekas, Katherine C Clark, Kwun Fong, Meera R Agar, Rohit Joshi, Sharon Kilbreath, Diana Ferreira, Magnus Ekström
INTRODUCTION: Chronic breathlessness is highly prevalent and distressing to patients and families. No medication is registered for its symptomatic reduction. The strongest evidence is for regular, low-dose, extended- release (ER) oral morphine. A recent large phase III study suggests the subgroup most likely to benefit have chronic obstructive pulmonary disease (COPD) and modified Medical Research Council breathlessness scores of 3 or 4. This protocol is for an adequately powered, parallel-arm, placebo-controlled, multisite, factorial, block-randomised study evaluating regular ER morphine for chronic breathlessness in people with COPD...
July 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28716290/yarsagumba-fungus-health-problems-in-the-himalayan-gold-rush
#8
Pranawa Koirala, Bidur Pandit, Pratibha Phuyal, Ken Zafren
INTRODUCTION: Seasonal migration of people in search of Yarsagumba fungus creates a population of collectors that faces hardship and health risks in austere high-altitude settings. METHODS: In 2016, our 4-person team performed a 2-day health-needs survey of people collecting Yarsagumba fungus near the village of Yak Kharka (4020 m) in the Manang District of Nepal. RESULTS: There were approximately 800 people, both male and female, from age 10 to over 60, collecting Yarsagumba fungus...
July 14, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28712673/extract-critical-factors-affecting-the-length-of-hospital-stay-of-pneumonia-patient-by-data-mining-case-study-an-iranian-hospital
#9
Naghmeh Khajehali, Somayeh Alizadeh
MOTIVATION: Pneumonia is a prevalent infection of lower respiratory tract caused by infected lungs. Length of stay (LOS) in hospital is one of the simplest and most important indicators in hospital activity that is used for different purposes. The aim of this study is to explore the important factors affecting the LOS of patients with pneumonia in hospitals. METHODS: The clinical data set for the study were collected from 387 patients in a specialized hospital in Iran between 2009 and 2015...
July 13, 2017: Artificial Intelligence in Medicine
https://www.readbyqxmd.com/read/28712182/trend-of-irrational-medication-among-the-students-of-department-of-pharmacy-abbottabad-university-of-science-and-technology-in-common-cold-and-flu
#10
Mujeeb Ur Rehman, Saif Ullah Mehsud, Sartaj Ali, Muhammad Ishaq, Mumtaz Ali Khan
BACKGROUND: Common cold and flu are mostly of viral pathogenesis with symptoms in upper respiratory tract. It is highly contagious and close inter-individual contact in winter season increase the spread spectrum. Mis-interpretation with bacterial cause leads to irrationality in its medication. METHODS: A cross-sectional study was conducted among pharmacy department students in February-March 2016. Data were collected through self-administered questionnaire and expressed as percentage frequency...
January 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28711942/conservative-management-of-primary-vaginal-endodermal-sinus-tumor-and-rhabdomyosarcoma
#11
Weimin Xie, Keng Shen, Jiaxin Yang, Dongyan Cao, Mei Yu, Yao Wang
The aim of this study was to evaluate the conservative management and prognosis of primary vaginal endodermal sinus tumor and rhabdomyosarcoma in children. Medical records of children with vaginal endodermal sinus tumor and rhabdomyosarcoma between 1996 and 2015 were reviewed. A total of 24 patients (median age, 12 months; range, 7-44 months) were included in this study, comprising 17 patients with endodermal sinus tumor and 7 patients with rhabdomyosarcoma. Among the 17 patients with endodermal sinus tumor, 15 were initially treated at our hospital with chemotherapy alone, and 2 were initially treated in other hospitals with conservative surgery and chemotherapy...
June 28, 2017: Oncotarget
https://www.readbyqxmd.com/read/28711676/should-we-consider-fecal-colonization-with-extended-spectrum-%C3%AE-lactamase-producing-enterobacteriaceae-in-empiric-therapy-of-community-onset-sepsis
#12
Daša Stupica, Lara Lusa, Mirijam Nahtigal Klevišar, Sara Terzić, Mateja Pirš, Manica Mueller Premru, Franc Strle
In patients colonized with extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E), the preference for carbapenems (CRB) over non-CRB antibiotics for empiric therapy of sepsis is questionable from an ecologic perspective and also how well colonization actually predicts an ESBL-E etiology of infection has been poorly investigated. The purpose of this retrospective observational study was to determine the positive predictive value (PPV) of ESBL-E fecal colonization for ESBL-E etiology of sepsis and the impact of empiric therapy on treatment outcome...
July 12, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28711430/implementation-of-a-national-bundle-care-program-to-reduce-catheter-associated-urinary-tract-infection-in-high-risk-units-of-hospitals-in-taiwan
#13
Chih-Cheng Lai, Chun-Ming Lee, Hsiu-Tzy Chiang, Ching-Tzu Hung, Ying-Chun Chen, Li-Hsiang Su, Zhi-Yuan Shi, Jein-Wei Liu, Chang-Pan Liu, Min-Chi Lu, Yin-Ching Chuang, Wen-Chien Ko, Shu-Hui Tseng, Yen-Hsu Chen, Po-Ren Hsueh
BACKGROUND/PURPOSE: This study was intended to investigate the impact of implementation of catheter-associated urinary tract infection (CA-UTI) bundle care on the incidence of CA-UTI in high-risk units. METHODS: Thirteen high-risk units, including medical (n = 5), surgical (n = 3), cardiac intensive care units (n = 2), respiratory care centers (n = 2), and respiratory care ward (n = 1) were included in this quality-improvement project. This study was divided into pre-intervention phase (from January 1 to July 31) and post-intervention phase (from August 1 to October 31) in 2013...
June 26, 2017: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/28711274/clinical-association-lyme-disease-and-guillain-barre-syndrome
#14
Kinner Patel, Siddharth Shah, Dinesh Subedi
Guillain-Barre Syndrome (GBS) is a life-threatening condition in which patients may present to the Emergency Department in respiratory distress leading to death. The early identification and treatment of such a condition is paramount in preventing mortality. While there are many infections associated with GBS, the association with Lyme disease is uncommon. Through our case we aim to highlight Borrelia burgdorferi as an important antecedent infection associated with the development of GBS. In this case we report a 31-year-old male who was diagnosed with Lyme disease and GBS with relevant clinical presentation including progressive numbness and weakness in bilateral hands and feet for the past 1week along with areflexia...
July 8, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28709419/the-clinical-and-virological-features-of-the-first-imported-case-causing-mers-cov-outbreak-in-south-korea-2015
#15
Ji Yeon Lee, You-Jin Kim, Eun Hee Chung, Dae-Won Kim, Ina Jeong, Yeonjae Kim, Mi-Ran Yun, Sung Soon Kim, Gayeon Kim, Joon-Sung Joh
BACKGROUND: In 2015, the largest outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) infection outside the Middle East occurred in South Korea. We summarized the epidemiological, clinical, and laboratory findings of the first Korean case of MERS-CoV and analyzed whole-genome sequences of MERS-CoV derived from the patient. CASE PRESENTATION: A 68-year-old man developed fever and myalgia 7 days after returning to Korea, following a 10-day trip to the Middle East...
July 14, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28708843/prevalence-of-respiratory-viruses-among-adults-by-season-age-respiratory-tract-region-and-type-of-medical-unit-in-paris-france-from-2011-to-2016
#16
Benoit Visseaux, Charles Burdet, Guillaume Voiriot, François-Xavier Lescure, Taous Chougar, Olivier Brugière, Bruno Crestani, Enrique Casalino, Charlotte Charpentier, Diane Descamps, Jean-François Timsit, Yazdan Yazdanpanah, Nadhira Houhou-Fidouh
BACKGROUND: Multiplex PCR tests have improved our understanding of respiratory viruses' epidemiology by allowing their wide range detection. We describe here the burden of these viruses in hospital settings over a five-year period. METHODS: All respiratory samples from adult patients (>20 years old) tested by multiplex-PCR at the request of physicians, from May 1 2011 to April 30 2016, were included retrospectively. Viral findings are reported by season, patient age group, respiratory tract region (upper or lower) and type of clinical unit (intensive care unit, pneumology unit, lung transplantation unit and other medical units)...
2017: PloS One
https://www.readbyqxmd.com/read/28708679/transpulmonary-pressure-describes-lung-morphology-during-decremental-positive-end-expiratory-pressure-trials-in-obesity
#17
Jacopo Fumagalli, Lorenzo Berra, Changsheng Zhang, Massimiliano Pirrone, Roberta R De Santis Santiago, Susimeire Gomes, Federico Magni, Glaucia A B Dos Santos, Desmond Bennett, Vinicius Torsani, Daniel Fisher, Caio Morais, Marcelo B P Amato, Robert M Kacmarek
OBJECTIVES: Atelectasis develops in critically ill obese patients when undergoing mechanical ventilation due to increased pleural pressure. The current study aimed to determine the relationship between transpulmonary pressure, lung mechanics, and lung morphology and to quantify the benefits of a decremental positive end-expiratory pressure trial preceded by a recruitment maneuver. DESIGN: Prospective, crossover, nonrandomized interventional study. SETTING: Medical and Surgical Intensive Care Units at Massachusetts General Hospital (Boston, MA) and University Animal Research Laboratory (São Paulo, Brazil)...
August 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28707161/a-weight-independent-association-between-atypical-antipsychotic-medications-and-obstructive-sleep-apnea
#18
Habibolah Khazaie, Amir Sharafkhaneh, Sepideh Khazaie, Mohammad Rasoul Ghadami
BACKGROUND: With increasing use of atypical antipsychotic (AAP) agents, the concern has been raised about the association between AAP agents and medical complications. Obstructive sleep apnea (OSA) is a common breathing disorder that adversely affects health and quality of life. Because the major risk factors for OSA are weight gain and obesity by altering the upper airway anatomy, an association between AAP and development of OSA is predictable. However, we hypothesized that AAP may promote OSA not only by weight gain but also because of its potential effects on upper airway muscle function...
July 13, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/28705229/brugada-syndrome-in-a-patient-with-amyotrophic-lateral-sclerosis-a-case-report
#19
Anusha Battineni, Rohit Gummi, Naresh Mullaguri, Raghav Govindarajan
BACKGROUND: Amyotrophic lateral sclerosis is a fatal neuromuscular disorder characterized by progressive death of the upper and lower motor neurons in the central nervous system. Patients with this disease die mostly as a result of respiratory failure; however, owing to prolonged survival through assisted ventilation, cardiovascular causes are increasingly responsible for mortality. We report what is to the best of our knowledge the first case of type 2 Brugada syndrome causing ventricular tachyarrhythmia and cardiac arrest in a patient with upper limb onset amyotrophic lateral sclerosis...
July 14, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28705192/medical-condition-and-care-of-undocumented-migrants-in-ambulatory-clinics-in-tel-aviv-israel-assessing-unmet-needs
#20
Zohar Mor, Yuval Raveh, Ido Lurie, Alex Leventhal, Roni Gamzu, Nadav Davidovitch, Orel Benari, Itamar Grotto
BACKGROUND: Approximately 150,000 undocumented migrants (UM) who are medically uninsured reside in Israel, including ~50,000 originating from the horn of Africa (MHA). Free medical-care is provided by two walk-in clinics in Tel-Aviv. This study aims to compare the medical complaints of UM from different origins, define their community health needs and assess gaps between medical needs and available services. METHODS: This cross-sectional study included a random sample of 610 UM aged 18-64 years, who were treated in these community clinics between 2008 and 2011...
July 14, 2017: BMC Health Services Research
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