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Pneumonia in elderly

Analía Rial, Florencia Ferrara, Norma Suárez, Paola Scavone, Juan Martín Marqués, José Alejandro Chabalgoity
Respiratory tract infections are among the most frequent infections in humans causing millions of deaths especially in children and the elderly. Antibiotics and vaccines are the main available tools of control, but resistant strains are continuously arising and available vaccines only account for few of many pathogens involved. Non-specific immunotherapies are an emerging alternative to induce protective immunity at the airways. Mucosally administered polyvalent bacterial lysates (PBLs) have been widely used for decades for prevention of respiratory diseases, but the bases of their proposed therapeutic effectiveness are still controversial...
October 20, 2016: Microbes and Infection
Wen-Guo Chen, Guo-Dong Shan, Hong Zhang, Ming Yang, Lin L, Min Yue, Guang-Wu Chen, Qing Gu, Hua-Tuo Zhu, Guo-Qiang Xu, Li-Hua Chen
The aim of the study was to evaluate the diagnostic and therapeutic value of double-balloon entoroscopy (DBE) in small bowel diseases (SBDs) in China.A retrospective review of 674 consecutive patients who underwent DBE between January 2007 and November 2015 was conducted. Patients were divided into 3 groups by age, young group (<45 years), middle-aged group (45-65 years), and elderly group (>65 years). Data were collected with regard to demographics, clinical, endoscopic findings, complications, diagnostic yield, and management...
October 2016: Medicine (Baltimore)
Harri Hemilä
BACKGROUND: Vitamin E has influenced the immune system in laboratory studies. Dozens of animal experiments have found that vitamin E offered protection against infections caused by viruses and bacteria. Previously, significant heterogeneity was found in the effect of vitamin E supplementation on pneumonia in humans. The aim of this study was to examine how the effect of vitamin E on pneumonia risk depends on age. METHODS: Secondary analysis of the Alpha-Tocopherol, Beta-Carotene Cancer Prevention study in Finland, 1985-1993, was performed...
2016: Clinical Interventions in Aging
Maya Izumi, Kenji Takeuchi, Seijun Ganaha, Sumio Akifusa, Yoshihisa Yamashita
BACKGROUND: Methods for preventing aspiration pneumonia are needed soon in order to reduce mortality from aspiration pneumonia and promote the health of the elderly. OBJECTIVE: The aim of this randomized controlled trial was to examine whether oral care with tongue cleaning improves coughing ability in elderly individuals living in geriatric care facilities. METHODS: Participants comprised 114 residents of 11 group homes and private nursing homes in Aso City in Kumamoto Prefecture...
October 17, 2016: Journal of Oral Rehabilitation
Rachel Mourot-Cottet, Frédéric Maloisel, François Séverac, Olivier Keller, Thomas Vogel, Martine Tebacher, Jean-Christophe Weber, Georges Kaltenbach, Jacques-Eric Gottenberg, Bernard Goichot, Jean Sibilia, Anne-Sophie Korganow, Raoul Herbrecht, Emmanuel Andrès
BACKGROUND: Little data is currently available in the literature on neutropenia and agranulocytosis in the elderly, and, to our knowledge, idiosyncratic drug-induced agranulocytosis is particularly poorly covered, or not at all. OBJECTIVE: We herein describe the clinical picture and outcome of patients aged ≥75 years with established idiosyncratic drug-induced agranulocytosis. PATIENTS AND METHODS: Data from 61 patients over 75 years old with idiosyncratic drug-induced agranulocytosis were retrospectively reviewed...
September 5, 2016: Drugs—Real World Outcomes
Marie-Odile Husson, Delphine Ley, Céline Portal, Madeleine Gottrand, Thomas Hueso, Jean-Luc Desseyn, Frédéric Gottrand
OBJECTIVES: Although n-3 long-chain polyunsaturated fatty acids (n-3 LC-PUFAs) are used widely in the treatment of chronic inflammatory diseases, their effect in infectious disease requires a particular attention. METHODS: The present article discusses their anti-inflammatory and immune properties involved in the host defence and presents a systematic review of the effects of their oral administration on the prevention and outcome of experimental and clinical infections...
October 14, 2016: Journal of Infection
Hong Qiu, Shengzhi Sun, Robert Tang, King-Pan Chan, Linwei Tian
The growth of pathogens potentially relevant to respiratory tract infection may be triggered by changes in ambient temperature. Few studies have examined the association between ambient temperature and pneumonia incidence, and no studies have focused on the susceptible elderly population. We aimed to examine the short-term association between ambient temperature and geriatric pneumonia and to assess the disease burden attributable to cold and hot temperatures in Hong Kong, China. Daily time-series data on emergency hospital admissions for geriatric pneumonia, mean temperature, relative humidity, and air pollution concentrations between January 2005 and December 2012 were collected...
October 15, 2016: American Journal of Epidemiology
Yoko Fujimaki, Koichi Tsunoda, Rika Kobayashi, Chong Tonghyo, Fujinobu Tanaka, Hiroyuki Kuroda, Tsutomu Numata, Toyota Ishii, Reiko Kuroda, Sawako Masuda, Sho Hashimoto, Hayato Misawa, Naoko Shindo, Takahiro Mori, Hiroko Mori, Naoki Uchiyama, Yuichirou Kamei, Masashi Tanaka, Hironobu Hamaya, Shingo Funatsuki, Satoko Usui, Ikuno Ito, Kohei Hamada, Akihito Shindo, Yutaka Tokumaru, Yoko Morita, Rumi Ueha, Takaharu Nito, Shu Kikuta, Sotaro Sekimoto, Kenji Kondo, Takashi Sakamoto, Kenji Itoh, Tatsuya Yamasoba, Sumio Matsumoto
OBJECTIVES: To evaluate the effect of a self-controlled vocal exercise in elderly people with glottal closure insufficiency. DESIGN: Parallel-arm, individual randomized controlled trial. METHODS: Patients who visited one of 10 medical centers under the National Hospital Organization group in Japan for the first time, aged 60 years or older, complaining of aspiration or hoarseness, and endoscopically confirmed to have glottal closure insufficiency owing to vocal cord atrophy, were enrolled in this study...
October 14, 2016: Clinical Rehabilitation
Harlan M Krumholz, Angela Hsieh, Rachel P Dreyer, John Welsh, Nihar R Desai, Kumar Dharmarajan
BACKGROUND: The risk of rehospitalization is elevated in the immediate post-discharge period and declines over time. It is not known if the extent and timing of risk vary across readmission diagnoses, suggesting that recovery and vulnerability after discharge differ by physiologic system. OBJECTIVE: We compared risk trajectories for major readmission diagnoses in the year after discharge among all Medicare fee-for-service beneficiaries hospitalized with heart failure (HF), acute myocardial infarction (AMI), or pneumonia from 2008-2010...
2016: PloS One
Anne L Wyllie, Lidewij W Rümke, Kayleigh Arp, Astrid A T M Bosch, Jacob P Bruin, Nynke Y Rots, Alienke J Wijmenga-Monsuur, Elisabeth A M Sanders, Krzysztof Trzciński
Carriage of Streptococcus pneumoniae in adults is rarely detected by the gold standard culture method. With molecular tests of high sensitivity now available, we analysed upper respiratory tract samples collected during autumn/winter 2012/2013 from parents of PCV7-vaccinated infants and from childless adults, directly comparing culture and qPCR-based S. pneumoniae detection. As compared to the gold standard of testing nasopharyngeal swabs, qPCR-based analysis of oral samples significantly improved detection of pneumococcal carriage (5% versus 20%, p < 0...
October 7, 2016: Scientific Reports
Burke A Cunha, John Gian
BACKGROUND: Hospitalized adults with fever and "pneumonia" can be a difficult diagnostic challenge particularly when the clinical findings may be due to different infectious diseases. METHODS: We recently had an elderly female who presented with fever, fatigue and dry cough with elevated serum transaminases and lung infiltrates. The diagnosis of Epstein-Barr virus (EBV) infectious mononucleosis (IM) was made based on a positive Monospot test, elevated EBV VCA IgM titer, and highly elevated EBV viral load...
October 3, 2016: Heart & Lung: the Journal of Critical Care
Devin M Boe, Lisbeth A Boule, Elizabeth J Kovacs
The world is undergoing an unprecedented shift in demographics, with the number of individuals over the age of 60 projected to reach 2 billion or more by 2050, representing 22% of the global population. The elderly are at a higher risk for chronic disease and more susceptible to infection, due in part to age-related dysfunction of the immune system resulting from low-grade chronic inflammation known as "inflamm-aging". The innate immune system of older individuals exhibits a diminished ability to respond to microbial threats and clear infections, resulting in a greater occurrence of many infectious diseases in the elderly...
October 6, 2016: Clinical and Experimental Immunology
Catia Cilloniz, Adrian Ceccato, Alicia San Jose, Antoni Torres
Community acquired pneumonia (CAP) is a major health problem in elderly persons and is associated with high morbidity and mortality. Areas covered: This article reviews the most recent publications relative to CAP in the elderly population, with a focus on epidemiology, prognostic factors, microbial etiology, therapy and prevention. The data discussed in this review were mainly obtained from a non-systematic review using Medline, and references from relevant articles. Expert Commentary: CAP can occur at any age, but its incidence and risk of death are linked to increasing age...
October 3, 2016: Expert Review of Respiratory Medicine
Antoni Payeras, Maria Peñaranda, Antonio Iñigo, Margarita Garau, José Luis Pérez, Carmen Gallegos, Melchor Riera
OBJECTIVES: To study the characteristics and outcomes of pneumococcal infections in patients aged ≥65 years since the authorization of the 13-valent pneumococcal conjugate vaccine (PCV-13) in Spain. METHODS: All pneumococcal pneumonias, empyemas or primary bacteraemias treated at two hospitals in Majorca from 2010 to 2015 were included. Clinical variables, serotypes, and antibiotic susceptibility were collected. RESULTS: Two hundred and forty-nine pneumonias, 11 primary bacteraemias, and 2 empyemas in 243 patients were studied; 181 (69...
August 11, 2016: Infectious Diseases
Masanari Takami, Motohiro Okada, Yoshio Enyo, Hiroshi Iwasaki, Hiroshi Yamada, Munehito Yoshida
PURPOSE: Noncontiguous double-level unstable spinal injuries (NDUSI) are uncommon and have not been well described. In this study, we aimed to better understand the patterns of NDUSI, in order to recommend proper diagnostic and treatment methods, as well as to raise awareness among traumatologists about the possibility of these uncommon injuries. METHODS: A total of 710 consecutive patients with spine fractures were treated for >9 years since 2007 at a single regional trauma center...
September 28, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Jun Hirai, Daisuke Sakanashi, Shusaku Haranaga, Takeshi Kinjo, Mao Hagihara, Hideo Kato, Hiroyuki Suematsu, Yuka Yamagishi, Jiro Fujita, Hiroshige Mikamo
BACKGROUND AND OBJECTIVE: In recent years, Streptococcus anginosus group (SAG) bacteria are becoming increasingly recognized as important pneumonia-causing pathogens. Although several small studies have been reported, the features of SAG pneumonia remain unclear, because the identification of SAG from sputum cultures is not routinely performed in most microbiology laboratories. The aim of this study was to elucidate the clinical characteristics of SAG pneumonia. PATIENT AND METHODS: This was a retrospective case-control study utilizing data obtained in our hospital between September 2009 and June 2016...
September 25, 2016: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
Takeshi Kera, Ayako Edahiro, Hirohiko Hirano, Hisashi Kawai, Hideyo Yoshida, Motonaga Kojima, Yoshinori Fujiwara, Kazushige Ihara, Shuichi Obuchi
BACKGROUND: Under the hypothesis that elderly people in the community may have deficient oropharyngeal dysfunction, the purpose of this case-control study was to compare oral and physical characteristics in elderly people with and without a history of pneumonia and to identify factors distinguishing them. METHODS: In 2014, we examined 1,311 elderly people who agreed to participate in a longitudinal and intervention study for the community-dwelling elderly. We looked at such physical characteristics as body composition, grip power, gait, and balance and at oropharyngeal characteristics, such as alternating motion rate (AMR) in speech and the repetitive saliva-swallowing test (RSST)...
September 27, 2016: Respiratory Care
Junghyun Kim, Jung-Kyu Lee, Eun Young Heo, Hee Soon Chung, Deog Kyeom Kim
BACKGROUND: The hallmark of COPD is chronic airway inflammation, which may be mediated by renin-angiotensin system. The renin-angiotensin system blockers such as angiotensin-converting enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARBs) have exhibited anti-inflammatory and immunomodulatory effects in patients with various diseases. We explored the effects of ACEi and ARBs on the risk of pneumonia in patients with COPD. METHODS: A nested case-control study was performed on COPD patients recruited from January 2010 to August 2013 in two referral hospitals in Korea...
2016: International Journal of Chronic Obstructive Pulmonary Disease
M S Reich, A J Dolenc, T A Moore, H A Vallier
BACKGROUND: Previous work established resuscitation parameters that minimize complications with early fracture management. This Early Appropriate Care (EAC) protocol was applied to patients with advanced age to determine if they require unique parameters to mitigate complications. METHODS: Between October 2010 and March 2013, 376 consecutive skeletally mature patients with unstable fractures of the pelvis, acetabulum, thoracolumbar spine, and/or proximal or diaphyseal femur fractures were treated at a level I trauma center and were prospectively studied...
September 26, 2016: Journal of Orthopaedic Surgery and Research
Hamad Chaudhary, C Matthew Stewart, Kimberly Webster, Robert J Herbert, Kevin D Frick, David W Eisele, Christine G Gourin
OBJECTIVE: To examine 30-day readmission rates and associations with risk factors, survival, length of hospitalization, and costs in elderly patients with laryngeal and oropharyngeal squamous cell cancer (SCC). STUDY DESIGN: Retrospective cross-sectional analysis of Surveillance, Epidemiology, and End Results-Medicare data. METHODS: We evaluated 1,518 patients diagnosed with laryngeal or oropharyngeal SCC from 2004 to 2007 who underwent primary surgery using cross-tabulations, multivariate regression modeling, and survival analysis...
September 23, 2016: Laryngoscope
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