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pneumonia in adults

Nikhil Satchidanand, Timothy J Servoss, Ranjit Singh, Angela M Bosinski, Penny Tirpak, Linda L Horton, Bruce J Naughton
BACKGROUND: Early, data-driven discussion surrounding palliative care can improve care delivery and patient experience. OBJECTIVE: To develop a 30-day mortality prediction tool for older patients in intensive care unit (ICU) with pneumonia that will initiate palliative care earlier in hospital course. DESIGN: Retrospective Electronic Health Record (EHR) review. SETTING: Four urban and suburban hospitals in a Western New York hospital system...
January 1, 2018: American Journal of Hospice & Palliative Care
Suvi Härmälä, Constantinos Parisinos, Laura Shallcross, Alastair O'Brien, Andrew Hayward
INTRODUCTION: In advanced chronic liver disease, diseases caused by common bacteria Streptococcus pneumoniae or influenza virus put people at an increased risk of serious health complications and death. The effectiveness of the available vaccines in reducing the risk of poor health outcomes, however, is less clear. METHODS AND ANALYSIS: We will search Medline (Ovid), Embase (Ovid), PubMed and Cochrane Central Register of Controlled Trials for published reports on randomised controlled trials and observational studies on the effectiveness of pneumococcal and influenza vaccines in people with chronic liver disease...
March 16, 2018: BMJ Open
Catia Cilloniz, Miquel Ferrer, Adamanthia Liapikou, Carolina Garcia-Vidal, Albert Gabarrus, Adrian Ceccato, Jorge Puig de La Bellacasa, Francesco Blasi, Antoni Torres
Question: To assess the incidence, characteristics, aetiology, risk factors and mortality of acute respiratory distress syndrome (ARDS) in ICU patients with community-acquired pneumonia (CAP) using the Berlin definition. Methods: We prospectively enrolled consecutive mechanically-ventilated ICU adults with CAP over 20 years, compared with mechanically-ventilated patients without ARDS. The main outcome was 30-day mortality. Results: Among 5,334 patients hospitalized with CAP, 930 (17%) were admitted to the ICU, and 432 required mechanical ventilation; 125 (29%) cases met the Berlin ARDS criteria...
March 15, 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
Carol Kelly, James D Chalmers, Iain Crossingham, Nicola Relph, Lambert M Felix, David J Evans, Stephen J Milan, Sally Spencer
BACKGROUND: Bronchiectasis is a chronic respiratory disease characterised by abnormal and irreversible dilatation and distortion of the smaller airways. Bacterial colonisation of the damaged airways leads to chronic cough and sputum production, often with breathlessness and further structural damage to the airways. Long-term macrolide antibiotic therapy may suppress bacterial infection and reduce inflammation, leading to fewer exacerbations, fewer symptoms, improved lung function, and improved quality of life...
March 15, 2018: Cochrane Database of Systematic Reviews
Ka Pang Chan, Deirdre B Fitzgerald, Y C Gary Lee
PURPOSE OF REVIEW: Pleural infection remains an important pulmonary disease, causing significant morbidity and mortality. There is a resurgence of disease burden despite introduction of antibiotics and pneumococcal vaccines. A revisit of the pathogenesis and update on intervention may improve the care of pleural infection. RECENT FINDINGS: Recent studies have uncovered the prognostic implication of the presence of a pleural effusion in patients with pneumonia. Identifying where the bacteria lives may have diagnostic and therapeutic implications...
March 13, 2018: Current Opinion in Pulmonary Medicine
Carlos M Luna, Laura Pulido, Diego Burgos
PURPOSE OF REVIEW: As Streptococcus pneumoniae was considered the etiological agent of nearly all the cases of pneumonia at the beginning of the 20th century, and today is identified in fewer than 10-15% of cases, we analyze the possible causes of such a decline. RECENT FINDINGS: Extensive use of early empiric antimicrobial therapy, discovery of previously unrecognized pathogens, availability to newer diagnostic methods for the recognition of the pneumonia pathogens (PCR, urinary antigens, monoclonal antibodies etc...
March 13, 2018: Current Opinion in Pulmonary Medicine
Irene Papanicolas, Liana R Woskie, Ashish K Jha
Importance: Health care spending in the United States is a major concern and is higher than in other high-income countries, but there is little evidence that efforts to reform US health care delivery have had a meaningful influence on controlling health care spending and costs. Objective: To compare potential drivers of spending, such as structural capacity and utilization, in the United States with those of 10 of the highest-income countries (United Kingdom, Canada, Germany, Australia, Japan, Sweden, France, the Netherlands, Switzerland, and Denmark) to gain insight into what the United States can learn from these nations...
March 13, 2018: JAMA: the Journal of the American Medical Association
Christy P Su, Levita Hidayat, Shafiqur Rahman, Veena Venugopalan
BACKGROUND: Medication reconciliation is a major patient safety concern, and the impact of a structured process to evaluate anti-infective agents at hospital discharge warrants further review. OBJECTIVE: The aim of this study was to (1) describe a structured, multidisciplinary approach to review anti-infectives at discharge and (2) measure the impact of a stewardship-initiated antimicrobial review process in identifying and preventing anti-infective-related medication errors (MEs) at discharge...
January 1, 2018: Journal of Pharmacy Practice
Sonja Suntrup-Krueger, Jens Minnerup, Paul Muhle, Inga Claus, Jens Burchard Schröder, Thomas Marian, Tobias Warnecke, Marianne Kalic, Klaus Berger, Rainer Dziewas
BACKGROUND: Early dysphagia screening and appropriate management are recommended by current guidelines to reduce complications and case fatality in acute stroke. However, data on the potential benefit of changes in dysphagia care on patient outcome are limited. Our objective was to assess the degree of implementation of dysphagia guidelines and determine the impact of modifications in dysphagia screening and treatment practices on disease complications and outcome in stroke patients over time...
March 13, 2018: Cerebrovascular Diseases
Bernard Louizette Christophe, Mariana Mott, Gabriela da Cunha, Juliana Caierão, Pedro D Azevedo, Cícero Dias
PURPOSE: Invasive pneumococcal disease (IPD) in the elderly is an important public health issue due to the increased proportion of this population in many countries including Brazil. We aimed to characterise pneumococci isolates in adults >50 years with IPD, following the introduction of the 10-valent pneumococcal conjugate vaccine (PCV10) as part of the National Childhood Immunisation Program for children ≤2 years in March 2010. METHODOLOGY: Between 2013 and 2015, pneumococcal isolates were collected and serotypes were determined using multiplex PCR and/or Quellung reaction...
March 13, 2018: Journal of Medical Microbiology
Leah Leibovitch, Iris Zohar, Ayala Maayan-Mazger, Ram Mazkereth, Tzipora Strauss, Ron Bilik
BACKGROUND: The estimated incidence of esophageal atresia (EA) with or without tracheo-esophageal fistula (TEF) is 1:3500 live births. During childhood these patients have various co-morbidities, but the overall quality of life among adults is similar to that of the general population. OBJECTIVES: To evaluate short- and long-term co-morbidities and quality of life among infants born with EA ± TEF at a large single medical center. METHODS: Medical records of 65 children born over a 21 year period were reviewed for short- and long-term medical data...
March 2018: Israel Medical Association Journal: IMAJ
Yogendra Amatya, Jordan Rupp, Frances M Russell, Jason Saunders, Brian Bales, Darlene R House
BACKGROUND: Lung ultrasound is an effective tool for diagnosing pneumonia in developed countries. Diagnostic accuracy in resource-limited countries where pneumonia is the leading cause of death is unknown. The objective of this study was to evaluate the sensitivity of bedside lung ultrasound compared to chest X-ray for pneumonia in adults presenting for emergency care in a low-income country. METHODS: Patients presenting to the emergency department with suspected pneumonia were evaluated with bedside lung ultrasound, single posterioranterior chest radiograph, and computed tomography (CT)...
March 12, 2018: International Journal of Emergency Medicine
Jin-Xin Zheng, Zhi-Wei Lin, Chen Chen, Zhong Chen, Fo-Jun Lin, Yang Wu, Si-Yu Yang, Xiang Sun, Wei-Ming Yao, Duo-Yun Li, Zhi-Jian Yu, Jia-Lin Jin, Di Qu, Qi-Wen Deng
Klebsiella pneumoniae bacteremia biofilm traits and distribution characteristics have not been clarified. This study aimed to determine the prevalence and characteristics of K. pneumoniae bacteremia biofilm formation (BF) and to explore the virulence factors associated with K. pneumoniae BF. A total of 250 K. pneumoniae bacteremia isolates were collected from patients in Shenzhen and Shanghai, China. Virulence genes in their genomes were detected by PCR. The isolates were subjected to multilocus sequence typing (MLST) and clonal complex (CC) classification based on housekeeping genes...
2018: Frontiers in Cellular and Infection Microbiology
Chin-Lin Tseng, Orysya Soroka, Leonard M Pogach
AIM: To expand the existing United States Agency for Health Research and Quality (AHRQ) Diabetes composite (AHRQ-DC) to include additional preventable hospitalizations specific or relevant to diabetes. METHODS: A cross-sectional analysis of 834,696 veteran patients with diabetes aged ≥65 years in 2012. An Expanded Diabetes Composite (Expanded-DC) was developed utilizing: (1) the diabetes-specific category: the AHRQ-DC (short-term and long-term complications, uncontrolled diabetes, lower extremity amputations) and two proposed conditions: hypoglycemia and lower extremity ulcers/inflammation/infections (LEU) and (2) the diabetes-relevant category: the AHRQ-Acute Composite (dehydration, pneumonia, urinary tract infections) and one proposed condition, acute kidney injury (AKI)...
February 2, 2018: Journal of Diabetes and its Complications
Iolanda Alves Braga, Paola Amaral de Campos, Paulo Pinto Gontijo Filho, Rosineide Marques Ribas
BACKGROUND: Healthcare-associated infection (HAI) represents a major problem for patient safety worldwide. AIM: To provide an up-to-date picture of the extent, aetiology, risk factors and patterns of infections in intensive care units (ICUs) in 28 Brazilian hospitals of different sizes. METHODS: A one-day point prevalence survey in 2016 enrolled the ICU of hospitals from the 12 meso regions located in the State of Minas Gerais, Southeast region of Brazil...
March 6, 2018: Journal of Hospital Infection
Miranda Wilhelm
Influenza affects millions of people in the United States each year. Older patients are particularly at risk for infection, hospitalization, and death due to influenza-related complications, such as pneumonia. One of the best ways to avoid becoming ill is to have the annual influenza vaccination. Unfortunately, immunization rates are poor in the older adult population, at about 65% each year. Vaccine effectiveness in this population is reduced because of lower seroconversion rates that arise from poorer immunologic response to vaccination...
March 2018: American Journal of Managed Care
Manju Ohri, Smriti Parashar, Venkatesh S Pai, Sujata Ghosh, Anuradha Chakraborti
Group B streptococcus (GBS) or Streptococcus agalactiae, is an opportunistic pathogen causing a wide range of infections like pneumonia, sepsis, and meningitis in newborn, pregnant women and adults. While this bacterium has adapted well to asymptomatic colonization of adult humans, it still remains a potentially devastating pathogen to susceptible infants. Advances in molecular techniques and refinement of in vitro and in vivo model systems have elucidated key elements of the pathogenic process, from initial attachment to the maternal vaginal epithelium to penetration of the newborn blood-brain barrier...
March 8, 2018: World Journal of Microbiology & Biotechnology
Osman Savran, Charlotte Suppli Ulrik
Background: Early life events may predispose to the development of chronic lung disease in adulthood. Aim: To provide an update on current knowledge of early nongenetic origins of COPD. Materials and methods: Systematic literature review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results: A total of 16 studies, comprising 69,365 individuals, met the predefined criteria and were included in the present review...
2018: International Journal of Chronic Obstructive Pulmonary Disease
William O'Riordan, Alison McManus, Juri Teras, Ivan Poromanski, Maria Cruz-Saldariagga, Megan Quintas, Laura Lawrence, ShuJui Liang, Sue Cammarata
Background: Delafloxacin is an IV/oral anionic fluoroquinolone with activity against Gram-positive (including MRSA), Gram-negative, atypical and anaerobic organisms. It is approved in the US for acute bacterial skin and skin structure infections caused by designated susceptible Gram-positive and Gram-negative organisms, and is in development for the treatment of community-acquired bacterial pneumonia. Methods: A multicenter, randomized, double-blind trial of 850 adults with ABSSSI compared delafloxacin 300 mg IV Q12h for 3 days with a switch to 450 mg oral delafloxacin, to vancomycin 15 mg/kg IV with aztreonam for 5-14 days...
March 6, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Vadim M Kemaykin, Nariman B Tabinbaev, Mahira S Khudaibergenova, Anastasia A Olifirovich, Layzzat M Abdrakhmanova, David W Denning, Nikolai Klimko
Our work aimed to generate a preliminary estimation of severe and chronic fungal diseases in the Republic of Kazakhstan with a model proposed by LIFE (Leading International Fungal Education). Calculations were carried out on data from 2015. Published results of studies of mycoses in Kazakhstan were identified; in the absence of national data from the scientific literature, the frequency of life-threatening and serious mycoses in defined groups of patients at risk from other countries were taken into account...
March 8, 2018: Journal of Fungi (Basel, Switzerland)
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