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https://www.readbyqxmd.com/read/29319770/factors-associated-with-hospital-mortality-in-renal-transplant-patients-admitted-to-the-intensive-care-unit-with-acute-respiratory-failure
#1
Rafael Mendes da Silva, Flavio Geraldo Rezende de Freitas, Antonio Tonete Bafi, Hélio Tedesco Silva Junior, Bartira de Aguiar Roza
INTRODUCTION: The lungs are often involved in a variety of complications after kidney transplantation. Acute respiratory failure (ARF) is one of the most serious manifestations of pulmonary involvement. OBJECTIVE: To describe the main causes of ARF in kidney transplant patients who require intensive care and identify the factors associated with mortality. METHODS: This retrospective study evaluated adult patients with ARF admitted to the intensive care unit of a center with high volume of transplants from August 2013 to August 2015...
October 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/29221274/predictors-of-high-flow-nasal-cannula-failure-in-immunocompromised-patients-with-acute-respiratory-failure-due-to-non-hiv-pneumocystis-pneumonia
#2
Won-Young Kim, Heungsup Sung, Sang-Bum Hong, Chae-Man Lim, Younsuck Koh, Jin Won Huh
Background: To evaluate the predictors of high flow nasal cannula (HFNC) failure in pneumocystis pneumonia (PCP) patients with acute respiratory failure (ARF). Methods: Fifty-two non-HIV-related PCP subjects were divided into a HFNC success group (44%) and a HFNC failure group (who required mechanical ventilation (MV) despite HFNC application) (56%). The clinical characteristics and physiologic effects were retrospectively reviewed and compared between the groups...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29202739/the-lung-microbiome-in-patients-with-pneumocystosis
#3
J Kehrmann, B Veckollari, D Schmidt, O Schildgen, V Schildgen, N Wagner, M Zeschnigk, L Klein-Hitpass, O Witzke, J Buer, J Steinmann
BACKROUND: Pneumocystis jirovecii pneumonia (PCP) is an opportunistic fungal infection that is associated with a high morbidity and mortality in immunocompromised individuals. In this study, we analysed the microbiome of the lower respiratory tract from critically ill intensive care unit patients with and without pneumocystosis. METHODS: Broncho-alveolar fluids from 65 intubated and mechanically ventilated intensive care unit patients (34 PCP+ and 31 PCP- patients) were collected...
December 4, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28867295/asthma-outcomes-and-management-during-pregnancy
#4
REVIEW
Catherine A Bonham, Karen C Patterson, Mary E Strek
Asthma during pregnancy poses a common, increasingly prevalent threat to the health of women and their children. The present article reviews recent insights gained from the epidemiology of asthma during pregnancy, demonstrating the many short- and long-term risks to mother and fetus incurred by poorly controlled maternal asthma. We further discuss emerging evidence that active management of asthma during pregnancy can positively influence and perhaps completely mitigate these poor outcomes. Recent high-quality trials examining best methods for asthma treatment are reviewed and synthesized to offer an evidence-based pathway for comprehensive treatment of asthma in the outpatient setting...
September 1, 2017: Chest
https://www.readbyqxmd.com/read/28567422/risk-factors-for-the-mortality-of-pneumocystis-jirovecii-pneumonia-in-non-hiv-patients-who-required-mechanical-ventilation-a-retrospective-case-series-study
#5
Toru Kotani, Shinshu Katayama, Yuya Miyazaki, Satoshi Fukuda, Yoko Sato, Koichi Ohsugi
BACKGROUND: The risk factors for the mortality rate of Pneumocystis jirovecii pneumonia (PCP) who required mechanical ventilation (MV) remained unknown. METHODS: A retrospective chart review was performed of all PCP patients admitted to our intensive care unit and treated for acute hypoxemic respiratory failure to assess the risk factors for the high mortality. RESULTS: Twenty patients without human immunodeficiency virus infection required mechanical ventilation; 19 received noninvasive ventilation; and 11 were intubated...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28378239/usefulness-of-1-3-beta-d-glucan-detection-in-non-hiv-immunocompromised-mechanical-ventilated-critically-ill-patients-with-ards-and-suspected-pneumocystis-jirovecii-pneumonia
#6
Tobias Lahmer, Clarissa Prazeres da Costa, Jürgen Held, Sebastian Rasch, Ursula Ehmer, Roland M Schmid, Wolfgang Huber
INTRODUCTION: Pneumocystis jirovecii pneumonia (PCP) is a major cause of disease in immunocompromised individuals. Diagnosis is typically obtained by microscopy and/or PCR. For ambiguous PCR results, we evaluated the new biomarker 1,3-Beta-D-Glucan (BDG). METHODS: BDG serum levels were assessed and correlated to PCR results in immunosuppressed patients with ARDS. RESULTS: 11 (22%) out of 50 patients had suspected PCP. APACHE II (26 vs. 24; p < 0...
August 2017: Mycopathologia
https://www.readbyqxmd.com/read/28361121/a-systematic-review-and-meta-analysis-of-the-data-behind-current-recommendations-for-corticosteroids-in-non-hiv-related-pcp-knowing-when-you-are-on-shaky-foundations
#7
Patil Injean, Samantha J Eells, Hoover Wu, Imani McElroy, Aric L Gregson, James A McKinnell
BACKGROUND: Randomized trials show a mortality benefit to adjunctive corticosteroids for human immunodeficiency virus (HIV)-related Pneumocystis jiroveci pneumonia (HIV-PCP). Guidelines for non-HIV PCP (NH-PCP) recommend adjunctive corticosteroids based on expert opinion. We conducted a systematic review and meta-analysis characterizing adjunctive corticosteroids for NH-PCP. METHODS: We searched MEDLINE from 1966 through 2015. Data on clinical outcomes from NH-PCP were extracted with a standardized instrument...
March 2017: Transplantation Direct
https://www.readbyqxmd.com/read/27855071/high-prevalence-of-pneumocystis-jirovecii-dihydropteroate-synthase-gene-mutations-in-patients-with-a-first-episode-of-pneumocystis-pneumonia-in-santiago-chile-and-clinical-response-to-trimethoprim-sulfamethoxazole-therapy
#8
Carolina A Ponce, Magali Chabé, Claudio George, Alejandra Cárdenas, Luisa Durán, Julia Guerrero, Rebeca Bustamante, Olga Matos, Laurence Huang, Robert F Miller, Sergio L Vargas
Mutations in the dihydropteroate synthase (DHPS) gene of Pneumocystis jirovecii are associated with the failure of sulfa prophylaxis. They can develop by selection in patients receiving sulfa drugs or be acquired via person-to-person transmission. DHPS mutations raise concern about the decreasing efficacy of sulfa drugs, the main available therapeutic tool for Pneumocystis pneumonia (PCP). The prevalence of Pneumocystis DHPS mutations was examined in Pneumocystis isolates from 56 sulfa-prophylaxis-naive adults with a first episode of PCP from 2002 to 2010 in Santiago, Chile...
February 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/27824870/clinical-course-radiological-manifestations-and-outcome-of-pneumocystis-jirovecii-pneumonia-in-hiv-patients-and-renal-transplant-recipients
#9
Lukas Ebner, Laura N Walti, Andri Rauch, Hansjakob Furrer, Alexia Cusini, Andreas M J Meyer, Stefan Weiler, Uyen Huynh-Do, Johannes Heverhagen, Spyridon Arampatzis, Andreas Christe
BACKGROUND: Pneumocystis jirovecii pneumonia (PCP) is a frequent opportunistic infection in immunocompromised patients. In literature, presentation and outcome of PCP differs between patients with human immunodeficiency virus (HIV) infection and renal transplant recipients (RTRs). METHODS: We conducted a cross-sectional study of patients with PCP based on the HIV and renal transplant registries at our institution. Radiological and clinical data from all confirmed PCP cases between 2005 and 2012 were compared...
2016: PloS One
https://www.readbyqxmd.com/read/27803824/successful-treatment-of-disseminated-bacillus-calmette-gu%C3%A3-rin-disease-in-an-hiv-infected-child-with-a-linezolid-containing-regimen
#10
Srđan Roglić, Drusia Dickson, Branko Miše, Klaudija Višković, Vera Katalinić-Janković, George Rutherford, Josip Begovac
Upon HIV infection diagnosis, an 8-month-old boy was transferred for evaluation of worsening respiratory distress requiring mechanical ventilation. Pneumocystis jirovecii pneumonia (PCP) was diagnosed; the boy also had a nonhealing ulcer at the site of vaccination with Statens Serum Institut (Danish strain) Bacillus Calmette-Guérin (BCG) vaccine and associated axillary lymphadenopathy. PCP treatment resulted in weaning from mechanical ventilation. Antimycobacterial treatment was immediately attempted but was discontinued because of hepatotoxicity...
2016: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/27721666/intermittent-courses-of-corticosteroids-also-present-a-risk-for-pneumocystis-pneumonia-in-non-hiv-patients
#11
Maria L Calero-Bernal, Isabel Martin-Garrido, Mikel Donazar-Ezcurra, Andrew H Limper, Eva M Carmona
Introduction. Pneumocystis pneumonia (PCP) is rising in the non-HIV population and associates with higher morbidity and mortality. The aggressive immunosuppressive regimens, as well as the lack of stablished guidelines for chemoprophylaxis, are likely contributors to this increased incidence. Herein, we have explored the underlying conditions, immunosuppressive therapies, and clinical outcomes of PCP in HIV-negative patients. Methods. Retrospective analysis of PCP in HIV-negative patients at Mayo Clinic from 2006-2010...
2016: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
https://www.readbyqxmd.com/read/27550993/ecil-guidelines-for-treatment-of-pneumocystis-jirovecii-pneumonia-in-non-hiv-infected-haematology-patients
#12
Georg Maschmeyer, Jannik Helweg-Larsen, Livio Pagano, Christine Robin, Catherine Cordonnier, Peter Schellongowski
The initiation of systemic antimicrobial treatment of Pneumocystis jirovecii pneumonia (PCP) is triggered by clinical signs and symptoms, typical radiological and occasionally laboratory findings in patients at risk of this infection. Diagnostic proof by bronchoalveolar lavage should not delay the start of treatment. Most patients with haematological malignancies present with a severe PCP; therefore, antimicrobial therapy should be started intravenously. High-dose trimethoprim/sulfamethoxazole is the treatment of choice...
September 2016: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/27537515/the-impact-of-pre-injury-controlled-substance-use-on-clinical-outcomes-after-trauma
#13
Vincent Cheng, Kenji Inaba, Megan Johnson, Saskya Byerly, Yue Jiang, Kazuhide Matsushima, Tobias Haltmeier, Elizabeth Benjamin, Lydia Lam, Demetrios Demetriades
BACKGROUND: A disproportionately high percentage of trauma patients use controlled substances, and they often co-ingest multiple drugs. Previous studies have evaluated the effect of individual drugs on clinical outcomes after trauma. However, the impact of all drugs included in a comprehensive screening panel has not yet been compared in a single cohort of patients. METHODS: All trauma patients who underwent urine drug screens after admission to the LAC + USC Medical Center (January 2008-June 2015) were identified retrospectively...
November 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27367877/effect-of-a-primary-care-management-intervention-on-mental-health-related-quality-of-life-among-survivors-of-sepsis-a-randomized-clinical-trial
#14
RANDOMIZED CONTROLLED TRIAL
Konrad Schmidt, Susanne Worrack, Michael Von Korff, Dimitry Davydow, Frank Brunkhorst, Ulrike Ehlert, Christine Pausch, Juliane Mehlhorn, Nico Schneider, André Scherag, Antje Freytag, Konrad Reinhart, Michel Wensing, Jochen Gensichen
IMPORTANCE: Survivors of sepsis face long-term sequelae that diminish health-related quality of life and result in increased care needs in the primary care setting, such as medication, physiotherapy, or mental health care. OBJECTIVE: To examine if a primary care-based intervention improves mental health-related quality of life. DESIGN, SETTING, AND PARTICIPANTS: Randomized clinical trial conducted between February 2011 and December 2014, enrolling 291 patients 18 years or older who survived sepsis (including septic shock), recruited from 9 intensive care units (ICUs) across Germany...
June 28, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/27351666/underlying-renal-insufficiency-the-pivotal-risk-factor-for-pneumocystis-jirovecii-pneumonia-in-immunosuppressed-patients-with-non-transplant-glomerular-disease
#15
Wen-Ling Ye, Nan Tang, Yu-Bing Wen, Hang Li, Min-Xi Li, Bin Du, Xue-Mei Li
PURPOSES: Data on PCP in patients with glomerular disease are rare. The aim of this study was to assess the predictors of PCP development, the risk factors for mortality and the incidence of acute kidney injury (AKI) when high-dose trimethoprim-sulphamethoxazole (TMP-SMX) was used in patients with non-transplant glomerular disease. METHODS: Forty-seven patients with PCP, as confirmed by positive results for Pneumocystis jirovecii DNA or Pneumocystis jirovecii cysts tested by a methenamine silver stain between January 1, 2003, and December 30, 2012, were retrospectively investigated...
November 2016: International Urology and Nephrology
https://www.readbyqxmd.com/read/27080997/extra-corporeal-membrane-oxygenation-to-facilitate-lung-protective-ventilation-and-prevent-ventilator-induced-lung-injury-in-severe-pneumocystis-pneumonia-with-pneumomediastinum-a-case-report-and-short-literature-review
#16
REVIEW
Husain Shabbir Ali, Ibrahim Fawzy Hassan, Saibu George
BACKGROUND: Pulmonary infections caused by Pneumocystis jirovecii in immunocompromised host can be associated with cysts, pneumatoceles and air leaks that can progress to pneumomediastinum and pneumothoraxes. In such cases, it can be challenging to maintain adequate gas exchange by conventional mechanical ventilation and at the same time prevent further ventilator-induced lung injury. We report a young HIV positive male with poorly compliant lungs and pneumomediastinum secondary to severe Pneumocystis infection, rescued with veno-venous extra corporeal membrane oxygenation (V-V ECMO)...
April 14, 2016: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/27037134/do-trauma-patients-with-phencyclidine-positive-urine-drug-screens-have-increased-morbidity-or-mortality
#17
Ryan Gallagher, Jonathan Dangers, Stephen L Thornton
BACKGROUND: Phencyclidine (PCP) use is anecdotally associated with agitation and injury and is frequently tested for in the setting of trauma. We sought to determine characteristics of trauma patients with a PCP-positive urine immunoassay drug screen (UDS) and if they had increased levels of care or mortality. METHODS: A 5-year retrospective review of a level 1 trauma center's trauma registry identified patients with a PCP-positive UDS. This group was then compared with 2 randomly selected control groups from the same trauma registry which were matched for age and sex but differed in that one had no sEtOH detected and a negative UDS (drug-free group) whereas the other had sEtOH or an other-than-PCP-positive UDS (other-drug group)...
June 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/26878193/pneumocystis-pneumonia-in-non-hiv-children-a-10-year-retrospective-study
#18
Chen Ling, Suyun Qian, Quan Wang, Jiansheng Zeng, Xinlei Jia, Jun Liu, Zheng Li
BACKGROUND: Pneumocytis pneumonia (PCP) is a life-threatening disease in non-HIV infected children. However, there have been few studies that have examined the clinical characteristics associated with PCP and outcomes for these pediatric patients. OBJECTIVES: A retrospective review was performed over a 10-year period to evaluate the clinical characteristics and outcome of non-HIV children diagnosed with PCP at Beijing Children's Hospital in China. RESULTS: A total of 60 non-HIV children diagnosed with PCP were included in the study...
February 15, 2016: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/26871522/a-state-level-assessment-of-hospital-based-palliative-care-and-the-use-of-life-sustaining-therapies-in-the-united-states
#19
Brian H Nathanson, William T McGee, Diane L Dietzen, Quenica Chen, Jared Young, Thomas L Higgins
BACKGROUND: It is unknown how the prevalence of hospitals with palliative care programs (PCPs) at the state level in the United States correlates with the treatment of critically ill patients. OBJECTIVE: We examined the relationship between state-level PCP prevalence and commonly used treatments for critically ill patients as well as other public health metrics. METHODS: We compiled state-level data for the year 2011 from multiple published sources...
April 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/25860046/-pneumocystis-jiroveci-infection-in-patients-with-and-without-hiva-comparison
#20
Alejandro Rey, Cecilia Losada, Julieta Santillán, Fernando Fiorentini, María Schiaffino, Héctor J Peroni, Diego Giunta, Laura Barcán, Gabriel Waisman
BACKGROUND: Respiratory infection caused by Pneumocystis jiroveci is a common opportunistic infection in patients with human immunodeficiency virus (HIV) with CD4 counts < 200 cells/mm³. However, it has also been reported in patients with other causes of immunosuppression. OBJECTIVES: To compare the characteristics, severity and mortality of respiratory infection by P. jiroveci in patients with and without HIV infection. METHODS: Retrospective cohort follow-up of adult patients admitted to our hospital with infection by P...
February 2015: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
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