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pneumonia new england

Nicola De Maio, Chieh-Hsi Wu, Daniel J Wilson
Exploiting pathogen genomes to reconstruct transmission represents a powerful tool in the fight against infectious disease. However, their interpretation rests on a number of simplifying assumptions that regularly ignore important complexities of real data, in particular within-host evolution and non-sampled patients. Here we propose a new approach to transmission inference called SCOTTI (Structured COalescent Transmission Tree Inference). This method is based on a statistical framework that models each host as a distinct population, and transmissions between hosts as migration events...
September 2016: PLoS Computational Biology
Stephanie D Grabitz, Hassan N Farhan, Katarina J Ruscic, Fanny P Timm, Christina H Shin, Tharusan Thevathasan, Anne K Staehr-Rye, Tobias Kurth, Matthias Eikermann
OBJECTIVES: Inhalational anesthetics are bronchodilators with immunomodulatory effects. We sought to determine the effect of inhalational anesthetic dose on risk of severe postoperative respiratory complications. DESIGN: Prospective analysis of data on file in surgical cases between January 2007 and December 2015. SETTING: Massachusetts General Hospital (tertiary referral center) and two affiliated community hospitals. PATIENTS: A total of 124,497 adult patients (105,267 in the study cohort and 19,230 in the validation cohort) undergoing noncardiac surgical procedures and requiring general anesthesia with endotracheal intubation...
September 15, 2016: Critical Care Medicine
Irene Ilott, Kate Gerrish, Sabrina A Eltringham, Carolyn Taylor, Sue Pownall
BACKGROUND: Swallowing difficulties challenge patient safety due to the increased risk of malnutrition, dehydration and aspiration pneumonia. A theoretically driven study was undertaken to examine the spread and sustainability of a locally developed innovation that involved using the Inter-Professional Dysphagia Framework to structure education for the workforce. A conceptual framework with 3 spread strategies (hierarchical control, participatory adaptation and facilitated evolution) was blended with a processual approach to sustaining organisational change...
2016: BMC Health Services Research
Jônatas Santos Abrahão, Graziele Pereira Oliveira, Lorena Christine Ferreira da Silva, Ludmila Karen Dos Santos Silva, Erna Geessien Kroon, Bernard La Scola
The aim of this protocol is to describe the replication, purification, and titration of mimiviruses. These viruses belong to the Mimiviridae family, the first member of which was isolated in 1992 from a cooling tower water sample collected during an outbreak of pneumonia in a hospital in Bradford, England. In recent years, several new mimiviruses have been isolated from different environmental conditions. These giant viruses are easily replicated in amoeba of the Acanthamoeba genus, its natural host. Mimiviruses present peculiar features that make them unique viruses, such as the particle and genome size and the genome's complexity...
2016: Current Protocols in Microbiology
Albert Jan van Hoek, Elizabeth Miller
BACKGROUND: Recently a large clinical trial showed that the use of 13-valent pneumococcal conjugate vaccine (PCV13) among immunocompetent individuals aged 65 years and over was safe and efficacious. The aim of this study was to assess the cost-effectiveness of vaccinating immunocompetent 65 year olds with PCV13 vaccine in England. England is a country with universal childhood pneumococcal conjugate vaccination programme in place (7-valent (PCV7) since 2006 and PCV13 since 2010), as well as a 23-valent pneumococcal polysaccharide (PPV23) vaccination programme targeting clinical risk-groups and those ≥65 years...
2016: PloS One
Sagar Lonial, Meletios Dimopoulos, Antonio Palumbo, Darrell White, Sebastian Grosicki, Ivan Spicka, Adam Walter-Croneck, Philippe Moreau, Maria-Victoria Mateos, Hila Magen, Andrew Belch, Donna Reece, Meral Beksac, Andrew Spencer, Heather Oakervee, Robert Z Orlowski, Masafumi Taniwaki, Christoph Röllig, Hermann Einsele, Ka Lung Wu, Anil Singhal, Jesus San-Miguel, Morio Matsumoto, Jessica Katz, Eric Bleickardt, Valerie Poulart, Kenneth C Anderson, Paul Richardson
BACKGROUND: Elotuzumab, an immunostimulatory monoclonal antibody targeting signaling lymphocytic activation molecule F7 (SLAMF7), showed activity in combination with lenalidomide and dexamethasone in a phase 1b-2 study in patients with relapsed or refractory multiple myeloma. METHODS: In this phase 3 study, we randomly assigned patients to receive either elotuzumab plus lenalidomide and dexamethasone (elotuzumab group) or lenalidomide and dexamethasone alone (control group)...
August 13, 2015: New England Journal of Medicine
Douwe F Postma, Cornelis H van Werkhoven, Leontine J R van Elden, Steven F T Thijsen, Andy I M Hoepelman, Jan A J W Kluytmans, Wim G Boersma, Clara J Compaijen, Eva van der Wall, Jan M Prins, Jan J Oosterheert, Marc J M Bonten
BACKGROUND: The choice of empirical antibiotic treatment for patients with clinically suspected community-acquired pneumonia (CAP) who are admitted to non-intensive care unit (ICU) hospital wards is complicated by the limited availability of evidence. We compared strategies of empirical treatment (allowing deviations for medical reasons) with beta-lactam monotherapy, beta-lactam-macrolide combination therapy, or fluoroquinolone monotherapy. METHODS: In a cluster-randomized, crossover trial with strategies rotated in 4-month periods, we tested the noninferiority of the beta-lactam strategy to the beta-lactam-macrolide and fluoroquinolone strategies with respect to 90-day mortality, in an intention-to-treat analysis, using a noninferiority margin of 3 percentage points and a two-sided 90% confidence interval...
April 2, 2015: New England Journal of Medicine
Marc J M Bonten, Susanne M Huijts, Marieke Bolkenbaas, Chris Webber, Scott Patterson, Samantha Gault, Cornelis H van Werkhoven, Anna M M van Deursen, Elisabeth A M Sanders, Theo J M Verheij, Michael Patton, Anne McDonough, Anita Moradoghli-Haftvani, Helen Smith, Tracey Mellelieu, Michael W Pride, Graham Crowther, Beate Schmoele-Thoma, Daniel A Scott, Kathrin U Jansen, Rita Lobatto, Bas Oosterman, Nils Visser, Esther Caspers, Andre Smorenburg, Emilio A Emini, William C Gruber, Diederick E Grobbee
BACKGROUND: Pneumococcal polysaccharide conjugate vaccines prevent pneumococcal disease in infants, but their efficacy against pneumococcal community-acquired pneumonia in adults 65 years of age or older is unknown. METHODS: In a randomized, double-blind, placebo-controlled trial involving 84,496 adults 65 years of age or older, we evaluated the efficacy of 13-valent polysaccharide conjugate vaccine (PCV13) in preventing first episodes of vaccine-type strains of pneumococcal community-acquired pneumonia, nonbacteremic and noninvasive pneumococcal community-acquired pneumonia, and invasive pneumococcal disease...
March 19, 2015: New England Journal of Medicine
Seema Jain, Derek J Williams, Sandra R Arnold, Krow Ampofo, Anna M Bramley, Carrie Reed, Chris Stockmann, Evan J Anderson, Carlos G Grijalva, Wesley H Self, Yuwei Zhu, Anami Patel, Weston Hymas, James D Chappell, Robert A Kaufman, J Herman Kan, David Dansie, Noel Lenny, David R Hillyard, Lia M Haynes, Min Levine, Stephen Lindstrom, Jonas M Winchell, Jacqueline M Katz, Dean Erdman, Eileen Schneider, Lauri A Hicks, Richard G Wunderink, Kathryn M Edwards, Andrew T Pavia, Jonathan A McCullers, Lyn Finelli
BACKGROUND: Incidence estimates of hospitalizations for community-acquired pneumonia among children in the United States that are based on prospective data collection are limited. Updated estimates of pneumonia that has been confirmed radiographically and with the use of current laboratory diagnostic tests are needed. METHODS: We conducted active population-based surveillance for community-acquired pneumonia requiring hospitalization among children younger than 18 years of age in three hospitals in Memphis, Nashville, and Salt Lake City...
February 26, 2015: New England Journal of Medicine
Olaf J Bakker, Sandra van Brunschot, Hjalmar C van Santvoort, Marc G Besselink, Thomas L Bollen, Marja A Boermeester, Cornelis H Dejong, Harry van Goor, Koop Bosscha, Usama Ahmed Ali, Stefan Bouwense, Wilhelmina M van Grevenstein, Joos Heisterkamp, Alexander P Houdijk, Jeroen M Jansen, Thom M Karsten, Eric R Manusama, Vincent B Nieuwenhuijs, Alexander F Schaapherder, George P van der Schelling, Matthijs P Schwartz, B W Marcel Spanier, Adriaan Tan, Juda Vecht, Bas L Weusten, Ben J Witteman, Louis M Akkermans, Marco J Bruno, Marcel G Dijkgraaf, Bert van Ramshorst, Hein G Gooszen
BACKGROUND: Early enteral feeding through a nasoenteric feeding tube is often used in patients with severe acute pancreatitis to prevent gut-derived infections, but evidence to support this strategy is limited. We conducted a multicenter, randomized trial comparing early nasoenteric tube feeding with an oral diet at 72 hours after presentation to the emergency department in patients with acute pancreatitis. METHODS: We enrolled patients with acute pancreatitis who were at high risk for complications on the basis of an Acute Physiology and Chronic Health Evaluation II score of 8 or higher (on a scale of 0 to 71, with higher scores indicating more severe disease), an Imrie or modified Glasgow score of 3 or higher (on a scale of 0 to 8, with higher scores indicating more severe disease), or a serum C-reactive protein level of more than 150 mg per liter...
November 20, 2014: New England Journal of Medicine
Anne von Gottberg, Linda de Gouveia, Stefano Tempia, Vanessa Quan, Susan Meiring, Claire von Mollendorf, Shabir A Madhi, Elizabeth R Zell, Jennifer R Verani, Katherine L O'Brien, Cynthia G Whitney, Keith P Klugman, Cheryl Cohen
BACKGROUND: In South Africa, a 7-valent pneumococcal conjugate vaccine (PCV7) was introduced in 2009 with a three-dose schedule for infants at 6, 14, and 36 weeks of age; a 13-valent vaccine (PCV13) replaced PCV7 in 2011. In 2012, it was estimated that 81% of 12-month-old children had received three doses of vaccine. We assessed the effect of vaccination on invasive pneumococcal disease. METHODS: We conducted national, active, laboratory-based surveillance for invasive pneumococcal disease...
November 13, 2014: New England Journal of Medicine
Daniel M Musher, Anna R Thorner
New England Journal of Medicine, Volume 371, Issue 17, Page 1619-1628, October 2014.
October 23, 2014: New England Journal of Medicine
Damaris D Nou, Anand Vaidya, Laura Dichtel, Joel T Katz, Katherine McGowan
New England Journal of Medicine, Volume 370, Issue 15, April 2014.
April 10, 2014: New England Journal of Medicine
Rachel Meacock, Søren Rud Kristensen, Matt Sutton
Despite growing adoption of pay-for-performance (P4P) programmes in health care, there is remarkably little evidence on the cost-effectiveness of such schemes. We review the limited number of previous studies and critique the frameworks adopted and the narrow range of costs and outcomes considered, before proposing a new more comprehensive framework, which we apply to the first P4P scheme introduced for hospitals in England. We emphasise that evaluations of cost-effectiveness need to consider who the residual claimant is on any cost savings, the possibility of positive and negative spillovers, and whether performance improvement is a transitory or investment activity...
January 2014: Health Economics
Rishma Maini, Katherine L Henderson, Elizabeth A Sheridan, Theresa Lamagni, Gordon Nichols, Valerie Delpech, Nick Phin
After an increase in the number of reported cases of Pneumocystis jirovecii pneumonia in England, we investigated data from 2000-2010 to verify the increase. We analyzed national databases for microbiological and clinical diagnoses of P. jirovecii pneumonia and associated deaths. We found that laboratory-confirmed cases in England had increased an average of 7% per year and that death certifications and hospital admissions also increased. Hospital admissions indicated increased P. jirovecii pneumonia diagnoses among patients not infected with HIV, particularly among those who had received a transplant or had a hematologic malignancy...
March 2013: Emerging Infectious Diseases
Ilia M Echevarria, Ann Schwoebel
Aspiration pneumonia is associated with significantly high morbidity and mortality rates, accompanied by high health care costs. As a result, aspiration pneumonia preventive efforts are a national priority. The development of an intervention model for the prevention of aspiration pneumonia in high-risk medical-surgical inpatients at an urban teaching hospital is described. The intervention model consists of the implementation and evaluation of a risk assessment tool and development of an aspiration pneumonia prevention protocol...
September 2012: Medsurg Nursing: Official Journal of the Academy of Medical-Surgical Nurses
S J Anthony, J A St Leger, K Pugliares, H S Ip, J M Chan, Z W Carpenter, I Navarrete-Macias, M Sanchez-Leon, J T Saliki, J Pedersen, W Karesh, P Daszak, R Rabadan, T Rowles, W I Lipkin
UNLABELLED: From September to December 2011, 162 New England harbor seals died in an outbreak of pneumonia. Sequence analysis of postmortem samples revealed the presence of an avian H3N8 influenza A virus, similar to a virus circulating in North American waterfowl since at least 2002 but with mutations that indicate recent adaption to mammalian hosts. These include a D701N mutation in the viral PB2 protein, previously reported in highly pathogenic H5N1 avian influenza viruses infecting people...
2012: MBio
B K Y Chan, S Kudsk-Iversen, S Balaguruswamy, T S Purewal
An elderly lady was admitted for pain management and rehabilitation following a fall. During her stay she developed a new heart murmur and sepsis. Subacute bacterial endocarditits was excluded, empirical ciprofloxacin was initiated and later converted to aztreonam with gentamicin for clinical deterioration. Subsequent investigations revealed meningococcal Y septicaemia secondary to pneumonia, with a possible oropharynx focus. Upon discharge she had returned to baseline state. The case reflects an unusual and increasing cause of pneumonia...
2012: BMJ Case Reports
Xuejing Chen, Ron A Adelman
PURPOSE: To study the microbial spectrum and antibacterial susceptibility of vitreous cultures in a tertiary referral center in Northeast United States. METHODS: All vitreous samples sent to the microbiology laboratory at a tertiary referral center from January 1988 to December 2008 were included in the study. The distribution and antibiotic susceptibility of all isolates from culture-positive samples were compared across 3 equal time periods 1988-1994, 1995-2001, and 2002-2008...
August 2012: Journal of Ocular Pharmacology and Therapeutics
John A Hermos, Melissa M Young, Jennifer R Fonda, David R Gagnon, Louis D Fiore, Elizabeth V Lawler
BACKGROUND: Observational studies linking proton pump inhibitor (PPI) exposure with community-acquired pneumonia (CAP) have reported either modest or no associations. Accordingly, we studied PPI exposure and CAP in veteran patients, using a retrospective, nested case-control design. METHODS: From linked pharmacy and administrative databases of the New England Veterans Healthcare System, we identified 71985 outpatients newly prescribed PPIs between 1998 and 2007; 1544 patients met criteria for CAP subsequent to PPI initiation; 15440 controls were matched through risk-set sampling by age and time under observation...
January 1, 2012: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
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