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Pulmonary infections

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130 papers 25 to 100 followers
https://www.readbyqxmd.com/read/28228053/hiv-related-pneumococcal-disease-prevention-in-adults
#1
Charles Feldman, Ronald Anderson, Theresa Rossouw
HIV-infected persons are particularly susceptible to the development of severe pneumococcal disease, even in the setting of combination antiretroviral therapy (cART), due to slow, incomplete recovery of anti-pneumococcal host defenses. This risk is increased by avoidable aspects of lifestyle, particularly smoking, which intensify immunosuppression. Clearly, more effective preventive measures are needed to counter this threat. Areas covered: This is a detailed review of the published literature focusing on currently available strategies for prevention of pneumococcal infection in HIV-infected patients, including cotrimoxazole prophylaxis, cART, pneumococcal vaccination, and smoking cessation strategies...
March 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28049128/immune-reconstitution-inflammatory-syndrome-associated-with-pulmonary-pathogens
#2
REVIEW
Radha Gopal, Rekha R Rapaka, Jay K Kolls
Immune reconstitution inflammatory syndrome (IRIS) is an exaggerated immune response to a variety of pathogens in response to antiretroviral therapy-mediated recovery of the immune system in HIV-infected patients. Although IRIS can occur in many organs, pulmonary IRIS, associated with opportunistic infections such as Mycobacterium tuberculosis and Pneumocystis jirovecii, is particularly associated with high morbidity and mortality. The pathology of IRIS is associated with a variety of innate and adaptive immune factors, including CD4(+) T-cells, CD8(+) T-cells, γδ T-cells, natural killer cells, macrophages, the complement system and surfactant proteins, Toll-like receptors and pro-inflammatory cytokines and chemokines...
January 2017: European Respiratory Review: An Official Journal of the European Respiratory Society
https://www.readbyqxmd.com/read/28143877/procalcitonin-to-guide-antibiotic-administration-in-copd-exacerbations-a-meta-analysis
#3
REVIEW
Alexander G Mathioudakis, Victoria Chatzimavridou-Grigoriadou, Alexandru Corlateanu, Jørgen Vestbo
Challenges in the differentiation of the aetiology of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) have led to significant overuse of antibiotics. Serum procalcitonin, released in response to bacterial infections, but not viral infections, could possibly identify AECOPD requiring antibiotics. In this meta-analysis we assessed the clinical effectiveness of procalcitonin-based protocols to initiate or discontinue antibiotics in patients presenting with AECOPD.Based on a prospectively registered protocol, we reviewed the literature and selected randomised or quasi-randomised trials comparing procalcitonin-based protocols to initiate or discontinue antibiotics versus standard care in AECOPD...
January 2017: European Respiratory Review: An Official Journal of the European Respiratory Society
https://www.readbyqxmd.com/read/28083768/invasive-fungal-tracheobronchitis-in-mechanically-ventilated-critically-ill-patients-underlying-conditions-diagnosis-and-outcomes
#4
Chun-Yu Lin, Wei-Lun Liu, Che-Chia Chang, Hou-Tai Chang, Han-Chung Hu, Kuo-Chin Kao, Ning-Hung Chen, Ying-Jen Chen, Cheng-Ta Yang, Chung-Chi Huang, George Dimopoulos
BACKGROUND: Invasive fungal tracheobronchitis (IFT) is a severe form of pulmonary fungal infection that is not limited to immunocompromised patients. Although respiratory failure is a crucial predictor of death, information regarding IFT in critically ill patients is limited. METHODS: In this retrospective, multicenter, observational study, we enrolled adults diagnosed as having IFT who had been admitted to the intensive care unit between January 2007 and December 2015...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28179437/predictors-of-mortality-in-chronic-pulmonary-aspergillosis
#5
David Lowes, Khaled Al-Shair, Pippa J Newton, Julie Morris, Chris Harris, Riina Rautemaa-Richardson, David W Denning
Chronic pulmonary aspergillosis (CPA) is a chronic progressive infection that destroys lung tissue in non-immunocompromised patients. Contemporary series suggest 50-85% 5-year mortality, with few prognostic factors identified.A cohort of 387 CPA patients referred to the UK's National Aspergillosis Centre from 1992 to June 2012 was studied until June 2015. The impact of objective and subjective variables including age, sex, previous pulmonary conditions, dyspnoea score, quality of life, serum albumin and C-reactive protein and radiological appearances were assessed using Kaplan-Meier curves, log rank tests and Cox proportional hazards modelling...
February 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28221171/pathogenesis-of-severe-pneumonia-advances-and-knowledge-gaps
#6
Joseph P Mizgerd
PURPOSE OF REVIEW: Pneumonia is a common disease that becomes severe in a subset of patients, dependent on host biology including mechanisms of immune resistance and tissue resilience. This review emphasizes discoveries in pneumonia biology from 2016, highlighting questions and directions that are especially pressing or newly emerging. RECENT FINDINGS: Novel cell-cell interactions mediating innate immune responses against microbes in the lung have been elucidated, between distinct leukocyte subtypes as well as between leukocytes and the structural cells of the lung...
February 17, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28198725/adult-pneumococcal-vaccination-advances-impact-and-unmet-needs
#7
Ricardo J José, Jeremy S Brown
PURPOSE OF REVIEW: Preventing pneumonia in the elderly and study participants individuals with comorbidities is an unmet clinical need. Streptococcus pneumoniae is the commonest bacterial cause of pneumonia, and we summarize recent findings regarding current S. pneumoniae vaccines, and debate their efficacy and cost-effectiveness in risk groups. We also discuss potential future vaccine strategies such as protein antigen vaccines. RECENT FINDINGS: Current vaccination with pneumococcal polysaccharide vaccine does not prevent S...
February 13, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28198726/community-acquired-pneumonia-requiring-hospitalization-rational-decision-making-and-interpretation-of-guidelines
#8
Douwe F Postma, Cornelis H van Werkhoven, Jan Jelrik Oosterheert
PURPOSE OF REVIEW: This review focuses on the evidence base for guideline recommendations on the diagnosis, the optimal choice, timing and duration of empirical antibiotic therapy, and the use of microbiological tests for patients hospitalized with community-acquired pneumonia (CAP): issues for which guidelines are frequently used as a quick reference. Furthermore, we will discuss possibilities for future research in these topics. RECENT FINDINGS: Many national and international guideline recommendations, even on critical elements of CAP management, are based on low-to-moderate quality evidence...
February 13, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28198727/new-guidelines-for-nosocomial-pneumonia
#9
Mark L Metersky, Andre C Kalil
PURPOSE OF REVIEW: Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) remain important causes of morbidity and mortality in hospitalized patients. New evidence-based guidelines for the diagnosis and treatment of these entities were released by the Infectious Diseases Society of America and the American Thoracic Society in 2016. This review summarizes the recommendations contained within these guidelines and their supporting rationale. RECENT FINDINGS: With respect to diagnosis of HAP and VAP, the guidelines suggest using semiquantitative cultures of noninvasively obtained respiratory samples instead of quantitative cultures of invasively obtained samples...
February 13, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/27984245/bacterial-pneumonia-as-an-influenza-complication
#10
Ignacio Martin-Loeches, Frank van Someren Gréve, Marcus J Schultz
PURPOSE OF REVIEW: The pathogenesis and impact of coinfection, in particular bacterial coinfection, in influenza are incompletely understood. This review summarizes results from studies on bacterial coinfection in the recent pandemic influenza outbreak. RECENT FINDINGS: Systemic immune mechanisms play a key role in the development of coinfection based on the complexity of the interaction of the host and the viral and bacterial pathogens. Several studies were performed to determine the point prevalence of bacterial coinfection in influenza...
December 15, 2016: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28030371/antibiotic-dosing-for-multidrug-resistant-pathogen-pneumonia
#11
Mohd H Abdul-Aziz, Jeffrey Lipman, Jason A Roberts
PURPOSE OF REVIEW: Nosocomial pneumonia caused by multidrug-resistant pathogens is increasing in the ICU, and these infections are negatively associated with patient outcomes. Optimization of antibiotic dosing has been suggested as a key intervention to improve clinical outcomes in patients with nosocomial pneumonia. This review describes the recent pharmacokinetic/pharmacodynamic data relevant to antibiotic dosing for nosocomial pneumonia caused by multidrug-resistant pathogens. RECENT FINDINGS: Optimal antibiotic treatment is challenging in critically ill patients with nosocomial pneumonia; most dosing guidelines do not consider the altered physiology and illness severity associated with severe lung infections...
April 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28079629/duration-of-pneumonia-therapy-and-the-role-of-biomarkers
#12
Katerina Kaziani, Adamantia Sotiriou, George Dimopoulos
PURPOSE OF REVIEW: Increasing antimicrobial resistance is a worldwide phenomenon that is threatening public health. Lower respiratory infections are one of the leading causes of morbidity that contribute to antibiotic consumption and thus the emergence of multidrug-resistant microbial strains. The goal of shortening antibiotic regimens' duration in common bacterial infections has been prioritized by antimicrobial stewardship programs as an action against this problem. RECENT FINDINGS: Data coming from randomized controlled trials, meta-analyses, and systematic reviews support the shortening of antimicrobial regimens in community-acquired, hospital-acquired, and ventilator-associated pneumonia...
January 12, 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28118220/respiratory-pathogen-panels-in-the-hospital-good-or-unnecessary
#13
Kelly A Cawcutt, Paul D Fey, Andre C Kalil
PURPOSE OF REVIEW: We aim to review the epidemiology of respiratory viral infections and the strengths and limitations of multiplex respiratory pathogen panels that are currently available along with their respective features and differences. RECENT FINDINGS: We give particular emphasis to the pathogens included on each test and evaluate their performance in the hospital setting. SUMMARY: We conclude with a discussion on the evidence for the clinical utility of respiratory pathogen multiplex panels in hospitalized patients, including the potential for coinfection with viral and bacterial pathogens...
April 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28118221/prevention-of-ventilator-associated-pneumonia
#14
Gianluigi Li Bassi, Tarek Senussi, Eli Aguilera Xiol
PURPOSE OF REVIEW: Ventilator-associated pneumonia (VAP) is an iatrogenic disease. Here we appraise recent advancements in the development and testing of strategies to prevent VAP. We also provide recommendations on the most promising interventions that should be applied. RECENT FINDINGS: In the last year, preventive bundles have consistently let to a reduction of VAP. A few trials on endotracheal tubes (ETTs) with novel cuffs failed to translate positive bench findings into clinical settings...
April 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28160220/community-acquired-pneumonia-in-hiv-positive-patients-an-update-on-etiologies-epidemiology-and-management
#15
REVIEW
André Almeida, Matteo Boattini
PURPOSE OF REVIEW: Community-acquired pneumonia (CAP) is the cause of a considerable burden of morbidity and mortality among HIV-infected patients. The purpose of this study was to review recent literature for epidemiological trends and management of CAP in HIV patients. RECENT FINDINGS: While the specific infectious etiologies are very diverse, bacterial infection and tuberculosis are the main causes of CAP in this population. Bacterial CAP mostly affects high-income countries, while tuberculosis is mostly in low-/middle-income countries...
January 2017: Current Infectious Disease Reports
https://www.readbyqxmd.com/read/28159152/epidemiology-of-viral-pneumonia
#16
REVIEW
Seema Jain
The burden of pneumonia, including that due to respiratory viruses, is markedly higher in the very young (<5 years) and older adults (≥50 years). Respiratory viruses substantially contribute to pneumonia in both adults and children, and when systematically tested for, are more commonly detected than bacteria in both adults and children. It is difficult to distinguish between viruses by clinical presentation, and the exact clinical implication of viral detections among patients with pneumonia depends on the pathogen detected; however, there is increasing evidence of their importance in pneumonia...
March 2017: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/28159154/viral-pneumonia-and-acute-respiratory-distress-syndrome
#17
REVIEW
Raj D Shah, Richard G Wunderink
Respiratory viruses are a common cause of severe pneumonia and acute respiratory distress syndrome (ARDS) in adults. The advent of new diagnostic technologies, particularly multiplex reverse transcription polymerase chain reaction, have increased the recognition of viral respiratory infections in critically ill adults. Supportive care for adults with ARDS caused by respiratory viruses is similar to the care of patients with ARDS from other causes. Although antiviral therapy is available for some respiratory viral infections, further research is needed to determine which groups of patients would benefit...
March 2017: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/28159155/postviral-complications-bacterial-pneumonia
#18
REVIEW
Jason E Prasso, Jane C Deng
Secondary bacterial pneumonia after viral respiratory infection remains a significant source of morbidity and mortality. Susceptibility is mediated by a variety of viral and bacterial factors, and complex interactions with the host immune system. Prevention and treatment strategies are limited to influenza vaccination and antibiotics/antivirals respectively. Novel approaches to identifying the individuals with influenza who are at increased risk for secondary bacterial pneumonias are urgently needed. Given the threat of further pandemics and the heightened prevalence of these viruses, more research into the immunologic mechanisms of this disease is warranted with the hope of discovering new potential therapies...
March 2017: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/28159156/antiviral-treatments
#19
REVIEW
Michael G Ison
Most viral respiratory tract infections are caused by classic respiratory viruses, including influenza, respiratory syncytial virus, human metapneumovirus, parainfluenza, rhinovirus, and adenovirus, whereas other viruses, such as herpes simplex, cytomegalovirus, and measles virus, can opportunistically affect the respiratory tract. The M2 inhibitors, amantadine and rimantadine, were historically effective for the prevention and treatment of influenza A but all circulating strains are currently resistant to these drugs...
March 2017: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/28159157/vaccines-in-the-prevention-of-viral-pneumonia
#20
REVIEW
Clementine S Fraser, Akhilesh Jha, Peter J M Openshaw
Pneumonia is of great global public health importance. Viral infections play both direct and indirect parts in its cause across the globe. Influenza is a leading cause of viral pneumonia in both children and adults, and respiratory syncytial virus is increasingly recognized as causing disease at both extremes of age. Vaccination offers the best prospect for prevention but current influenza vaccines do not provide universal and durable protection, and require yearly reformulation. In the future, it is hoped that influenza vaccines will give better and universal protection, and that new vaccines can be found for other causes of viral pneumonia...
March 2017: Clinics in Chest Medicine
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