Read by QxMD icon Read


shared collection
52 papers 0 to 25 followers Community-Acquired Pneumonia
By Braulio Méndez Residente 3er año Medicina Interna
Harold Horowitz
No abstract text is available yet for this article.
February 9, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Antoni Torres, Nanshan Zhong, Jan Pachl, Jean-François Timsit, Marin Kollef, Zhangjing Chen, Jie Song, Dianna Taylor, Peter J Laud, Gregory G Stone, Joseph W Chow
BACKGROUND: Nosocomial pneumonia is commonly associated with antimicrobial-resistant Gram-negative pathogens. We aimed to assess the efficacy and safety of ceftazidime-avibactam in patients with nosocomial pneumonia, including ventilator-associated pneumonia, compared with meropenem in a multinational, phase 3, double-blind, non-inferiority trial (REPROVE). METHODS: Adults with nosocomial pneumonia (including ventilator-associated pneumonia), enrolled at 136 centres in 23 countries, were randomly assigned (1:1) to 2000 mg ceftazidime and 500 mg avibactam (by 2 h intravenous infusion every 8 h) or 1000 mg meropenem (by 30-min intravenous infusion every 8 h) for 7-14 days; regimens were adjusted for renal function...
March 2018: Lancet Infectious Diseases
Alexandre Biasi Cavalcanti, Érica Aranha Suzumura, Ligia Nasi Laranjeira, Denise de Moraes Paisani, Lucas Petri Damiani, Helio Penna Guimarães, Edson Renato Romano, Marisa de Moraes Regenga, Luzia Noriko Takahashi Taniguchi, Cassiano Teixeira, Roselaine Pinheiro de Oliveira, Flavia Ribeiro Machado, Fredi Alexander Diaz-Quijano, Meton Soares de Alencar Filho, Israel Silva Maia, Eliana Bernardete Caser, Wilson de Oliveira Filho, Marcos de Carvalho Borges, Priscilla de Aquino Martins, Mirna Matsui, Gustavo Adolfo Ospina-Tascón, Thiago Simões Giancursi, Nelson Dario Giraldo-Ramirez, Silvia Regina Rios Vieira, Maria da Graça Pasquotto de Lima Assef, Mohd Shahnaz Hasan, Wojciech Szczeklik, Fernando Rios, Marcelo Britto Passos Amato, Otávio Berwanger, Carlos Roberto Ribeiro de Carvalho
Importance: The effects of recruitment maneuvers and positive end-expiratory pressure (PEEP) titration on clinical outcomes in patients with acute respiratory distress syndrome (ARDS) remain uncertain. Objective: To determine if lung recruitment associated with PEEP titration according to the best respiratory-system compliance decreases 28-day mortality of patients with moderate to severe ARDS compared with a conventional low-PEEP strategy. Design, Setting, and Participants: Multicenter, randomized trial conducted at 120 intensive care units (ICUs) from 9 countries from November 17, 2011, through April 25, 2017, enrolling adults with moderate to severe ARDS...
October 10, 2017: JAMA: the Journal of the American Medical Association
Alexander Kaysin, Anthony J Viera
Community-acquired pneumonia is a leading cause of death. Risk factors include older age and medical comorbidities. Diagnosis is suggested by a history of cough, dyspnea, pleuritic pain, or acute functional or cognitive decline, with abnormal vital signs (e.g., fever, tachycardia) and lung examination findings. Diagnosis should be confirmed by chest radiography or ultrasonography. Validated prediction scores for pneumonia severity can guide the decision between outpatient and inpatient therapy. Using procalcitonin as a biomarker for severe infection may further assist with risk stratification...
November 1, 2016: American Family Physician
Elan D Louis
PURPOSE OF REVIEW: Tremor, which is a rhythmic oscillation of a body part, is among the most common involuntary movements. Rhythmic oscillations may manifest in a variety of ways; as a result, a rich clinical phenomenology surrounds tremor. For this reason, diagnosing tremor disorders can be particularly challenging. The aim of this article is to provide the reader with a straightforward approach to the diagnosis and management of patients with tremor. RECENT FINDINGS: Scientific understanding of the pathophysiologic basis of tremor disorders has grown considerably in recent years with the use of a broad range of neuroimaging approaches and rigorous, controlled postmortem studies...
August 2016: Continuum: Lifelong Learning in Neurology
Elena Prina, Adrian Ceccato, Antoni Torres
Despite improvements in the management of community-acquired pneumonia (CAP), morbidity and mortality are still high, especially in patients with more severe disease. Early and appropriate antibiotics remain the cornerstone in the treatment of CAP. However, two aspects seem to contribute to a worse outcome: an uncontrolled inflammatory reaction and an inadequate immune response. Adjuvant treatments, such as corticosteroids and intravenous immunoglobulins, have been proposed to counterbalance these effects. The use of corticosteroids in patients with severe CAP and a strong inflammatory reaction can reduce the time to clinical stability, the risk of treatment failure, and the risk of progression to acute respiratory distress syndrome...
October 1, 2016: Critical Care: the Official Journal of the Critical Care Forum
Fiona Havers, Anna M Bramley, Lyn Finelli, Carrie Reed, Wesley H Self, Christopher Trabue, Sherene Fakhran, Robert Balk, D Mark Courtney, Timothy D Girard, Evan J Anderson, Carlos G Grijalva, Kathryn M Edwards, Richard G Wunderink, Seema Jain
BACKGROUND: Prior retrospective studies suggest that statins may benefit patients with community-acquired pneumonia (CAP) due to antiinflammatory and immunomodulatory effects. However, prospective studies of the impact of statins on CAP outcomes are needed. We determined whether statin use was associated with improved outcomes in adults hospitalized with CAP. METHODS: Adults aged ≥18 years hospitalized with CAP were prospectively enrolled at 3 hospitals in Chicago, Illinois, and 2 hospitals in Nashville, Tennessee, from January 2010-June 2012...
June 15, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Catia Cillóniz, Albert Gabarrús, Miquel Ferrer, Jorge Puig de la Bellacasa, Mariano Rinaudo, Josep Mensa, Michael S Niederman, Antoni Torres
BACKGROUND: Pseudomonas aeruginosa is not a frequent pathogen in community-acquired pneumonia (CAP). However, in patients with severe CAP, P aeruginosa can be the etiology in 1.8% to 8.3% of patients, with a case-fatality rate of 50% to 100%. We describe the prevalence, clinical characteristics, outcomes, and risk factors associated with CAP resulting from multidrug-resistant (MDR) and non-MDR P aeruginosa. METHODS: Prospective observational study of 2,023 consecutive adult patients with CAP with definitive etiology...
August 2016: Chest
Raquel K Belforti, Tara Lagu, Sarah Haessler, Peter K Lindenauer, Penelope S Pekow, Aruna Priya, Marya D Zilberberg, Daniel Skiest, Thomas L Higgins, Mihaela S Stefan, Michael B Rothberg
BACKGROUND: Fluoroquinolones have equivalent oral and intravenous bioavailability, but hospitalized patients with community-acquired pneumonia (CAP) generally are treated intravenously. Our objectives were to compare outcomes of hospitalized CAP patients initially receiving intravenous vs oral respiratory fluoroquinolones. METHODS: This was a retrospective cohort study utilizing data from 340 hospitals involving CAP patients admitted to a non-intensive care unit (ICU) setting from 2007 to 2010, who received intravenous or oral levofloxacin or moxifloxacin...
July 1, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Jonathan S Lee, Daniel L Giesler, Walid F Gellad, Michael J Fine
IMPORTANCE: Antibiotic therapy is the cornerstone of medical management for community-acquired pneumonia. OBJECTIVE: To assess the associations between 3 key aspects of antibiotic therapy (optimal time to antibiotic initiation, initial antibiotic selection, and criteria for the transition from intravenous to oral therapy) and short-term mortality in adults hospitalized with community-acquired pneumonia. EVIDENCE REVIEW: Bibliographic databases of MEDLINE, EMBASE, and the Cochrane Collaboration were searched for studies of adults hospitalized with radiographically confirmed community-acquired pneumonia published from January 1, 1995, until November 5, 2015...
February 9, 2016: JAMA: the Journal of the American Medical Association
Carlos M Barrera, Analia Mykietiuk, Hristo Metev, Mimi Floarea Nitu, Najumuddin Karimjee, Pablo Alexis Doreski, Ismail Mitha, Cristina Mihaela Tanaseanu, Joseph McDermott Molina, Yuri Antonovsky, Dirkie Johanna Van Rensburg, Brian H Rowe, Jose Flores-Figueroa, Barbara Rewerska, Kay Clark, Kara Keedy, Amanda Sheets, Drusilla Scott, Gary Horwith, Anita F Das, Brian Jamieson, Prabhavathi Fernandes, David Oldach
BACKGROUND: Community-acquired bacterial pneumonia (CABP) is a leading cause of morbidity and mortality, and treatment recommendations, each with specific limitations, vary globally. We aimed to compare the efficacy and safety of solithromycin, a novel macrolide, with moxifloxacin for treatment of CABP. METHODS: We did this global, double-blind, double-dummy, randomised, active-controlled, non-inferiority trial at 114 centres in North America, Latin America, Europe, and South Africa...
April 2016: Lancet Infectious Diseases
Naomi J Gadsby, Clark D Russell, Martin P McHugh, Harriet Mark, Andrew Conway Morris, Ian F Laurenson, Adam T Hill, Kate E Templeton
BACKGROUND: The frequent lack of a microbiological diagnosis in community-acquired pneumonia (CAP) impairs pathogen-directed antimicrobial therapy. This study assessed the use of comprehensive multibacterial, multiviral molecular testing, including quantification, in adults hospitalized with CAP. METHODS: Clinical and laboratory data were collected for 323 adults with radiologically-confirmed CAP admitted to 2 UK tertiary care hospitals. Sputum (96%) or endotracheal aspirate (4%) specimens were cultured as per routine practice and also tested with fast multiplex real-time polymerase-chain reaction (PCR) assays for 26 respiratory bacteria and viruses...
April 1, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Forest W Arnold, Jose Bordon, Rafael Fernandez-Botran, Madhavi J Rane, Silvia M Uriarte, Robert Kelley, Timothy L Wiemken, Paula Peyrani, Julio A Ramirez
PURPOSE: The objective of this study was to measure plasma cytokine levels and blood neutrophil functions as well as clinical outcomes in hospitalized patients with community-acquired pneumonia (CAP) treated with or without macrolide use--a known modulator of inflammatory response. METHODS: Subjects with CAP had peripheral blood analyzed for some neutrophil functions (degranulation of secretory vesicles and specific granules, respiratory burst response and phagocytosis) and ten cytokine levels measured in serum and sputum supernatants...
February 2016: Lung
You-Dong Wan, Tong-Wen Sun, Zi-Qi Liu, Shu-Guang Zhang, Le-Xin Wang, Quan-Cheng Kan
BACKGROUND: Corticosteroids are an option in the treatment of community-acquired pneumonia (CAP). However, the benefits and adverse effects of corticosteroids, especially in severe CAP, have not been well assessed. METHODS: PubMed, Embase, and Cochrane library databases from inception to May 2015 were searched. Randomized controlled trials (RCTs) and cohort studies that evaluated use of corticosteroids in adult patients with CAP were included. The quality of outcomes was evaluated using Grading of Recommendations Assessment, Development and Evaluation methodology...
January 2016: Chest
Ricardo José, Andrew Williams, Michal Sulikowski, David Brealey, Jeremy Brown, Rachel Chambers
BACKGROUND: Community-acquired pneumonia is commonly caused by Streptococcus pneumoniae, which is associated with excessive neutrophilic inflammation. The high-affinity thrombin receptor, proteinase-activated receptor 1 (PAR1), has been implicated in mediating the interplay between coagulation and inflammation. However, its role during S pneumoniae-induced neutrophilic inflammation, and the mechanisms for neutrophil recruitment in this context are poorly understood. We aimed to investigate the role of neutrophilic inflammation and PAR1 in S pneumoniae-induced pneumonia...
February 26, 2015: Lancet
Elena Prina, Otavio T Ranzani, Antoni Torres
Community-acquired pneumonia causes great mortality and morbidity and high costs worldwide. Empirical selection of antibiotic treatment is the cornerstone of management of patients with pneumonia. To reduce the misuse of antibiotics, antibiotic resistance, and side-effects, an empirical, effective, and individualised antibiotic treatment is needed. Follow-up after the start of antibiotic treatment is also important, and management should include early shifts to oral antibiotics, stewardship according to the microbiological results, and short-duration antibiotic treatment that accounts for the clinical stability criteria...
September 12, 2015: Lancet
Reed A C Siemieniuk, Maureen O Meade, Pablo Alonso-Coello, Matthias Briel, Nathan Evaniew, Manya Prasad, Paul E Alexander, Yutong Fei, Per O Vandvik, Mark Loeb, Gordon H Guyatt
BACKGROUND: Community-acquired pneumonia (CAP) is common and often severe. PURPOSE: To examine the effect of adjunctive corticosteroid therapy on mortality, morbidity, and duration of hospitalization in patients with CAP. DATA SOURCES: MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials through 24 May 2015. STUDY SELECTION: Randomized trials of systemic corticosteroids in hospitalized adults with CAP...
October 6, 2015: Annals of Internal Medicine
Antoni Torres, Francesco Blasi, Nathalie Dartois, Murat Akova
Pneumococcal disease (including community-acquired pneumonia and invasive pneumococcal disease) poses a burden to the community all year round, especially in those with chronic underlying conditions. Individuals with COPD, asthma or who smoke, and those with chronic heart disease or diabetes mellitus have been shown to be at increased risk of pneumococcal disease compared with those without these risk factors. These conditions, and smoking, can also adversely affect patient outcomes, including short-term and long-term mortality rates, following pneumonia...
October 2015: Thorax
Yann-Erick Claessens, Marie-Pierre Debray, Florence Tubach, Anne-Laure Brun, Blandine Rammaert, Pierre Hausfater, Jean-Marc Naccache, Patrick Ray, Christophe Choquet, Marie-France Carette, Charles Mayaud, Catherine Leport, Xavier Duval
RATIONALE: Clinical decision making relative to community-acquired pneumonia (CAP) diagnosis is difficult. Chest radiograph is key in establishing parenchymal lung involvement. However, radiologic performance may lead to misdiagnosis, rendering questionable the use of chest computed tomography (CT) scan in patients with clinically suspected CAP. OBJECTIVES: To assess whether early multidetector chest CT scan affects diagnosis and management of patients visiting the emergency department with suspected CAP...
October 15, 2015: American Journal of Respiratory and Critical Care Medicine
Brendon P Scicluna, Peter M C Klein Klouwenberg, Lonneke A van Vught, Maryse A Wiewel, David S Y Ong, Aeilko H Zwinderman, Marek Franitza, Mohammad R Toliat, Peter Nürnberg, Arie J Hoogendijk, Janneke Horn, Olaf L Cremer, Marcus J Schultz, Marc J Bonten, Tom van der Poll
RATIONALE: Community-acquired pneumonia (CAP) accounts for a major proportion of intensive care unit (ICU) admissions for respiratory failure and sepsis. Diagnostic uncertainty complicates case management, which may delay appropriate cause-specific treatment. OBJECTIVES: To characterize the blood genomic response in patients with suspected CAP and identify a candidate biomarker for the rapid diagnosis of CAP on ICU admission. METHODS: The study comprised two cohorts of consecutively enrolled patients treated for suspected CAP on ICU admission...
October 1, 2015: American Journal of Respiratory and Critical Care Medicine
2016-07-11 01:06:34
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"