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By Faye Kehler Family Physician and GP Anesthetist since 1987 interested in all aspects of Medicine
William D Travis, Ulrich Costabel, David M Hansell, Talmadge E King, David A Lynch, Andrew G Nicholson, Christopher J Ryerson, Jay H Ryu, Moisés Selman, Athol U Wells, Jurgen Behr, Demosthenes Bouros, Kevin K Brown, Thomas V Colby, Harold R Collard, Carlos Robalo Cordeiro, Vincent Cottin, Bruno Crestani, Marjolein Drent, Rosalind F Dudden, Jim Egan, Kevin Flaherty, Cory Hogaboam, Yoshikazu Inoue, Takeshi Johkoh, Dong Soon Kim, Masanori Kitaichi, James Loyd, Fernando J Martinez, Jeffrey Myers, Shandra Protzko, Ganesh Raghu, Luca Richeldi, Nicola Sverzellati, Jeffrey Swigris, Dominique Valeyre
BACKGROUND: In 2002 the American Thoracic Society/European Respiratory Society (ATS/ERS) classification of idiopathic interstitial pneumonias (IIPs) defined seven specific entities, and provided standardized terminology and diagnostic criteria. In addition, the historical "gold standard" of histologic diagnosis was replaced by a multidisciplinary approach. Since 2002 many publications have provided new information about IIPs. PURPOSE: The objective of this statement is to update the 2002 ATS/ERS classification of IIPs...
September 15, 2013: American Journal of Respiratory and Critical Care Medicine
Laura L Hammitt, David R Murdoch, J Anthony G Scott, Amanda Driscoll, Ruth A Karron, Orin S Levine, Katherine L O'Brien
Diagnosing the etiologic agent of pneumonia has an essential role in ensuring the most appropriate and effective therapy for individual patients and is critical to guiding the development of treatment and prevention strategies. However, establishing the etiology of pneumonia remains challenging because of the relative inaccessibility of the infected tissue and the difficulty in obtaining samples without contamination by upper respiratory tract secretions. Here, we review the published and unpublished literature on various specimens available for the diagnosis of pediatric pneumonia...
April 2012: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Daniel H Kett, Ennie Cano, Andrew A Quartin, Julie E Mangino, Marcus J Zervos, Paula Peyrani, Cynthia M Cely, Kimbal D Ford, Ernesto G Scerpella, Julio A Ramirez
BACKGROUND: The American Thoracic Society and Infectious Diseases Society of America provide guidelines for management of hospital-acquired, ventilator-associated, and health-care-associated pneumonias, consisting of empirical antibiotic regimens for patients at risk for multidrug-resistant pathogens. We aimed to improve compliance with these guidelines and assess outcomes. METHODS: We implemented a performance-improvement initiative in four academic medical centres in the USA with protocol-based education and prospective observation of outcomes...
March 2011: Lancet Infectious Diseases
Simone Gattarello, Bárbara Borgatta, Jordi Solé-Violán, Jordi Vallés, Loreto Vidaur, Rafael Zaragoza, Antoni Torres, Jordi Rello
OBJECTIVE: The objective of the present study was to compare antibiotic prescribing practices and survival in the ICU for patients with pneumococcal severe community-acquired pneumonia (SCAP) between 2000 and 2013. METHODS: This was a matched case-control study of two prospectively recorded cohorts in Europe. Eighty patients from the Community-Acquired Pneumonia en la Unidad de Cuidados Intensivos (CAPUCI) II study (case group) were matched with 80 patients from CAPUCI I (control group) based on the following: shock at admission, need of mechanical ventilation, COPD, immunosuppression, and age...
July 2014: Chest
Charles Feldman, Ronald Anderson
Improving the outcome of patients with community-acquired pneumonia (CAP) is an ongoing challenge, even in the setting of significant advances in antimicrobial chemotherapy and critical care. Recognition of the underlying involvement of inflammation-mediated organ dysfunction as a determinant of adverse outcomes in CAP has aroused intense interest in the protective potential of adjunctive anti-inflammatory therapies in CAP, particularly the role of corticosteroids (CS). This is the primary topic of the current review which is focused on an evaluation of the latest meta-analyses encompassing both recent and earlier clinical trials, with particular emphasis on the stringent meta-analysis undertaken by Siemieniuk and colleagues (Ann Intern Med 2015;163:519-528)...
March 2016: Journal of Thoracic Disease
Michael Romano, Tomislav Jelic, Jordan Chenkin
There is evidence to suggest that point-of-care ultrasound assessment of the lungs has a higher sensitivity and specificity than chest radiography for the diagnosis of pneumonia. It is unknown if the same is true for pneumonia complications. We present and discuss the case of a 61-year-old woman who presented to the emergency department with confusion, decreased level of consciousness, and signs of sepsis. A chest x-ray revealed a right sided infiltrate. An ultrasound of the patient's lungs was performed, and revealed a complex loculated fluid collection consistent with an empyema...
September 2016: CJEM
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