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Pneumonia

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42 papers 25 to 100 followers
By M KKhan Pediatric Intensivist
https://www.readbyqxmd.com/read/29084336/effectiveness-of-%C3%AE-lactam-monotherapy-vs-macrolide-combination-therapy-for-children-hospitalized-with-pneumonia
#1
MULTICENTER STUDY
Derek J Williams, Kathryn M Edwards, Wesley H Self, Yuwei Zhu, Sandra R Arnold, Jonathan A McCullers, Krow Ampofo, Andrew T Pavia, Evan J Anderson, Lauri A Hicks, Anna M Bramley, Seema Jain, Carlos G Grijalva
Importance: β-Lactam monotherapy and β-lactam plus macrolide combination therapy are both common empirical treatment strategies for children hospitalized with pneumonia, but few studies have evaluated the effectiveness of these 2 treatment approaches. Objective: To compare the effectiveness of β-lactam monotherapy vs β-lactam plus macrolide combination therapy among a cohort of children hospitalized with pneumonia. Design, Setting, and Participants: We analyzed data from the Etiology of Pneumonia in the Community Study, a multicenter, prospective, population-based study of community-acquired pneumonia hospitalizations conducted from January 1, 2010, to June 30, 2012, in 3 children's hospitals in Nashville, Tennessee; Memphis, Tennessee; and Salt Lake City, Utah...
December 1, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28281094/clinical-features-and-inflammatory-markers-in-pediatric-pneumonia-a-prospective-study
#2
Are Stuwitz Berg, Christopher Stephen Inchley, Hans Olav Fjaerli, Truls Michael Leegaard, Morten Lindbaek, Britt Nakstad
In this prospective, observational study on previously healthy children <18 years, we aimed to study the diagnostic ability of clinical features and inflammatory markers to (i) predict pathologic chest radiography in suspected pneumonia and (ii) differentiate etiology in radiological proven pneumonia. In 394 cases of suspected pneumonia, 265 (67%) had radiographs consistent with pneumonia; 34/265 had proof of bacterial etiology. Of the cases, 86.5% had received pneumococcal conjugate vaccine. In suspected pneumonia, positive chest radiography was significantly associated with increasing C-reactive protein (CRP) values, higher age, and SpO2 ≤92% in multivariate logistic regression, OR 1...
May 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28687247/bacterial-and-viral-pneumonia-new-insights-from-the-drakenstein-child-health-study
#3
REVIEW
Heather J Zar
Pneumonia remains the major cause of childhood morbidity and mortality globally, despite improved preventative strategies. Increasing evidence also links early life pneumonia with the development of chronic non-communicable respiratory diseases into childhood and adulthood. The Drakenstein Child Health Study is a unique, multidisciplinary, South African birth cohort, investigating the incidence, risk factors, aetiology and long term impact of early life pneumonia on child health. The study provides novel data showing a high incidence of pneumonia despite excellent immunisation coverage; that pneumonia is due to multiple pathogens; that dysbiosis of the nasopharyngeal flora precedes and predisposes to pneumonia; and that early life pneumonia results in reduced lung function...
September 2017: Paediatric Respiratory Reviews
https://www.readbyqxmd.com/read/28545484/timing-of-appropriate-empirical-antimicrobial-administration-and-outcome-of-adults-with-community-onset-bacteremia
#4
Ching-Chi Lee, Chung-Hsun Lee, Ming-Yuan Hong, Hung-Jen Tang, Wen-Chien Ko
BACKGROUND: Early administration of appropriate antimicrobials has been correlated with a better prognosis in patients with bacteremia, but the optimum timing of early antibiotic administration as one of the resuscitation strategies for severe bacterial infections remains unclear. METHODS: In a retrospective cohort study, adults with community-onset bacteremia at the emergency department (ED) were analyzed. Effects of different cutoffs of time to appropriate antibiotic (TtAa) administration after arrival at the ED on 28-day mortality were examined, after adjustment for independent predictors of mortality identified by multivariate regression analysis...
May 26, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28756034/efficacy-of-corticosteroid-treatment-for-severe-community-acquired-pneumonia-a-meta-analysis
#5
Wei-Fang Wu, Qiang Fang, Guo-Jun He
BACKGROUND: The benefits and adverse effects of corticosteroids in the treatment of severe community-acquired pneumonia (CAP) have not been well assessed. The aim of this systematic review of the literature and meta-analysis was to evaluate the clinical efficacy of adjuvant corticosteroid therapy in patients with severe CAP. METHODS: The following databases were searched: PubMed, the Cochrane database, Embase, Wanfang, the China National Knowledge Infrastructure (CNKI), and the WeiPu (VIP) database in Chinese...
July 15, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27960207/antibiotic-resistance-in-community-acquired-pneumonia-pathogens
#6
Richard G Wunderink, Yudong Yin
The overwhelming majority of cases of community-acquired pneumonia (CAP) can be treated with the standard antibiotic regimens of a macrolide and cephalosporin or a fluoroquinolone. Despite high rates, current levels of β-lactam resistance generally do not result in treatment failure for patients with CAP when appropriate agents and doses are used. Following the introduction of the pneumococcal conjugate vaccines, the incidence of invasive pneumococcal disease declined drastically, coinciding with a decrease in penicillin resistance...
December 2016: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28159152/epidemiology-of-viral-pneumonia
#7
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/28159153/the-virome-of-the-human-respiratory-tract
#8
REVIEW
Kristine M Wylie
The human respiratory tract virome is defined here as the viruses present in the human respiratory tract that can infect human cells. Sensitive, culture-independent molecular assays (polymerase chain reaction and high-throughput sequencing) reveal that in addition to common viruses that cause acute, symptomatic infections the virome also includes viruses that do not cause clinical symptoms, have unknown pathogenic effect, or cause symptoms but are not among the most common viral respiratory tract pathogens...
March 2017: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/28159154/viral-pneumonia-and-acute-respiratory-distress-syndrome
#9
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
#10
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
#11
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
#12
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
https://www.readbyqxmd.com/read/28159158/diagnosing-viral-and-atypical-pathogens-in-the-setting-of-community-acquired-pneumonia
#13
REVIEW
Grant W Waterer
The 'atypical' pathogens causing pneumonia have long been problematic for physicians because we have had to rely on serologic tests to make a diagnosis. The introduction of polymerase chain reaction techniques revolutionized the diagnosis of respiratory infections and now a new wave of technologies promising faster, cheaper, and more comprehensive testing are becoming available. This review focuses principally on the diagnosis of Legionella, Mycoplasma, and influenza infections, but also covers recent publications on the cutting edge of diagnostic tools likely to transform the field of infectious diseases over the coming decade...
March 2017: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/28159159/respiratory-syncytial-virus-infection-an-illness-for-all-ages
#14
REVIEW
Edward E Walsh
Respiratory syncytial virus (RSV) is the single most important cause of severe respiratory infection in very young infants. It has also been recently recognized as a significant cause of severe illness in elderly adults, those with underlying cardiopulmonary disease, and the immunocompromised. RSV is suspected of playing a major role in the development of asthma. Prophylaxis in high-risk infants using a monoclonal antibody is the only effective specific therapy available but recent breakthroughs in vaccine design and antiviral drugs offer the promise of effective prophylactic and therapeutic agents against RSV...
March 2017: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/28159160/other-community-respiratory-viruses
#15
REVIEW
Richard G Wunderink
Polymerase chain reaction-based diagnosis has become the standard for viral pneumonia and other respiratory tract infections. Expansion of respiratory viral panels (RVPs) outside of influenza and, possibly, respiratory syncytial virus has led to the ability to diagnose viral infections for which no approved specific antiviral treatment exists. Careful clinical evaluation of the patient with a positive RVP is, therefore, critical given the limited repertoire of treatments. Generic treatments with intravenous immunoglobulin, ribavirin, and interferons may benefit select severe viral pneumonia patients, whereas cidofovir has activity for severe adenoviral pneumonia...
March 2017: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/28159161/atypical-pneumonia-updates-on-legionella-chlamydophila-and-mycoplasma-pneumonia
#16
REVIEW
Lokesh Sharma, Ashley Losier, Thomas Tolbert, Charles S Dela Cruz, Chad R Marion
Community-acquired pneumonia (CAP) has multiple causes and is associated with illness that requires admission to the hospital and mortality. The causes of atypical CAP include Legionella species, Chlamydophila, and Mycoplasma. Atypical CAP remains a diagnostic challenge and, therefore, likely is undertreated. This article reviews the advancements in the evaluation and treatment of patients and discusses current conflicts and controversies of atypical CAP.
March 2017: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/28159162/pandemic-and-avian-influenza-a-viruses-in-humans-epidemiology-virology-clinical-characteristics-and-treatment-strategy
#17
REVIEW
Hui Li, Bin Cao
The intermittent outbreak of pandemic influenza and emergence of novel avian influenza A virus is worldwide threat. Although most patients present with mild symptoms, some deteriorate to severe pneumonia and even death. Great progress in the understanding of the mechanism of disease pathogenesis and a series of vaccines has been promoted worldwide; however, incidence, morbidity, and mortality remains high. To step up vigilance and improve pandemic preparedness, this article elucidates the virology, epidemiology, pathogenesis, clinical characteristics, and treatment of human infections by influenza A viruses, with an emphasis on the influenza A(H1N1)pdm09, H5N1, and H7N9 subtypes...
March 2017: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/28159163/epidemic-and-emerging-coronaviruses-severe-acute-respiratory-syndrome-and-middle-east-respiratory-syndrome
#18
REVIEW
David S Hui
Bats are the natural reservoirs of severe acute respiratory syndrome (SARS)-like coronaviruses (CoVs) and likely the reservoir of Middle East respiratory syndrome (MERS)-CoV. The clinical features of SARS-CoV infection and MERS-CoV infection are similar but MERS-CoV infection progresses to respiratory failure more rapidly. Although the estimated pandemic potential of MERS-CoV is lower than that of SARS-CoV, the case fatality rate of MERS is higher. The transmission route and the possibility of other intermediary animal sources remain uncertain among many sporadic primary cases...
March 2017: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/28159164/respiratory-viral-infections-in-chronic-lung-diseases
#19
REVIEW
Clemente J Britto, Virginia Brady, Seiwon Lee, Charles S Dela Cruz
Chronic lung diseases, such as chronic obstructive pulmonary disease (COPD), asthma, cystic fibrosis (CF) and interstitial lung diseases (ILD), affect many individuals worldwide. Patients with these chronic lung diseases are susceptible to respiratory lung infections and some of these viral infections can contribute to disease pathogenesis. This review highlights the associations of lung infections and the respective chronic lung diseases and how infection in the different lung diseases affects disease exacerbation and progression...
March 2017: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/28159165/viral-pneumonia-in-patients-with-hematologic-malignancy-or-hematopoietic-stem-cell-transplantation
#20
REVIEW
Erik Vakil, Scott E Evans
Viral pneumonias in patients with hematologic malignancies and recipients of hematopoietic stem cell transplantation cause significant morbidity and mortality. Advances in diagnostic techniques have enabled rapid identification of respiratory viral pathogens from upper and lower respiratory tract samples. Lymphopenia, myeloablative and T-cell depleting chemotherapy, graft-versus-host disease, and other factors increase the risk of developing life-threatening viral pneumonia. Chest imaging is often nonspecific but may aid in diagnoses...
March 2017: Clinics in Chest Medicine
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