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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
Long-xiang Su, Kun Meng, Xin Zhang, Hui-juan Wang, Peng Yan, Yan-hong Jia, Dan Feng, Li-xin Xie
BACKGROUND: Timely diagnosis and prognostic assessment of ventilator-associated pneumonia remain major challenges in critical care. OBJECTIVE: To explore the value of soluble triggering receptor expressed on myeloid cells 1, procalcitonin, and the Clinical Pulmonary Infection Score in the diagnosis and prognostic assessment of ventilator-associated pneumonia. METHODS: For 92 patients, bronchoalveolar lavage fluid was cultured for detection of microorganisms, serum levels of the receptor and procalcitonin and levels of the receptor in exhaled ventilator condensate were measured, and the Clinical Pulmonary Infection Score was calculated...
November 2012: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
James D Chalmers
No abstract text is available yet for this article.
October 2016: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
Mohamed Eltorki, Daniel Rosenfield
Young, non-verbal children presenting to the emergency department (ED) with non-specific complaints pose a significant diagnostic challenge to the emergency physician (EP). Given the paucity of pediatric research and clinical decision rules (CDR)(1) for many common conditions that present to the ED, this can lead to over-investigation, which can have negative consequences for the patient and families.(2) Traditionally, rigorous evidence requires derivation of a rule, testing and validating the rule in small contexts, and externally validating the CDR in multiple settings...
September 24, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Michael B Anthracopoulos
No abstract text is available yet for this article.
September 2016: Acta Paediatrica
H Cody Meissner
No abstract text is available yet for this article.
January 7, 2016: New England Journal of Medicine
Maria A Pereda, Miguel A Chavez, Catherine C Hooper-Miele, Robert H Gilman, Mark C Steinhoff, Laura E Ellington, Margaret Gross, Carrie Price, James M Tielsch, William Checkley
BACKGROUND AND OBJECTIVE: Pneumonia is the leading cause of death of children. Diagnostic tools include chest radiography, but guidelines do not currently recommend the use of lung ultrasound (LUS) as a diagnostic method. We conducted a meta-analysis to summarize evidence on the diagnostic accuracy of LUS for childhood pneumonia. METHODS: We performed a systematic search in PubMed, Embase, the Cochrane Library, Scopus, Global Health, World Health Organization-Libraries, and Latin American and Caribbean Health Sciences Literature of studies comparing LUS diagnostic accuracy against a reference standard...
April 2015: Pediatrics
Jason Phua, Nathan C Dean, Qi Guo, Win Sen Kuan, Hui Fang Lim, Tow Keang Lim
Mortality rates for severe community-acquired pneumonia (CAP) range from 17 to 48 % in published studies.In this review, we searched PubMed for relevant papers published between 1981 and June 2016 and relevant files. We explored how early and aggressive management measures, implemented within 24 hours of recognition of severe CAP and carried out both in the emergency department and in the ICU, decrease mortality in severe CAP.These measures begin with the use of severity assessment tools and the application of care bundles via clinical decision support tools...
August 28, 2016: Critical Care: the Official Journal of the Critical Care Forum
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