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Latest & greatest articles for pneumonia
The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on pneumonia or other clinical topics then use Trip today.
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Effects of pulmonary rehabilitation on daily life physical activity of fibrotic idiopathic interstitial pneumonia patients Fibrotic idiopathic interstitial pneumonia patients derived benefit from a pulmonary rehabilitation programme in terms of exercise tolerance, anxiety, depression and quality of life without increasing their daily life physical activity http://ow.ly/WV7U30kgNkU.
Proton-Pump Inhibitors and Long-Term Risk of Community-Acquired Pneumonia in Older Adults To estimate associations between long-term use of proton pump inhibitors (PPIs) and pneumonia incidence in older adults in primary care.Longitudinal analyses of electronic medical records.England PARTICIPANTS: Individuals aged 60 and older in primary care receiving PPIs for 1 year or longer (N=75,050) and age- and sex-matched controls (N=75,050).Net hazard ratios for pneumonia incidence in Year 2 (...) of treatment were estimated using the prior event rate ratio (PERR), which adjusts for pneumonia incidence differences before initiation of treatment. Inverse probability weighted models adjusted for 78 demographic, disease, medication, and healthcare usage measures.During the second year after initiating treatment, PPIs were associated with greater hazard of incident pneumonia (PERR-adjusted hazard ratio=1.82, 95% confidence interval=1.27-2.54), accounting for pretreatment pneumonia rates. Estimates were
Distribution and determinants of pneumonia diagnosis using Integrated Management of Childhood Illness guidelines: a nationally representative study in Malawi Pneumonia remains the leading cause of child mortality in sub-Saharan Africa. The Integrated Management of Childhood Illness (IMCI) strategy was developed to standardise care in low-income and middle-income countries for major childhood illnesses and can effectively improve healthcare worker performance. Suboptimal clinical evaluation can (...) result in missed diagnoses and excess morbidity and mortality. We estimate the sensitivity of pneumonia diagnosis and investigate its determinants among children in Malawi.Data were obtained from the 2013-2014 Service Provision Assessment survey, a census of health facilities in Malawi that included direct observation of care and re-examination of children by trained observers. We calculated sensitivity of pneumonia diagnosis and used multilevel log-binomial regression to assess factors associated
Pneumococcal vaccines for people with COPD reduce their chance of catching pneumonia Pneumococcal vaccines for people with COPD reduce their chance of catching pneumonia Discover Portal Discover Portal Pneumococcal vaccines for people with COPD reduce their chance of catching pneumonia Published on 30 May 2017 doi: Pneumococcal vaccines reduce the risk of community-acquired pneumonia in people with moderate to severe chronic obstructive pulmonary disease (COPD). Pneumococcal vaccination (...) is currently recommended for people with COPD and other respiratory diseases. However, until now there has been a lack of data whether it actually improves outcomes in these groups. This updated Cochrane review identified 12 trials including 2171 adults with COPD, comparing those who did and did not receive pneumococcal vaccination. One episode of community-acquired pneumonia was prevented for every 21 people vaccinated. There was also evidence that vaccination reduced the risk of exacerbations of COPD
New evidence available on corticosteroids added to antibiotics in severe pneumonia New evidence available on corticosteroids added to antibiotics in severe pneumonia Discover Portal Discover Portal New evidence available on corticosteroids added to antibiotics in severe pneumonia Published on 9 November 2015 doi: For adults admitted to hospital with severe pneumonia, this review found that adding corticosteroids to the usual antibiotic treatment may be beneficial. The evidence was less (...) supportive of using corticosteroids in people with less severe pneumonia. Results showed modest benefits in allowing patients to reach a clinically stable recovery and leave hospital an average of one day earlier. Reduced need for artificial breathing support was the main benefit for people with non-severe pneumonia. The review showed that using corticosteroids increased levels of blood sugar. This and other potential adverse events were not well investigated, as people at risk of them were excluded from
Contemporary Situation of Community-acquired Pneumonia in China: A Systematic Review The prevalence and microbial pattern reported for Community-acquired pneumonia (CAP) differ considerably and contemporary situation remains changing over time. We therefore searched both international and domestic databases for relevant references and pooled incidence of CAP and etiological distribution were estimated separately between children and adults groups. The results showed that CAP remained a major (...) public health issue in China, with a relatively higher incidence than that reported in Western countries. Although pathogens were not detected in nearly half of patients, Mycoplasma pneumoniae remained to be the most frequently detected agent across age groups, the detection yield of which was lower than that reported from other countries. Notably, the incidence of influenza virus A in adults was almost four times higher than that in children while the prevalence of respiratory syncytial virus
Neutrophil-to-lymphocyte Ratio Relation to Sepsis Severity Scores and Inflammatory Biomarkers in Patients with Community-acquired Pneumonia: A Case Series Neutrophil to lymphocyte ratio (NLR) as calculated from the white cell differential blood count is considered a promising marker for the prognosis of patients with various diseases, including sepsis. This study was designed to assess the possible use of neutrophil-to-lymphocyte ratio in the prediction of survival outcomes in patients (...) with community acquired pneumonia (CAP). A secondary objective was to compare the prognostic accuracy of NLR with the commonly used severity scores of sepsis SOFA, APACHE II and SAPS II.This was a retrospective study based on data extracted from 26 patients suffering from acute CAP. The study period was from February 01, 2017 until April 30, 2017. All patients with CAP were presented in the Emergency Department (ED) of the University Hospital of Patras, Greece and were treated after admission in the Internal
Translating Lung Microbiome Profiles into the Next-Generation Diagnostic Gold Standard for Pneumonia: a Clinical Investigatorâ€™s Perspective Severe bacterial pneumonia is a major global cause of morbidity and mortality, yet current diagnostic approaches rely on identification of causative pathogens by cultures, which require extended incubation periods and often fail to detect relevant pathogens. Consequently, patients are prescribed broad-spectrum antibiotics in a "one-size-fits-all" manner (...) , which may be inappropriate for their individual needs and promote antibiotic resistance. My research focuses on leveraging next-generation sequencing of microbial DNA directly from patient samples for the development of new, culture-independent definitions of pneumonia. In this perspective article, I discuss the current state of the field and focus on the conceptual and research design challenges for clinical translation. With ongoing technological advancements and application of computational
Inflammation-Based Prognostic Score Predicts Postoperative Survival of Patients with Interstitial Pneumonia After Undergoing Lung Cancer Resection Idiopathic interstitial pneumonias (IIPs) are associated with an increased risk of lung cancer. Glasgow prognostic score (GPS), which uses serum C-reactive protein (CRP) and albumin levels to indicate systemic inflammatory response and nutrition level, has been reported to be a predictor of overall survival in patients with various types of cancer (...) (p < 0.001), usual interstitial pneumonia pattern (p = 0.006), and GPS of 2 (p = 0.003) as predictive factors associated with CSS, while univariate analysis indicated pTNM (p = 0.042), GPS of 1 (p = 0.044), and %DLCO (p = 0.038) as predictive factors associated with ODSS.GPS is an independent prognostic factor of OS and RFS in lung cancer patients with IIPs undergoing a lung resection procedure. Furthermore, a GPS of 2 was found to be associated with CSS following lung cancer resection, while
Inpatient management of community-acquired pneumonia at the European Gaza Hospital: a clinical audit. Disease severity scores such as CURB-65 are often used to guide the management of patients with community-acquired pneumonia. Early and adequate empirical antibiotic treatment reduces mortality. The aim of this study was to examine the severity assessment and management of patients presenting with community-acquired pneumonia at the European Gaza Hospital in the Gaza Strip and to compare (...) this to the best available evidence.Medical records of all patients admitted to the European Gaza Hospital with a diagnosis of community-acquired pneumonia between Dec 1, 2015, and March 31, 2016, were reviewed retrospectively. Clinical practice was compared with recommendations for severity assessment and the management of community-acquired pneumonia, as reported in guidelines by the National Institute for Health and Care Excellence and the American Thoracic Society. Ethical approval was obtained from
Cost-effectiveness of the antimicrobial treatment for inpatients infected with Klebsiella pneumoniae carbapenemase: a systematic review protocol. The objective of this review is to evaluate the cost-effectiveness of antimicrobial therapy treatment for inpatients infected with Klebsiella pneumoniae carbapenemase.More specifically, the review question is: What is the best evidence on the cost-effectiveness of the antimicrobial treatment for inpatients infected with Klebsiella Pneumoniae
Anesthesia Assistance in Outpatient Colonoscopy and Risk of Aspiration Pneumonia, Bowel Perforation, and Splenic Injury The increase in use of anesthesia assistance (AA) to achieve deep sedation with propofol during colonoscopy has significantly increased colonoscopy costs without evidence for increased quality and with possible harm. We investigated the effects of AA on colonoscopy complications, specifically bowel perforation, aspiration pneumonia, and splenic injury.In a population-based (...) cohort study using administrative databases, we studied adults in Ontario, Canada undergoing outpatient colonoscopy from 2005 through 2012. Patient, endoscopist, institution, and procedure factors were derived. The primary outcome was bowel perforation, defined using a validated algorithm. Secondary outcomes were splenic injury and aspiration pneumonia. Using a matched propensity score approach, we matched persons who had colonoscopy with AA (1:1) with those who did not. We used logistic regression
Game Changer? How Many Days of Antibiotics is Best for Treating Community Acquired Pneumonia? Game Changer? How Many Days of Antibiotics is Best for Treating Community Acquired Pneumonia? – Clinical Correlations Search Game Changer? How Many Days of Antibiotics is Best for Treating Community Acquired Pneumonia? January 16, 2018 6 min read By Calvin Ngai, MD Peer Reviewed A 71-year-old Caucasian woman with hypertension presented with a 2-day history of productive cough and fever. She was living (...) alone and had no history of any recent hospitalizations. On examination, she was alert and oriented but slightly tachypneic; her lungs were clear to auscultation bilaterally. Laboratory tests were significant for a white blood cell count of 18,000 m L with 89% neutrophils. The chest x-ray showed a right lower lobe infiltrate. She was admitted and started on antibiotics for treatment of community acquired pneumonia (CAP). She improved clinically, and after remaining afebrile for 48 hours, she
New Sepsis Definition (Sepsis-3) and Community-acquired Pneumonia Mortality. A Validation and Clinical Decision-Making Study The Sepsis-3 Task Force updated the clinical criteria for sepsis, excluding the need for systemic inflammatory response syndrome (SIRS) criteria. The clinical implications of the proposed flowchart including the quick Sequential (Sepsis-related) Organ Failure Assessment (qSOFA) and SOFA scores are unknown.To perform a clinical decision-making analysis of Sepsis-3 (...) in patients with community-acquired pneumonia.This was a cohort study including adult patients with community-acquired pneumonia from two Spanish university hospitals. SIRS, qSOFA, the Confusion, Respiratory Rate and Blood Pressure (CRB) score, modified SOFA (mSOFA), the Confusion, Urea, Respiratory Rate, Blood Pressure and Age (CURB-65) score, and Pneumonia Severity Index (PSI) were calculated with data from the emergency department. We used decision-curve analysis to evaluate the clinical usefulness
Pneumonia caused by proton pump inhibitors (PPI) MED CHECK - TIP December 2017 / Vol.3 No.9 · Page 27 -The Informed Prescriber C N o 9 M ED HECK D e ce m b e r 2 0 1 7 WHO downgrades Tamiflu Suvorexant : A hypnotic causing cataplexy Insomnia, Sleep Duration, Harm of hypnotics PPI causes Pneumonia Editorial WHO downgraded oseltamivir (Tamiflu) New Products Hypnotic (sleeping pill), suvorexant (brand name Belsomra) A substance that causes narcolepsy and cataplexy Teriparatide More harm than (...) benefit: Review Insomnia, Optimal Sleep Duration and Harm of Sleeping pills Pneumonia caused by proton pump inhibitors (PPI) (1) meta-analysis (2) Critical appraisal of a study CONTENTS (December 2017, Vol. 3, No. 9 ) 28 29 34 36 40 42 Volume 3 Page 28 · MED CHECK - TIP December 2017/ Vol.3 No.9 WHO downgrades Tamiflu after reviewing evidence WHO (World Health Organization) reviews their model list of essential medicines every two years. In the revision launched in June 2017, oseltamivir (Tamiflu
Prevention of Ventilator-Associated and Early Postoperative Pneumonia Through Tapered Endotracheal Tube Cuffs: A Systematic Review and Meta-Analysis of Randomized Controlled Trials Microaspiration of subglottic secretions is considered a major pathogenic mechanism of hospital-acquired pneumonia, either early postoperative or ventilator-associated pneumonia. Tapered endotracheal tube cuffs have been proposed to provide a better seal of the extraluminal airway, thereby preventing microaspiration (...) and possibly hospital-acquired pneumonia. We performed a systematic review and meta-analysis to assess the value of endotracheal tubes with tapered cuffs in the prevention of hospital-acquired pneumonia.A systematic search of MEDLINE, EMBASE, CENTRAL/CCTR, ClinicalTrials.gov, and ICTRP was conducted up to March 2017.Eligible trials were randomized controlled clinical trials comparing the impact of tapered cuffs versus standard cuffs on hospital-acquired pneumonia.Random-effects meta-analysis calculated
The Effects of Gastrointestinal Function on the Incidence of Ventilator-associated Pneumonia in Critically Ill Patients. To investigate the effect of gastrointestinal function on the incidence of ventilator-associated pneumonia (VAP) in critically ill patients.From August 2012 to June 2016, 160 critically ill patients in the ICU (Intensive Care Unit) of our hospital were selected as the research group; patients were divided equally into an observation group and a control group, 80 patients
Bronchiolitis obliterans organising pneumonia Bronchiolitis obliterans organising pneumonia - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Bronchiolitis obliterans organising pneumonia Last reviewed: February 2019 Last updated: January 2018 Summary An inflammatory disorder involving both the peripheral bronchioles and alveoli simultaneously. It has distinctive radiographic findings, histological features (...) , and response to corticosteroids (unlike usual interstitial pneumonia). Most common type is idiopathic BOOP; other types include focal nodular, post-infection, drug-related, rheumatological, immunological, organ transplantation, radiotherapy, environmental, and miscellaneous BOOP. Accounts for 20% to 30% of all cases of chronic infiltrative lung diseases. It occurs equally among men and women, and is not related to smoking. High-resolution chest CT scan shows bilateral patchy triangular ground glass
Aspiration pneumonia Aspiration pneumonia - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Aspiration pneumonia Last reviewed: February 2019 Last updated: January 2018 Summary Diagnosis is based on clinical signs or symptoms of pneumonia in a person with a history or risk factors for aspiration. Sputum or tracheal Gram stain reveals mixed flora. Infection usually involves the dependent lung lobe. Complications (...) of disease include lung abscess and empyema. Definition Aspiration pneumonia results from inhalation of oropharyngeal contents into the lower airways that leads to lung injury and resultant bacterial infection. It commonly occurs in patients with altered mental status who have an impaired gag or swallowing reflex. The bacteriology and presentation of aspiration pneumonia have changed over the past five decades. Older studies characterised an anaerobic pleuropulmonary syndrome, with necrotising pneumonia
Pneumocystis jirovecii pneumonia Pneumocystis jirovecii pneumonia - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Pneumocystis jirovecii pneumonia Last reviewed: February 2019 Last updated: January 2018 Summary The organism was known formerly as Pneumocystis carinii . Still the most common AIDS-defining opportunistic infection. Suspicion for Pneumocystis pneumonia (PCP) is based on clinical signs or symptoms (...) of pneumonia in a person with immune suppression, especially when due to HIV infection. Diagnosis is made by detection of the organism in either induced sputum or bronchoalveolar lavage (BAL). The treatment of choice is trimethoprim/sulfamethoxazole (TMP/SMX). The incidence of PCP is declining with the use of combination antiretroviral therapy (ART) and PCP prophylaxis. Definition Pneumocystis pneumonia (PCP) is an infection of the lung caused by the fungal organism Pneumocystis jirovecii (formerly known