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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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Polysaccharide conjugate vaccine against pneumococcal pneumonia in adults. Pneumococcal polysaccharide conjugate vaccines prevent pneumococcal disease in infants, but their efficacy against pneumococcal community-acquired pneumonia in adults 65 years of age or older is unknown.In a randomized, double-blind, placebo-controlled trial involving 84,496 adults 65 years of age or older, we evaluated the efficacy of 13-valent polysaccharide conjugate vaccine (PCV13) in preventing first episodes (...) of vaccine-type strains of pneumococcal community-acquired pneumonia, nonbacteremic and noninvasive pneumococcal community-acquired pneumonia, and invasive pneumococcal disease. Standard laboratory methods and a serotype-specific urinary antigen detection assay were used to identify community-acquired pneumonia and invasive pneumococcal disease.In the per-protocol analysis of first episodes of infections due to vaccine-type strains, community-acquired pneumonia occurred in 49 persons in the PCV13 group
Regulation of neutrophilic inflammation in lung injury induced by community-acquired pneumonia. 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.We used the most clinically advanced PAR-1 antagonist, SCH530348, and performed neutrophil depletion and chemokine neutralisation studies in two murine models. We also did translational studies to examine CXC and CC chemokine receptor expression by flow cytometry on neutrophils in blood and bronchoalveolar lavage fluid (BALF) from
Community-acquired pneumonia requiring hospitalization among U.S. children. Incidence estimates of hospitalizations for community-acquired pneumonia among children in the United States that are based on prospective data collection are limited. Updated estimates of pneumonia that has been confirmed radiographically and with the use of current laboratory diagnostic tests are needed.We conducted active population-based surveillance for community-acquired pneumonia requiring hospitalization among (...) of pneumonia. The median age of the children was 2 years (interquartile range, 1 to 6); 497 of 2358 children (21%) required intensive care, and 3 (<1%) died. Among 2222 children with radiographic evidence of pneumonia and with specimens available for bacterial and viral testing, a viral or bacterial pathogen was detected in 1802 (81%), one or more viruses in 1472 (66%), bacteria in 175 (8%), and both bacterial and viral pathogens in 155 (7%). The annual incidence of pneumonia was 15.7 cases per 10,000
Effect of corticosteroids on treatment failure among hospitalized patients with severe community-acquired pneumonia and high inflammatory response: a randomized clinical trial. In patients with severe community-acquired pneumonia, treatment failure is associated with excessive inflammatory response and worse outcomes. Corticosteroids may modulate cytokine release in these patients, but the benefit of this adjunctive therapy remains controversial.To assess the effect of corticosteroids (...) in patients with severe community-acquired pneumonia and high associated inflammatory response.Multicenter, randomized, double-blind, placebo-controlled trial conducted in 3 Spanish teaching hospitals involving patients with both severe community-acquired pneumonia and a high inflammatory response, which was defined as a level of C-reactive protein greater than 150 mg/L at admission. Patients were recruited and followed up from June 2004 through February 2012.Patients were randomized to receive either
Trajectories of risk after hospitalization for heart failure, acute myocardial infarction, or pneumonia: retrospective cohort study. To characterize the absolute risks for older patients of readmission to hospital and death in the year after hospitalization for heart failure, acute myocardial infarction, or pneumonia.Retrospective cohort study.4767 hospitals caring for Medicare fee for service beneficiaries in the United States, 2008-10.More than 3 million Medicare fee for service beneficiaries (...) in risk from maximum daily declines after discharge; and the extent to which risks are higher among patients recently discharged from hospital compared with the general elderly population.Within one year of hospital discharge, readmission to hospital and death, respectively, occurred following 67.4% and 35.8% of hospitalizations for heart failure, 49.9% and 25.1% for acute myocardial infarction, and 55.6% and 31.1% for pneumonia. Risk of first readmission had declined 50% by day 38 after
Association between hospitalization for pneumonia and subsequent risk of cardiovascular disease. The risk of cardiovascular disease (CVD) after infection is poorly understood.To determine whether hospitalization for pneumonia is associated with an increased short-term and long-term risk of CVD.We examined 2 community-based cohorts: the Cardiovascular Health Study (CHS, n = 5888; enrollment age, ≥65 years; enrollment period, 1989-1994) and the Atherosclerosis Risk in Communities study (ARIC, n (...) = 15,792; enrollment age, 45-64 years; enrollment period, 1987-1989). Participants were followed up through December 31, 2010. We matched each participant hospitalized with pneumonia to 2 controls. Pneumonia cases and controls were followed for occurrence of CVD over 10 years after matching. We estimated hazard ratios (HRs) for CVD at different time intervals, adjusting for demographics, CVD risk factors, subclinical CVD, comorbidities, and functional status.Hospitalization for pneumonia.Incident CVD
Adjunct prednisone therapy for patients with community-acquired pneumonia: a multicentre, double-blind, randomised, placebo-controlled trial. Clinical trials yielded conflicting data about the benefit of adding systemic corticosteroids for treatment of community-acquired pneumonia. We assessed whether short-term corticosteroid treatment reduces time to clinical stability in patients admitted to hospital for community-acquired pneumonia.In this double-blind, multicentre, randomised, placebo (...) -controlled trial, we recruited patients aged 18 years or older with community-acquired pneumonia from seven tertiary care hospitals in Switzerland within 24 h of presentation. Patients were randomly assigned (1:1 ratio) to receive either prednisone 50 mg daily for 7 days or placebo. The computer-generated randomisation was done with variable block sizes of four to six and stratified by study centre. The primary endpoint was time to clinical stability defined as time (days) until stable vital signs
2015LancetControlled trial quality: predicted high
The TaperGuard Evac oral tracheal tube for mechanically ventilated intensive care patients at risk of ventilator-associated pneumonia Shile Shiley Endotr y Endotracheal T acheal T ube with T ube with T aperGuard Cuff aperGuard Cuff for intensiv for intensive care patients at risk of e care patients at risk of v ventilator-associated pneumonia entilator-associated pneumonia Medtech innovation briefing Published: 2 March 2015 nice.org.uk/guidance/mib22 pathways Summary Summary The T aperGuard (...) Evac oral tracheal tube is intended for airway management in critically ill patients needing mechanical ventilation. Two randomised controlled trials comparing the use of T aperGuard Evac with conventional tubes found no statistically significant differences between the groups in the incidence of ventilator-associated pneumonia, time to onset of ventilator-associated pneumonia, or length of intensive care unit stay. Using T aperGuard Evac costs £111.07 (for a box of 10 single-use tubes), plus
Pharmacokinetic/pharmacodynamic measures for guiding antibiotic treatment for hospital acquired pneumonia Pharmacokinetic/pharmacodynamic measures for guiding antibiotic treatment for hospital acquired pneumonia Pharmacokinetic/pharmacodynamic measures for guiding antibiotic treatment for hospital acquired pneumonia Lux LJ, Posey RE, Daniels LS, Henke DC, Durham C, Jonas DE, Lohr KN Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA (...) . No evaluation of the quality of this assessment has been made for the HTA database. Citation Lux LJ, Posey RE, Daniels LS, Henke DC, Durham C, Jonas DE, Lohr KN. Pharmacokinetic/pharmacodynamic measures for guiding antibiotic treatment for hospital acquired pneumonia. Rockville: Agency for Healthcare Research and Quality (AHRQ). Comparative Effectiveness Review No. 136. 2014 Authors' objectives To conduct a systematic review of the use of pharmacokinetic/pharmacodynamic (PK/PD) measures or strategies
Approach to the Hospitalized Patient with Community-Acquired Pneumonia: Should Procalcitonin Be Part of the Initial Evaluation? Approach to the Hospitalized Patient with Community-Acquired Pneumonia: Should Procalcitonin Be Part of the Initial Evaluation? – Clinical Correlations Search Approach to the Hospitalized Patient with Community-Acquired Pneumonia: Should Procalcitonin Be Part of the Initial Evaluation? November 21, 2014 7 min read By Matthew Light, MD Peer Reviewed A 79 year-old female (...) chest x-ray shows a lingular consolidation with air bronchograms. The Pneumonia Severity Index . The patient is given ceftriaxone and azithromycin and admitted to the medicine service. The question arises, is there a role for checking a procalcitonin (PCT) level in this patient as part of the initial work-up or tracking PCT levels during hospitalization? Rates of hospitalization for pneumonia (PNA) in the United States, though trending down, . In addition . With such substantial morbidity
Antibiotics for community-acquired pneumonia in adult outpatients. Lower respiratory tract infection (LRTI) is the third leading cause of death worldwide and the first leading cause of death in low-income countries. Community-acquired pneumonia (CAP) is a common condition that causes a significant disease burden for the community, particularly in children younger than five years, the elderly and immunocompromised people. Antibiotics are the standard treatment for CAP. However, increasing
The Use of Endotracheal Tubes with Subglottic Secretion Drainage to Prevent Ventilator-Associated Pneumonia TITLE: The Use of Endotracheal Tubes with Subglottic Secretion Drainage to Prevent Ventilator-Associated Pneumonia: Clinical Effectiveness and Safety DATE: 15 July 2014 RESEARCH QUESTIONS 1. What is the clinical effectiveness of endotracheal tubes with subglottic secretion drainage for the prevention of ventilator-associated pneumonia? 2. What is the clinical evidence on the safety (...) and harms of endotracheal tubes with subglottic secretion drainage for the prevention of ventilator-associated pneumonia? KEY FINDINGS One health technology assessment, three systematic reviews, one randomized controlled trial, and three non-randomized studies were identified regarding endotracheal tubes with subglottic secretion drainage for the prevention of ventilator-associated pneumonia. METHODS A limited literature search was conducted on key resources including PubMed, The Cochrane Library (2014
Azithromycin (Zedbac) - for the treatment of community-acquired pneumonia (CAP) Final Appraisal Recommendation Advice No: 1914 – July 2014 Azithromycin (Zedbac ® ) 500 mg powder for solution for infusion Limited submission by Aspire Pharma Ltd Additional notes: ? The company submission included evidence for azithromycin (Zedbac ® ) in the treatment of CAP due to susceptible microorganisms, in adult patients where initial intravenous therapy is required. No evidence was provided for azithromycin (...) /patient carers (where available) and the lay member perspective. This recommendation has been ratified by Welsh Government and will be considered for review every three years. Recommendation of AWMSG Azithromycin (Zedbac ® ) 500 mg powder for solution for infusion is recommended as an option for restricted use within NHS Wales. Azithromycin (Zedbac ® ) 500 mg powder for solution for infusion should be restricted for use within NHS Wales for the treatment of community- acquired pneumonia (CAP) due
Randomised controlled trial and health economic evaluation of the impact of diagnostic testing for influenza, respiratory syncytial virus and Streptococcus pneumoniae infection on the management of acute admissions in the elderly and high-risk 18- to 64-y Randomised controlled trial and health economic evaluation of the impact of diagnostic testing for influenza, respiratory syncytial virus and Streptococcus pneumoniae infection on the management of acute admissions in the elderly and high-risk (...) 18- to 64-year-olds Randomised controlled trial and health economic evaluation of the impact of diagnostic testing for influenza, respiratory syncytial virus and Streptococcus pneumoniae infection on the management of acute admissions in the elderly and high-risk 18- to 64-year-olds Nicholson KG, Abrams KR, Batham S, Medina MJ, Warren FC, Barer M, Bermingham A, Clark TW, Latimer N, Fraser M, Perera N, Rajakumar K, Zambon M Record Status This is a bibliographic record of a published health
Risk of Pneumonia in Adults With Closed Versus Unclosed Atrial Septal Defect (from a Nationwide Cohort Study) Atrial septal defect (ASD) is associated with pulmonary hyperperfusion and inflammation and has been linked with increased risk of pneumonia. We investigated the risk of pneumonia in patients with ASD and the impact of ASD closure in a nationwide cohort study. All adults in Denmark (n = 1,168) diagnosed with ASD from 1977 to 2009 were identified through Danish public registries. We (...) compared the risk of hospitalization for pneumonia, use of antibiotics, and mortality with age- and gender-matched general population controls. The median follow-up from time of diagnosis was 9.6 years (range 1 to 33). Cox regression analysis showed that both patients with closed (n = 863) and unclosed (n = 305) ASD had a higher risk of hospitalization for pneumonia (adjusted hazard ratios [HRs] 2.8, 95% confidence interval [CI] 2.3 to 3.5 and 3.1, 95% CI 2.4 to 4.0, respectively) than controls
Antibiotic therapy versus no antibiotic therapy for children aged two to 59 months with WHO-defined non-severe pneumonia and wheeze. Worldwide, pneumonia is the leading cause of death among children under five years of age and accounts for approximately two million deaths annually. The World Health Organization (WHO) has developed case management guidelines based on simple clinical signs to help clinicians decide on the appropriate pneumonia treatment. Children and infants who exhibit fast (...) breathing (50 breaths per minute or more in infants two months to 12 months of age and 40 or more in children 12 months to five years of age) and cough are presumed to have non-severe pneumonia and the WHO recommends antibiotics. Implementation of these guidelines to identify and manage pneumonia at the community level has been shown to reduce acute respiratory infection (ARI)-related mortality by 36%, although apprehension exists regarding these results due to the questionable quality of evidence
Sleep apnea and risk of pneumonia: a nationwide population-based study Evidence evaluating the risk of pneumonia in patients with obstructive sleep apnea is limited and mostly focuses on patients who receive continuous positive airway pressure (CPAP) therapy or on pediatric patients. We aimed to explore the risk of incident pneumonia among adults with sleep apnea, either with or without the need of CPAP therapy.From Jan. 1, 2000, we identified adult patients with sleep apnea from the Taiwan (...) National Health Insurance Research Database. A control cohort without sleep apnea, matched for age, sex and comorbidities, was selected for comparison. The 2 cohorts were followed until Dec. 31, 2010, and observed for occurrence of pneumonia.Of the 34,100 patients (6816 study patients and 27,284 matched controls), 2757 (8.09%) had pneumonia during a mean follow-up period of 4.50 years, including 638 (9.36%) study patients and 2119 (7.77%) controls. Kaplan-Meier analysis showed a higher incidence
In Patients with Feeding Tubes, Dentists Should Consider Pre-Medicating to Reduce the Chances of Aspiration Pneumonia During Invasive Dental Treatment UTCAT2632, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title In Patients with Feeding Tubes, Dentists Should Consider Pre-Medicating to Reduce the Chances of Aspiration Pneumonia During Invasive Dental Treatment Clinical Question In an adult patient with feeding tubes (...) Group Study type (level of evidence) #1) Dyment/1999 Children with feeding tubes Narrative Review Key results Patients with feeding tubes often present with large amounts of calculus, decreased caries activity, oral hypersensitivity, and dental erosion caused by gastro-esophageal reflex. These oral manifestations will affect the patient’s general health. Recurrent pneumonia is a concern for tube-fed patients where complications arise from impaired protective airway reflexes. Frequent, professional