Medicine and Health Sciences Commons^™

Community-Acquired Pneumonia In Adults: Diagnostic Reliability Of Physical Examination Techniques And Their Teaching In Academia, Amber Tordoff, Lauren A. Williams

Physician Assistant Capstones, 2016 to 2019

Background: Chest physical examination techniques are taught in academia, but their usefulness in the evaluation and diagnosis of patients in the clinical setting is controversial. Objective: To investigate the accuracy of physical examination techniques and their reliability in diagnosing community acquired pneumonia (CAP) and suggest a modified teaching approach to be used in academia. Design: Systematic Literature Review. Methods: Database search of PubMed and Google Scholar using the search terms “prediction of pneumonia in adults” and “prediction rule for pulmonary infiltrates.” Filters were implemented to include articles that only dealt with human subjects and were full text. Articles …

Multicentre Pilot Study Evaluation Of Lung Ultrasound For The Management Of Paediatric Pneumonia In Low-Resource Settings: A Study Protocol, Jennifer L. Lenahan, Giovanni Volpicelli, Alessandro Lamorte, Fyezah Jehan, Quique Bassat, Amy Sarah Ginsburg

Department of Paediatrics and Child Health

Introduction:
Pneumonia is the leading infectious cause of death among children under 5 years of age worldwide. However, pneumonia is challenging to diagnose. Lung ultrasound (LUS) is a promising diagnostic technology. Further evidence is needed to better understand the role of LUS as a tool for the diagnosis of childhood pneumonia in low-resource settings.
Methods and analysis:
This study aims to pilot LUS in Mozambique and Pakistan and to generate evidence regarding the use of LUS as a diagnostic tool for childhood pneumonia. Children with cough <14 days with chest indrawing (n=230) and without chest indrawing (n=40) are enrolled. World Health Organization Integrated Management of Childhood Illness assessment is performed at enrolment, along with a chest radiograph and LUS examination. Respiratory and blood specimens are collected for viral and bacterial testing and biomarker assessment. Enrolled children are followed for 14 days (in person) and 30 days (phone call) post-enrolment with LUS examinations performed on Days 2, 6 and 14. Qualitative and quantitative data are also collected to assess feasibility, usability and acceptability of LUS among healthcare providers and caregivers. The primary outcome is LUS findings at enrolment with secondary outcomes including patient outcomes, repeat LUS findings, viral and bacterial test results, and patient status after 14 and 30 days of follow-up.
Ethics and dissemination:
This trial was approved by the Western Institutional Review Board as …

Retrospective Cohort Study Of The Efficacy Of Azithromycin Vs. Doxycycline As Part Of Combination Therapy In Non-Intensive Care Unit Veterans Hospitalized With Community-Acquired Pneumonia, Justin Spivey, Heather Sirek, Robert Wood, Kalpit Devani, Billy Brooks, Jonathan Moorman

Billy Brooks

The IDSA Community-Acquired Pneumonia (CAP) Guideline recommends ceftriaxone in combination with doxycycline as an alternative to combination therapy with ceftriaxone and azithromycin for non-intensive care unit (ICU) patients hospitalized with CAP. This is an attractive alternative regimen due to recent concerns of increased cardiovascular risk associated with azithromycin. The objective of this study was to compare the clinical outcomes of azithromycin and doxycycline each in combination with ceftriaxone for non-ICU Veterans hospitalized with CAP.

A Continuum Of Disease From Community-Acquired Pneumonia To Multiple Organ Dysfunction Syndrome, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Comparison Of Mortality And Therapy In Community Acquired Pneumonia, Gina Maki, Daniela Moreno, Anthony Harris, Steven Lawrence, Andrew Masica, Lois Lamerato, Marcus J. Zervos

The University of Louisville Journal of Respiratory Infections

Background: Community associated pneumonia (CAP) is one the most common causes of hospital admissions, exceeding more than one million per year in the United States, contributing to 3.4% of inpatient mortality. Our objective was to compare 30-day mortality using therapies recommended for treatment of CAP.

Methods: A multicenter retrospective analysis from four different hospitals was assessed from 2008 to 2013. The data was obtained from electronic medical records which included more than 70,000 patients. CAP patients were identified using discharge diagnostic codes during the years 2008-2013, as well as receiving therapy with ceftriaxone and azithromycin or a respiratory fluoroquinolone. Demographic …

Use Of Ultrasound For Diagnosis Of Pneumonia In Adults, A Review, Dafang Chen, Rodrigo Cavallazzi

The University of Louisville Journal of Respiratory Infections

Pneumonia is a common lung infection with significant morbidity and mortality. Currently, the diagnosis of pneumonia is made by patient history confirmed with chest radiograph or computed tomography. These modalities, however, have limitations including low accuracy, radiation exposure, and high cost. Lung ultrasound has become more prevalent in evaluating pulmonary conditions and has shown to be highly accurate in the diagnosis of pneumonia. The purpose of this review is to discuss sonographic findings associated with pneumonia, techniques used to obtain quality images, and the evidence in literature supporting the use of lung ultrasound in the diagnosis of pneumonia. Numerous studies …

Exploring The Role Of Ceftaroline In The Treatment Of Community-Acquired Pneumonia, Zachary Meyer

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of File TM Jr, Low DE, Eckburg PB, Talbot GH, Friedland HD, Lee J, Llorens L, Critchley IA, Thye DA, FOCUS 1 investigators. FOCUS 1: a randomized, double-blinded, multicentre, Phase III trial of the efficacy and safety of ceftaroline fosamil versus ceftriaxone in community-acquired pneumonia. J Antimicrob Chemother. 2011 Apr;66 Suppl 3:iii19-32. doi: 10.1093/jac/dkr096

Ticagrelor Reduces Thromboinflammatory Markers In Patients With Pneumonia, Travis R. Sexton, Guoying Zhang, Tracy E. Macaulay, Leigh Ann Callahan, Richard Charnigo, Olga A. Vsevolozhskaya, Zhenyu Li, Susan S. Smyth

Gill Heart & Vascular Institute Faculty Publications

Despite treatment advances for sepsis and pneumonia, significant improvements in outcome have not been realized. Antiplatelet therapy may improve outcome in pneumonia and sepsis. In this study, the authors show that ticagrelor reduced leukocytes with attached platelets as well as the inflammatory biomarker interleukin (IL)-6. Pneumonia patients receiving ticagrelor required less supplemental oxygen and lung function tests trended toward improvement. Disruption of the P2Y₁₂ receptor in a murine model protected against inflammatory response, lung permeability, and mortality. Results indicate a mechanistic link between platelets, leukocytes, and lung injury in settings of pneumonia and sepsis, and suggest possible therapeutic approaches …

Readmissions In Adult Patients Following Hospitalization For Influenza: A Nationwide Cohort Study, Srikanth Yandrapalli, Wilbert S. Aronow, William H. Frishman

NYMC Faculty Publications

BACKGROUND:

Influenza epidemics are a major health care concern in the US. Influenza related complications can increase in-hospital complications, and readmissions following a hospitalization for influenza. We sought to determine the 30-day readmission rate, etiologies, outcomes, and healthcare burden of 30-day readmissions in adults hospitalized for influenza.

METHODS:

The 2014 US National Readmissions Database (NRD) was retrospectively analyzed to identify patients ≥18 years of age hospitalized for influenza and discharged between January and November 2014. We used this time frame as this was the most recent data available for analysis and included patients who had 30-day follow-up. Survey design based …

Communication Between Clinicians And The Hospital-Based Microbiology Laboratory: Strategies For 2018 And Beyond, Hans H. Liu

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Exploring Health Care Seeking Knowledge, Perceptions And Practices For Childhood Diarrhea And Pneumonia And Their Context In A Rural Pakistani Community, Wafa Aftab, Leah Shipton, Fauziah Rabbani, Kashif Sangrasi, Shagufta Perveen, Aysha Zahidie, Imran Naeem, Shamim Qazi

Community Health Sciences

BACKGROUND:

Where access to facilities for childhood diarrhea and pneumonia is inadequate, community case management (CCM) is an effective way of improving access to care. In Pakistan, utilization of CCM for these diseases through the Lady Health Worker Program remains low. Challenges of access to facilities persist leading to delayed care and poor outcomes. Estimating caregiver knowledge, understanding their perceptions and practices, and recognizing how these are related to care seeking decisions about childhood diarrhea and pneumonia is crucial to bring about coherence between supply and demand-side practices.

METHODS:

Data was collected from family caregivers to explore their knowledge, perceptions …

Expert Consensus For Respiratory Physiotherapy Management Of Mechanically Ventilated Adults With Community-Acquired Pneumonia: A Delphi Study, Lisa Van Der Lee, Anne-Marie Hill, Shane Patman

Physiotherapy Papers and Journal Articles

Rationale and aims: Patients with community‐acquired pneumonia (CAP) are frequently admitted to an intensive care unit. Physiotherapy may be provided to optimize respiratory function; however, there is significant variability in clinical practice and limited research directing best practice for this cohort. This study aimed to determine expert consensus for best physiotherapy practice for invasively ventilated adults with CAP.

Method: A modified Delphi technique involved an international expert panel completing three rounds of an online questionnaire. The initial 35‐statement questionnaire, based on a systematic literature review and survey of current clinical practice, covered physiotherapy assessment and treatment of intubated patients with …

Early Recognition And Treatment Of Acquired Pneumonia, Michael Lamorgese

Walden Dissertations and Doctoral Studies

Sepsis is a life-threatening organ dysfunction disease process that costs the healthcare system millions of dollars each year. By using existing assets, the number of patients admitted to the hospital suffering from sepsis secondary to community-acquired pneumonia can be reduced. The purpose of this project was to improve and expand the scope of practice of the registered nurse working in a private medical office to initiate treatment for suspected CAP using evidence-based practice. Data from the last quarter of 2017 and the first quarter of 2018 were compared. The purpose of comparing these data sets was to examine outcomes of …

Immunohistochemical Expression Of Secretory Proteins In Pneumonic Rat Lungs, Enver Beytut

Turkish Journal of Veterinary & Animal Sciences

The present study evaluated the expression of secretory proteins involving surfactant proteins (SP-A, SP-B, proSP-C), Clara cell secretory protein (CCSP), and thyroid transcription factor-I (TTF-I), together with lambda light chain IgG (λ-IgG), proliferating cell nuclear antigen (PCNA), and lymphocytic phenotypes (T and B cells) in the pneumonic rat lungs. The most prominent gross lesion was severe pulmonary abscession. The lungs showed severe parenchymal destruction and necrosis encapsulated by fibrous tissue. Immunostaining for SPs displayed evident hyperplasia of type II pneumocytes. Immunoreaction to SP-A and SP-B occurred strongly on the luminal surface of type II cells, and to proSP-C in the …

Routine Immunizations In Chester, Vt, Wyll T. Everett

Family Medicine Clerkship Student Projects

No abstract provided.

Investigation Of Phikz Phage Therapy Against Pseudomonas Aeruginosa In Mousepneumonia Model, Kübra Can, Uğur Aksu, Osman Şadi̇ Yenen

Turkish Journal of Medical Sciences

Background/aim: The aim of this study was to investigate the effects of PhiKZ phage therapy and meropenem alone or combined treatments in a pneumonia mouse model induced by the Pseudomonas aeruginosa PAO1 strain. The cross-talk between lungs and kidneys was also determined. Materials and methods: The systemic, lung-specific, and kidney-specific inflammation levels and the bacterial load in lung tissue and biochemical parameters were investigated after PhiKZ phage therapy and meropenem alone or combined treatments in a pneumonia mouse model induced by the P. aeruginosa PAO1 strain. The cross-talk between lungs and kidneys was also determined by measuring plasma levels of …

Antibiotic Treatment Outcomes In Community-Acquired Pneumonia, Aykut Çi̇lli̇, Abdullah Sayiner, Burcu Çelenk, Ayşin Şakar Coşkun, Oğuz Kilinç, Armağan Hazar, Anil Aktaş Samur, Sezai̇ Taşbakan, Grant W. Waterer, Yavuz Havlucu, Öznur Kiliç, Fatma Tokgöz, Uğur Bi̇lge

Turkish Journal of Medical Sciences

Background/aim: The optimal empiric antibiotic regimen for patients with community-acquired pneumonia (CAP) remains unclear. This study aimed to evaluate the clinical cure rate, mortality, and length of stay among patients hospitalized with communityacquired pneumonia in nonintensive care unit (ICU) wards and treated with a ß-lactam, ß-lactam and macrolide combination, or a fluoroquinolone. Materials and methods: This prospective cohort study was performed using standardized web-based database sheets from January 2009 to September 2013 in nine tertiary care hospitals in Turkey. Results: Six hundred and twenty-one consecutive patients were enrolled. A pathogen was identified in 78 (12.6%) patients. The most frequently isolated …