Latest & greatest articles for pneumonia

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Top results for pneumonia

1. Should HIV-uninfected patients with Pneumocystis pneumonia be treated with corticosteroids?

Should HIV-uninfected patients with Pneumocystis pneumonia be treated with corticosteroids? Chiefs’ Inquiry Corner – March 17th, 2019 – Clinical Correlations Search Chiefs’ Inquiry Corner – March 17th, 2019 March 18, 2019 3 min read Propofol is a short-acting, intravenous sedative-hypnotic that is metabolized by the liver and excreted in the urine as conjugates of 2,6-diisopropyl-1,4 quinol. The pharmacokinetics of propofol favor its use for the induction/maintenance of anesthesia (...) with other causes of immunocompromise, especially in those with solid organ or liquid transplants, chronic steroid use, chemotherapeutics, and other immunosuppressive medications. As the use of immunosuppressive agents has increased in recent years, so has the rate of non-HIV associated Pneumocystis pneumonia (PCP). The use of steroids in HIV-infected patients with PCP has been well established, but the role of steroids in HIV-uninfected patients is much less clear. Patients with PCP who are not infected

2019 Clinical Correlations

2. Community-acquired pneumonia

Community-acquired pneumonia Community-acquired pneumonia - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Community-acquired pneumonia Last reviewed: February 2019 Last updated: February 2019 Summary Risk factors relate to environment, lifestyle factors, patient status, and comorbidities. Typically characterised by a new lung infiltrate on chest x-ray, together with one or more of the following: fever, chills, cough (...) , sputum production, dyspnoea, myalgia, arthralgia, pleuritic pain. Diagnosis should include a chest x-ray, although this has been challenged by studies using CT scanning. Initial treatment is empirical with antibiotics, following international guidelines and local epidemiology. Definition Community-acquired pneumonia (CAP) is defined as pneumonia acquired outside hospital or healthcare facilities. Clinical diagnosis is based on a group of signs and symptoms related to lower respiratory tract infection

2019 BMJ Best Practice

3. Omadacycline for Community-Acquired Bacterial Pneumonia. (PubMed)

Omadacycline for Community-Acquired Bacterial Pneumonia. Omadacycline, a new once-daily aminomethylcycline antibiotic agent that can be administered intravenously or orally, reaches high concentrations in pulmonary tissues and is active against common pathogens that cause community-acquired bacterial pneumonia.In a double-blind trial, we randomly assigned (in a 1:1 ratio) adults with community-acquired bacterial pneumonia (Pneumonia Severity Index risk class II, III, or IV) to receive (...) reported in 41.1% of the patients in the omadacycline group and 48.5% of the patients in the moxifloxacin group; the most frequent events were gastrointestinal (10.2% and 18.0%, respectively), and the largest difference was for diarrhea (1.0% and 8.0%). Twelve deaths (8 in the omadacycline group and 4 in the moxifloxacin group) occurred during the trial.Omadacycline was noninferior to moxifloxacin for the treatment of community-acquired bacterial pneumonia in adults. (Funded by Paratek Pharmaceuticals

2019 NEJM

4. Adult Outpatients With Acute Cough Due to Suspected Pneumonia or Influenza: CHEST Guideline and Expert Panel Report

Adult Outpatients With Acute Cough Due to Suspected Pneumonia or Influenza: CHEST Guideline and Expert Panel Report Patients commonly present to primary care services with upper and lower respiratory tract infections, and guidelines to help physicians investigate and treat acute cough due to suspected pneumonia and influenza are needed.A systematic search was carried out with eight patient, intervention, comparison, outcome questions related to acute cough due to suspected pneumonia (...) or influenza.There was a lack of randomized controlled trials in the setting of outpatients presenting with acute cough due to suspected pneumonia or influenza who were not hospitalized. Both clinical suggestions and research recommendations were made on the evidence available and CHEST Expert Cough Panel advice.For outpatient adults with acute cough due to suspected pneumonia, we suggest the following clinical symptoms and signs are suggestive of pneumonia: cough; dyspnea; pleural pain; sweating, fevers

2019 EvidenceUpdates

5. Association of Prescribed Opioids With Increased Risk of Community-Acquired Pneumonia Among Patients With and Without HIV

Association of Prescribed Opioids With Increased Risk of Community-Acquired Pneumonia Among Patients With and Without HIV Some opioids are known immunosuppressants; however, the association of prescribed opioids with clinically relevant immune-related outcomes is understudied, especially among people living with HIV.To assess the association of prescribed opioids with community-acquired pneumonia (CAP) by opioid properties and HIV status.This nested case-control study used data from patients

2019 EvidenceUpdates

6. Pneumococcal vaccines for people with COPD reduce their chance of catching pneumonia

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

2019 NIHR Dissemination Centre

7. Ultrasound shows potential for confirming the diagnosis of pneumonia in children

Ultrasound shows potential for confirming the diagnosis of pneumonia in children Diagnosis of pneumonia in children may be confirmed by ultrasound Discover Portal Discover Portal Ultrasound shows potential for confirming the diagnosis of pneumonia in children Published on 24 July 2018 doi: Ultrasound scans of the lungs can be more accurate than chest X-rays for diagnosing pneumonia in children in some circumstances. A review of the published evidence found that lung ultrasound was more (...) sensitive (missed fewer cases) and about as specific (gave about the same number of false alarms) as chest X-ray, when used to confirm suspected community-acquired pneumonia in children. While pneumonia is a clinical diagnosis, X-ray is often used for confirmation. Ultrasound also spares the child from the radiation associated with X-ray imaging. Many emergency departments already use ultrasound, so it might be practical to train paediatric staff to use it as a first-line test. However, the study found

2019 NIHR Dissemination Centre

8. Chest physiotherapy for pneumonia in children. (PubMed)

Chest physiotherapy for pneumonia in children. Pneumonia is a lung infection that causes more deaths in children aged under five years than any other single cause. Chest physiotherapy is widely used as adjuvant treatment for pneumonia. Physiotherapy is thought to help remove inflammatory exudates, tracheobronchial secretions, and airway obstructions, and reduce airway resistance to improve breathing and enhance gas exchange. This is an update of a review published in 2013.To assess (...) and GRADE to assess the quality of the evidence for each outcome.We included three new RCTs for this update, for a total of six included RCTs involving 559 children aged from 29 days to 12 years with pneumonia who were treated as inpatients. Pneumonia severity was described as moderate in one trial, severe in two trials, and was not stated in three trials. The studies assessed five different interventions: effects of conventional chest physiotherapy (3 studies, 211 children), positive expiratory

2019 Cochrane

9. A Multivariable Prediction Model for Pneumocystis jirovecii Pneumonia in Hematology Patients with Acute Respiratory Failure

A Multivariable Prediction Model for Pneumocystis jirovecii Pneumonia in Hematology Patients with Acute Respiratory Failure The incidence of Pneumocystis jirovecii pneumonia (PjP) is rising. Longer time to treatment is associated with higher mortality.To develop a multivariable risk prediction model for PjP diagnosis.In a prospective multicenter cohort of ICU patients with hematological malignancies and acute respiratory failure, factors associated with documented PjP were identified. The risk

2019 EvidenceUpdates

10. Placebo vs Amoxicillin for Nonsevere Fast-Breathing Pneumonia in Malawian Children Aged 2 to 59 Months: A Double-blind, Randomized Clinical Noninferiority Trial

Placebo vs Amoxicillin for Nonsevere Fast-Breathing Pneumonia in Malawian Children Aged 2 to 59 Months: A Double-blind, Randomized Clinical Noninferiority Trial Pneumonia is the leading infectious killer of children. Rigorous evidence supporting antibiotic treatment of children with nonsevere fast-breathing pneumonia in low-resource African settings is lacking.To assess whether treatment with placebo for nonsevere fast-breathing pneumonia is substantively less effective than 3 days of treatment (...) with amoxicillin.This double-blind, 2-arm, randomized clinical noninferiority trial with follow-up of 14 days screened 1343 HIV-uninfected children aged 2 to 59 months with nonsevere fast-breathing pneumonia at outpatient departments of hospitals in Lilongwe, Malawi, Africa, between June 2016 and June 2017.Placebo or amoxicillin dispersible tablets administered twice daily for 3 days.The primary end point was the proportion of children failing treatment by day 4 with a relative noninferiority margin of 1.5 times

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2019 EvidenceUpdates

11. Systematic review of studies investigating ventilator associated pneumonia (VAP) diagnostic procedures in secondary care

Systematic review of studies investigating ventilator associated pneumonia (VAP) diagnostic procedures in secondary care Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any

2019 PROSPERO

12. Systematic literature review on the efficacy and effectiveness of pneumococcal conjugate vaccines in high risk medical groups for preventing community acquired pneumonia and invasive pneumococcal disease

Systematic literature review on the efficacy and effectiveness of pneumococcal conjugate vaccines in high risk medical groups for preventing community acquired pneumonia and invasive pneumococcal disease Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears

2019 PROSPERO

13. Subglottic secretion drainage for preventing ventilator-associated pneumonia: an overview of reviews

Subglottic secretion drainage for preventing ventilator-associated pneumonia: an overview of reviews Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any associated files

2019 PROSPERO

14. Efficacy and safety of moxifloxacin and levofloxacin in the treatment of community-acquired pneumonia: a meta-analysis

Efficacy and safety of moxifloxacin and levofloxacin in the treatment of community-acquired pneumonia: a meta-analysis Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any

2019 PROSPERO

15. Diagnosis of ventilator associated pneumonia in mechanically ventilated patients: a systematic review and meta-analysis

Diagnosis of ventilator associated pneumonia in mechanically ventilated patients: a systematic review and meta-analysis Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any

2019 PROSPERO

16. Association between inflammation factors (IF) and mycoplasma pneumonia (MP) in children: protocol for a systematic review

Association between inflammation factors (IF) and mycoplasma pneumonia (MP) in children: protocol for a systematic review Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any

2019 PROSPERO

17. Biomarkers of severity in pediatric community-acquired pneumonia: a systematic review and meta-analysis

Biomarkers of severity in pediatric community-acquired pneumonia: a systematic review and meta-analysis Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any associated files

2019 PROSPERO

18. Association of the Hospital Readmissions Reduction Program With Mortality Among Medicare Beneficiaries Hospitalized for Heart Failure, Acute Myocardial Infarction, and Pneumonia. (PubMed)

Association of the Hospital Readmissions Reduction Program With Mortality Among Medicare Beneficiaries Hospitalized for Heart Failure, Acute Myocardial Infarction, and Pneumonia. The Hospital Readmissions Reduction Program (HRRP) has been associated with a reduction in readmission rates for heart failure (HF), acute myocardial infarction (AMI), and pneumonia. It is unclear whether the HRRP has been associated with change in patient mortality.To determine whether the HRRP was associated (...) with a change in patient mortality.Retrospective cohort study of hospitalizations for HF, AMI, and pneumonia among Medicare fee-for-service beneficiaries aged at least 65 years across 4 periods from April 1, 2005, to March 31, 2015. Period 1 and period 2 occurred before the HRRP to establish baseline trends (April 2005-September 2007 and October 2007-March 2010). Period 3 and period 4 were after HRRP announcement (April 2010 to September 2012) and HRRP implementation (October 2012 to March 2015

2018 JAMA

19. Pneumonia Vaccine for Adults: Is the efficacy as effective as the effort?

Pneumonia Vaccine for Adults: Is the efficacy as effective as the effort? Tools for Practice is proudly sponsored by the Alberta College of Family Physicians (ACFP). ACFP is a provincial, professional voluntary organization, representing more than 4,800 family physicians, family medicine residents, and medical students in Alberta. Established over sixty years ago, the ACFP strives for excellence in family practice through advocacy, continuing medical education and primary care research (...) . www.acfp.ca Reviewed: August 27, 2018 Evidence Updated: Slight change to first systematic review ’s population and vaccine subtypes Bottom Line: No Change First Published: July 30, 2018 Pneumonia Vaccine for Adults: Is the efficacy as effective as the effort? Clinical Question: How effective is the pneumococcal vaccine in preventing pneumonia or other clinically important outcomes in adults? Bottom Line: At best, pneumococcal vaccines may prevent pneumonia for an additional 1 in 55 adults and 1 in 20 COPD

2018 Tools for Practice

20. Are Corticosteroids Beneficial in the Treatment of Community-Acquired Pneumonia? (SRS Therapy)

Are Corticosteroids Beneficial in the Treatment of Community-Acquired Pneumonia? (SRS Therapy) TAKE-HOME MESSAGE For adult patients with severe community-acquired pneumonia, corticosteroids reduce morbidity and mortality. For pediatric patients and adults with nonsevere community-acquired pneumonia, corticosteroids appear to reduce morbidity, but not mortality. Are Corticosteroids Bene?cial in the Treatment of Community-Acquired Pneumonia? EBEM Commentators Thomas Seagraves, MD Michael Gottlieb (...) , MD Department of Emergency Medicine Rush University Medical Center Chicago, IL Results Comparison of corticosteroids with control for community-acquired pneumonia. Outcome No. of Studies (No. of Participants) Relative Risk (95% CI) I 2 ,% Mortality (adults with severe CAP) 9 (995) 0.58 (0.40–0.84) 12 Mortality (adults with nonsevere CAP) 4 (868) 0.95 (0.45–2.00) 0 Early clinical failure (adults with severe CAP) 5 (419) 0.32 (0.15–0.70) 74 Early clinical failure (adults with nonsevere CAP) 2 (905

2018 Annals of Emergency Medicine Systematic Review Snapshots