Presentation
RESULTS: Individuals with periodontitis were three times as likely to present with NP (unadjusted odds ratio [OR unadjusted] 3.06, 95% confidence interval [95% CI]: 1.82 to 5.15) as those without periodontal disease. [ncbi.nlm.nih.gov]
In this new work, leading international authorities present anupdate on current best practice for the diagnosis, treatment, andprevention of nosocomial pneumonia. [amazon.com]
Entire Body System
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Multiple Organ Dysfunction Syndrome
organ dysfunction syndrome, defined as three or more organ system failures (28) not present on Day 1. [atsjournals.org]
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Acutely Ill Patient
At the time of randomization to treatment, the two groups were similar in age, underlying diseases, and severity of acute illness. [nejm.org]
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Recurrent Respiratory Infections
In exceptional cases, antibiotic treatment may be considered in patients at risk and/or those with MDRO colonization with increasing purulent airway secretions or recurrent respiratory infections (weak recommendation, evidence level C). [aerzteblatt.de]
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Vietnamese
Loan et al. conducted a RCT including 229 adults and children with tetanus admitted to a Vietnamese hospital [42]. The intervention group was assigned to a semi-recumbent position of 30 . [aricjournal.biomedcentral.com]
Jaw & Teeth
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Dysgeusia
The most common adverse reactions (occurring in more than 1% of patients) reported in the summary of product characteristics are fungal infection, insomnia, dysgeusia, headache, dizziness, nausea, constipation, diarrhoea, vomiting, increased alanine aminotransferase [nice.org.uk]
Neurologic
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Headache
The most common adverse reactions (occurring in more than 1% of patients) reported in the summary of product characteristics are fungal infection, insomnia, dysgeusia, headache, dizziness, nausea, constipation, diarrhoea, vomiting, increased alanine aminotransferase [nice.org.uk]
Patients with HAP are likely to have a poor appetite, diaphoresis, and headache. Expect a high temperature, usually greater than 100[degrees] F (37.8[degrees] C), and a heart rate of more than 100 beats/minute. [nursingcenter.com]
They may consist of headache, malaise, diarrhea, confusion, falling, and decreased appetite. Diagnosis is confirmed by chest x-ray. [academickids.com]
Other less common features are headache, nausea, vomiting, diarrhea and myalgias. For CAP, 80% of patients have fevers and 45-70% of patients have tachypnea. [pulmonologyadvisor.com]
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Cognitive Impairment
If patients had a cognitive impairment (e.g., because of dementia), their contact person was asked to provide the consent. [frontiersin.org]
Workup
Laboratory Evaluation Lab studies are useful, and workup includes: 1. CBC and differential. 2. Liver function tests. 3. Sputum Gram’s stain and culture. 4. Blood cultures. 5. [intjinfection.com]
The diagnostic workup may offer additional data that should be interpreted in the context of the patient's condition. 5. [frca.co.uk]
If the patient receives appropriate antimicrobial therapy for 2 weeks and does not respond (ie, improved infiltrates findings on chest radiograph), initiate a diagnostic workup to detect nonbacterial infections (eg, herpesvirus type 1 [HSV-1] pneumonitis [emedicine.medscape.com]
Diagnostic Tests in the Workup of Pulmonary Infiltrates in the ICU 1. Respiratory Cultures Sputum Endotracheal or Tracheobronchial aspirate** [Toni: should this be transbronchial?] [antimicrobe.org]
X-Ray
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Esophageal Motility Disorder
Aspiration is one of the pathologic mechanisms involved in HAP and is associated with supine position, dysphagia, altered mental status, esophageal motility disorders, vomiting, gastroesophageal reflux, tracheal intubation, enteral nutrition, nasogastric [aricjournal.biomedcentral.com]
Treatment
PURPOSE: Results from studies comparing health care resource use (HCRU), costs of treatment, and cost-effectiveness of linezolid compared with vancomycin therapy in the treatment of hospitalized patients with methicillin-resistant Staphylococcus aureus [ncbi.nlm.nih.gov]
Prognosis
Cheng (Shanghai, China) Annual Congress 2012 - Respiratory infections: prognosis and outcome [ ] Health care associated pneumonia versus community acquired pneumonia: Comparison of etiology, treatment and prognosis C. Araujo, N. Andre, P. [ers-education.org]
Early and precise identification of this pathogen can lead to better prognosis of the associated infections and an improved approach to controlling the spread of carbapenemase-resistant gram-negative bacteria. [ncbi.nlm.nih.gov]
Treatment and prognosis The early onset type has a better prognosis. High morbidity and mortality are seen patients with Hospital acquired pneumonia as they are already hospitalised for another condition. Promoted articles (advertising) [radiopaedia.org]
Etiology
The etiology of 50% of the nosocomial infection cases was polymicrobial. [ncbi.nlm.nih.gov]
ETIOLOGIC DIAGNOSIS OF PNEUMONIA All Patients Patients with Etiologic Diagnosis Only VAP (n 164) NV-ICUAP (n 151) P Value VAP (n 117) NV-ICUAP (n 64) P Value Etiologic diagnosis, n (%) 117 (71) 64 (42) 0.001 — — — Polymicrobial pneumonia, n (%) 27 (17 [atsjournals.org]
Keywords: hospital-acquired pneumonia, ventilator-associated pneumonia, epidemiology, microbial etiology This work is published and licensed by Dove Medical Press Limited. [dovepress.com]
Two hundred seventy-five consecutive patients treated with bone marrow transplantation (BMT) during a 9-year interval were analyzed for the incidence and etiology of nosocomial pneumonia. [jco.ascopubs.org]
[ ] Risk factors, etiology and prognosis of adult patients with hospital -acquired pneumonia in Shanghai N. Li, Q. [ers-education.org]
Epidemiology
The incidence and microbiologic epidemiology of NIP and VAP were studied. RESULTS: There were 873 patients enrolled. [ncbi.nlm.nih.gov]
Keywords: hospital-acquired pneumonia, ventilator-associated pneumonia, epidemiology, microbial etiology This work is published and licensed by Dove Medical Press Limited. [dovepress.com]
Pathophysiology
In critically ill patients, pathophysiological changes alter the pharmacokinetics of antibiotics. Imipenem exhibits primarily time-dependent killing. [ncbi.nlm.nih.gov]
Reviews " Nosocomial Pneumonia achieves its stated goal of seeking to present current knowledge on the pathophysiology, clinical presentation, diagnosis, and treatment of nosocomial pneumonia. [wiley.com]
Pathophysiology Extrinsic factors Exposure to causative agent Exposure to pulomary irritant Intrinsic factors (host related) Pulmonary injury – COPD, bronchiectasis, CF, Ca Loss of protective airway reflexes – CVA, intoxication, altered mental [slideshare.net]
Because aerobic gram-negative bacilli (eg, Pseudomonas aeruginosa) are the major pathogens associated with HAP, the pathophysiology of nosocomial pneumonia relates to the destructive effect on lung tissue. [emedicine.medscape.com]
Prevention
Various preventive strategies have been increasingly used to prevent the development of pneumonia. [ncbi.nlm.nih.gov]
Other preventive interventions Besides the above mentioned interventions, other preventive measures have been considered for the prevention of HAP. [aricjournal.biomedcentral.com]
The preventive strategies are highlighted in Table IV (page 18). [the-hospitalist.org]