Community acquired pneumonia (CAP) is caused by pathogens acquired outside of a hospital setting. It is classified based on location and timing of acquisition. Empirical antibiotic treatment is recommended and should not be delayed. Severity is assessed using scoring systems like PORT and CURB-65 to determine treatment setting. Common pathogens include Streptococcus pneumoniae and atypical bacteria. Radiography can help establish diagnosis and prognosis. Outpatient treatment involves oral antibiotics while inpatient may require IV antibiotics. Duration of treatment and prevention strategies like vaccination are also discussed.
Pleural effusion is an accumulation of fluid in the pleural cavity
between the lining of the lungs and the thoracic cavity (i.e., the visceral
and parietal pleurae
).
Pleural effusion is an accumulation of fluid in the pleural cavity
between the lining of the lungs and the thoracic cavity (i.e., the visceral
and parietal pleurae
).
Bronchitis is an acute inflammation of the air passages within the lungs. It occurs when the trachea (windpipe) and the large and small bronchi (airways) within the lungs become inflamed because of infection or irritation from certain causes. Homeopathy is the best treatment with no side effects. For further information contact Ph. : +91-265-2250212,
(M) +91 97236 69210
Skype Id : cosmic1021
Email:
drmahavrat@homeopathyhealing.net
Lecture slides about bronchiectasis with contents including definition, causes, pathogenesis and pathology, and how to make diagnosis. Treatment for bronchiectasis is presented separately.
Pneumonia is an inflammatory condition of the lung affecting primarily the small air sacs known as alveoli. Typically symptoms include some combination of productive or dry cough, chest pain, fever, and trouble breathing. Severity is variable.
Pneumonia is usually caused by infection with viruses or bacteria and less commonly by other microorganisms, certain medications and conditions such as autoimmune diseases. Risk factors include cystic fibrosis, chronic obstructive pulmonary disease (COPD), asthma, diabetes, heart failure, a history of smoking, a poor ability to cough such as following a stroke, and a weak immune system. Diagnosis is often based on the symptoms and physical examination. Chest X-ray, blood tests, and culture of the sputum may help confirm the diagnosis. The disease may be classified by where it was acquired with community, hospital, or health care associated pneumonia.
Vaccines to prevent certain types of pneumonia are available. Other methods of prevention include handwashing and not smoking. Treatment depends on the underlying cause. Pneumonia believed to be due to bacteria is treated with antibiotics. If the pneumonia is severe, the affected person is generally hospitalized. Oxygen therapy may be used if oxygen levels are low.
Pneumonia affects approximately 450 million people globally (7% of the population) and results in about four million deaths per year. Pneumonia was regarded by William Osler in the 19th century as "the captain of the men of death". With the introduction of antibiotics and vaccines in the 20th century, survival improved. Nevertheless, in developing countries, and among the very old, the very young, and the chronically ill, pneumonia remains a leading cause of death. Pneumonia often shortens suffering among those already close to death and has thus been called "the old man's friend"
Apparently a lengthy presentation actually very good for junior physicians as it covers all aspects of assessment, diagnosis and treatment of pleural effusion
Bronchitis is an acute inflammation of the air passages within the lungs. It occurs when the trachea (windpipe) and the large and small bronchi (airways) within the lungs become inflamed because of infection or irritation from certain causes. Homeopathy is the best treatment with no side effects. For further information contact Ph. : +91-265-2250212,
(M) +91 97236 69210
Skype Id : cosmic1021
Email:
drmahavrat@homeopathyhealing.net
Lecture slides about bronchiectasis with contents including definition, causes, pathogenesis and pathology, and how to make diagnosis. Treatment for bronchiectasis is presented separately.
Pneumonia is an inflammatory condition of the lung affecting primarily the small air sacs known as alveoli. Typically symptoms include some combination of productive or dry cough, chest pain, fever, and trouble breathing. Severity is variable.
Pneumonia is usually caused by infection with viruses or bacteria and less commonly by other microorganisms, certain medications and conditions such as autoimmune diseases. Risk factors include cystic fibrosis, chronic obstructive pulmonary disease (COPD), asthma, diabetes, heart failure, a history of smoking, a poor ability to cough such as following a stroke, and a weak immune system. Diagnosis is often based on the symptoms and physical examination. Chest X-ray, blood tests, and culture of the sputum may help confirm the diagnosis. The disease may be classified by where it was acquired with community, hospital, or health care associated pneumonia.
Vaccines to prevent certain types of pneumonia are available. Other methods of prevention include handwashing and not smoking. Treatment depends on the underlying cause. Pneumonia believed to be due to bacteria is treated with antibiotics. If the pneumonia is severe, the affected person is generally hospitalized. Oxygen therapy may be used if oxygen levels are low.
Pneumonia affects approximately 450 million people globally (7% of the population) and results in about four million deaths per year. Pneumonia was regarded by William Osler in the 19th century as "the captain of the men of death". With the introduction of antibiotics and vaccines in the 20th century, survival improved. Nevertheless, in developing countries, and among the very old, the very young, and the chronically ill, pneumonia remains a leading cause of death. Pneumonia often shortens suffering among those already close to death and has thus been called "the old man's friend"
Apparently a lengthy presentation actually very good for junior physicians as it covers all aspects of assessment, diagnosis and treatment of pleural effusion
Pneumonia lecture,Describe the common pathogenesis and pathogens of pneumonia
Discuss diagnosis and initial management of community acquired pneumonia (CAP)
Understand features of the Pneumonia PORT Severity Index
Discuss the IDSA/ATS guidelines and recommendations for final antibiotic choice
Understand issues in basic management for pneumonia in children, nursing home patients, and immunocompromised patients.
Oxygen Therapy is not Beneficial in COPD Patients with Moderate HypoxaemiaGamal Agmy
A Randomized Trial of Long-Term Oxygen for COPD with Moderate Desaturation
The Long-Term Oxygen Treatment Trial Research Group*
N Engl J Med. 2016 October 27; 375(17): 1617–1627
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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4. *HCAP: diagnosis made < 48h after hospitalization with any of the following risk factors:
(1)hospitalized in an acute care hospital for > 48h within 90d of the diagnosis; (2) resided in a nursing home or long-term care facility; (3) received recent IV antibiotic therapy, chemotherapy, or wound care within the 30d preceding the current diagnosis; and (4) attended a hospital or hemodialysis clinic
HCAP
5. Infection of the lung parenchyma in a person who is not hospitalized or living in a long-term care facility for ≥ 2 weeks. This pneumonia develops in the outpatient setting or within 48 hours of admission to a hospital.
Definition of CAP
6. Symptoms:
• Respiratory: Cough dry or productive, mucopurulent sputum , sometimes rusty, dyspnea, sometimes pleuritic chest pain
• Non-respiratory: Fever, body aches, altered mental state, vomiting or diarrhea.
The clinical diagnosis of CAP
7. Signs:
Generally: Fever, sometimes hypothermia, tachycardia, tachypnea.
Local: signs of consolidation
The clinical diagnosis of CAP
8. 8 CAP – The Two Types of Presentations Classical
•Sudden onset of CAP
•High fever, shaking chills
•Pleuritic chest pain, SOB
•Productive cough
•Rusty sputum, blood tinge
•Poor general condition
•High mortality up to 20% in patients with bacteremia
•S.pneumoniae causative
•Gradual & insidious onset
•Low grade fever
•Dry cough, No blood tinge
•Good GC – Walking CAP
•Low mortality 1-2%; except in cases of Legionellosis
•Mycoplasma, Chlamydiae, Legionella, Ricketessiae, Viruses are causative Atypical
9. Sputum Gram stain:
is a rapid and inexpensive test that can help a lot:
• Differentiate Gm –ve from Gm +ve bacteria.
• Excess pus cells without organism suspect atypical infection.
The Bacteriological Diagnosis of CAP
10. Cultures to identify the causative organism:
Sputum cultures are not recommended in cases of CAP except in certain occasions:
• Patients admitted in hospital or ICU.
• Patients who do not respond to empirical antibiotic therapy.
• Suspection of resistant strains of S.pneumoniae.
The Bacteriological Diagnosis of CAP
11. Blood Culture:
Recommended for all patients with moderate and high severity CAP, preferably before antibiotic therapy is commenced.
Examination of sputum for Mycobacterium TB
The Bacteriological Diagnosis of CAP
12. 12
CAP – Pathogenesis Inhalation Aspiration Hematogenous
13.
14. 14 PORT Scoring – PSI
Clinical Parameter
Scoring
Age in years
Example
For Men (Age in yrs)
50
For Women (Age -10)
(50-10)
NH Resident
10 points
Co-morbid Illnesses
Neoplasia
30 points
Liver Disease
20 points
CHF
10 points
CVD
10 points
Renal Disease (CKD)
10 points
Clinical Parameter
Scoring
Clinical Findings
Altered Sensorium
20 points
Respiratory Rate > 30
20 points
SBP < 90 mm
20 points
Temp < 350 C or > 400 C
15 points
Pulse > 125 per min
10 points
Investigation Findings
Arterial pH < 7.35
30 points
BUN > 30
20 points
Serum Na < 130
20 points
Hematocrit < 30%
10 points
Blood Glucose > 250
10 points
Pa O2
10 points
X Ray e/o Pleural Effusion
10 points Pneumonia Patient Outcomes Research Team (PORT)
15. 15 Classification of Severity - PORT Predictors Absent Class I 70 Class II 71 – 90 Class III 91 - 130 Class IV > 130 Class V
16. 16
CAP – Management based on PSI Score
PORT Class
PSI Score
Mortality %
Treatment Strategy
Class I
No RF
0.1 – 0.4
Out patient
Class II
70
0.6 – 0.7
Out patient
Class III
71 - 90
0.9 – 2.8
Brief hospitalization
Class IV
91 - 130
8.5 – 9.3
Inpatient
Class V
> 130
27 – 31.1
IP - ICU
17. 17
CURB 65 Rule – Management of CAP CURB 65 Confusion BUN > 30 RR > 30 BP SBP <90 DBP <60 Age > 65 CURB 0 or 1 Home Rx CURB 2 Short Hosp CURB 3 Medical Ward CURB 4 or 5 ICU care
18.
19. 19
CAP – Criteria for ICU Admission
Major criteria
Invasive mechanical ventilation required
Septic shock with the need of vasopressors
Minor criteria (least 3)
Confusion/disorientation
Blood urea nitrogen ≥ 20 mg%
Respiratory rate ≥ 30 / min;
Core temperature < 36ºC
Severe hypotension;
PaO2/FiO2 ratio ≤ 250
Multi-lobar infiltrates
WBC < 4000 cells;
Platelets <100,000
21. 21
CAP – Value of Chest Radiograph •Usually needed to establish diagnosis •It is a prognostic indicator •To rule out other disorders •May help in etiological diagnosis
J Chr Dis 1984;37:215-25
22. 22 Infiltrate Patterns and Pathogens
CXR Pattern
Possible Pathogens
Lobar
S.pneumo, Kleb, H. influ, Gram Neg
Patchy
Atypicals, Viral, Legionella
Interstitial
Viral, PCP, Legionella
Cavitatory
Anerobes, Kleb, TB, S.aureus, Fungi
Large effusion
Staph, Anaerobes, Klebsiella
38. S Curve of Golden
When there is a mass adjacent to a fissure, the fissure takes the shape of an "S". The proximal convexity is due to a mass, and the distal concavity is due to atelectasis. Note the shape of the transverse fissure.
This example represents a RUL mass with atelectasis
45. Pneumonia
Posterior intercostal scan shows a hypoechoic consolidated area that contains multiple echogenic lines that represent an air bronchogram.
46. Post-stenotic pneumonia
Posterior intercostal scan shows a hypoechoic consolidated area that contains anechoic, branched tubular structures in the bronchial tree (fluid bronchogram).
47. Contrast-enhanced ultrasonography of pneumonia
A: Baseline scan shows a hypoechoic consolidated area
B: Seven seconds after iv bolus of contrast agent, the lesion shows marked and homogeneous enhancement
C: The lesion remains substantially unmodified after 90 s.
50. MECHANISMS OF ACTION OF ANTIBACTERIAL DRUGS
Mechanism of action include:
Inhibition of cell wall synthesis
Inhibition of protein synthesis
Inhibition of nucleic acid synthesis
Inhibition of metabolic pathways
Interference with cell membrane integrity
51. EFFECTS OF COMBINATIONS OF DRUGS
Sometimes the chemotherapeutic effects of two drugs given simultaneously is greater than the effect of either given alone.
This is called synergism. For example, penicillin and streptomycin in the treatment of bacterial endocarditis. Damage to bacterial cell walls by penicillin makes it easier for streptomycin to enter.
52. EFFECTS OF COMBINATIONS OF DRUGS
Other combinations of drugs can be antagonistic.
For example, the simultaneous use of penicillin and tetracycline is often less effective than when wither drugs is used alone. By stopping the growth of the bacteria, the bacteriostatic drug tetracycline interferes with the action of penicillin, which requires bacterial growth.
53. EFFECTS OF COMBINATIONS OF DRUGS
Combinations of antimicrobial drugs should be used only for:
1.To prevent or minimize the emergence of resistant strains.
2.To take advantage of the synergistic effect.
3.To lessen the toxicity of individual drugs.
55. The Ideal Drug*
1.Selective toxicity: against target pathogen but not against host
LD50 (high) vs. MIC and/or MBC (low)
2.Bactericidal vs. bacteriostatic
3.Favorable pharmacokinetics: reach target site in body with effective concentration
4.Spectrum of activity: broad vs. narrow
5.Lack of “side effects”
Therapeutic index: effective to toxic dose ratio
6.Little resistance development
57. Resistance Physiological Mechanisms
4. Altered target
RIF – altered RNA polymerase (mutants)
NAL – altered DNA gyrase
STR – altered ribosomal proteins
ERY – methylation of 23S rRNA
5. Synthesis of resistant pathway
TMPr plasmid has gene for DHF reductase; insensitive to TMP
(cont’d) REVIEW
58. Empirical Treatment is the recommended strategy in treatment of CAP and shouldn’t be delayed.
59. 59 CAP – Special Features – Pathogen wise
Typical – S.pneumoniae, H.influenza, M.catarrhalis
Blood tinged sputum - Pneumococcal, Klebsiella, Legionella
H.influenzae
CAP has associated of pleural effusion:S.Pneumoniae – commonest – penicillin resistance problem
S.aureus, K.pneumoniae, P.aeruginosa
S.aureus causes CAP in post-viral influenza; Serious CAP
K.pneumoniae primarily in patients of chronic alcoholism
P.Aeruginosa causes CAP in pts with CSLD or CF, Nosocom
Aspiration CAP only is caused by multiple pathogens
Extra pulmonary manifestations only in Atypical CAP
60. Outpatient treatment: Oral Respiratory Fluroquinolones OR Oral B-Lactam/ B-Lactamase + Oral New Macrolide OR IM 3rd Generation Cefalosporines + New Macrolide Recommendations for the Empirical Treatment:
61. In-patient treatment: Non-ICU:
Intravenous ( IV )Respiratory fluoro- quinolone OR IV B-Lactam/ B-Lactamase + IV New Macrolide OR IV 3rd Generation Cephalosporin + IV New Macrolide Recommendations for the Empirical Treatment:
62. In-patient treatment: ICU:
No Monotherapy.
IV Respiratory fluoroquinolone + 3rd or 4th generation cephalosporin
OR IV Imipenem + IV New Macrolide
Recommendations for the Empirical Treatment:
63. Special entities in ICU:
Aspiration:
As Before + i.v. Clindamycin OR Metronidazole
Risk of Pseudomonas Infection:
Antipseudomonal beta-lactam (3rd or 4th generation cephalosporin OR Piperacillin-tazobactam OR carbapenem) Plus (aminoglycoside OR antipseudomonal fluoroquinolone) For community-acquired methicillin-resistant Staphylococcus aureus infection (MRSA): Add Teicoplanin OR linezolid Alternative: Vancomycin (considering its renal side effects) Recommendations for the Empirical Treatment:
64. 64 Duration of Therapy
•Minimum of 5 days
•Afebrile for at least 48 to 72 h
•Longer duration of therapy
If initial therapy was not active against the identified pathogen or complicated by extra pulmonary infection
65. 65
Strategies for Prevention of CAP
•Cessation smoking
•Influenza Vaccine It offers 90% protection and reduces mortality by 80%
•Pneumococcal Vaccine (Pneumonia shot)
It protects against 23 types of Pneumococci
70% of us have Pneumococci in our RT
It is not 100% protective but reduces mortality
Age 19-64 with co morbidity of high for pneumonia
Above 65 all must get it even without high risk
•Starting first dose of antibiotic within 4 h & O2 status
66. 66 Switch to Oral Therapy
Four criteria
Improvement in cough, dyspnea & clinical signs
Afebrile on two occasions 8 h apart
WBC decreasing towards normal
Functioning GI tract with adequate oral intake
If overall clinical picture is otherwise favorable, hemodynamically stable; can switch to oral therapy while still febrile.
67. 67 Management of Poor Responders
Consider non-infectious illnesses
Consider less common pathogens
Consider serologic testing
Broaden antibiotic therapy
Consider bronchoscopy
68. 68 CAP – Complications
Hypotension and septic shock
3-5% Pleural effusion; Clear fluid + pus cells
1% Empyema thoracis pus in the pleural space
Lung abscess – destruction of lung - CSLD
Single (aspiration) anaerobes, Pseudomonas
Multiple (metastatic) Staphylococcus aureus
Septicemia – Brain abscess, Liver Abscess
Multiple Pyemic Abscesses
69. 69 CAP – So How Best to Win the War?
Early antibiotic administration within 4-6 hours
Empiric antibiotic Rx. as per guidelines (IDSA / ATS)
PORT – PSI scoring and Classification of cases
Early hospitalization in Class IV and V
Change Abx. as per pathogen & sensitivity pattern
Decrease smoking cessation - advice / counseling
Arterial oxygenation assessment in the first 24 h
Blood culture collection in the first 24 h prior to Abx.
Pneumococcal & Influenza vaccination; Smoking cessation
70. Broncho-Vaxom is an extract of different bacterial species frequently responsible of respiratory infections. It stimulates the immune system in order to increase the body’s natural defences against a wide spectrum of respiratory pathogens. BRONCHO-VAXOM
Broncho-Vaxom ® prevents and/or reduces the severity of acute attacks of chronic bronchitis and recurrent infections of the respiratory tract, in particular .
71. Broncho-Vaxom prevents and/or reduces the severity of acute attacks of chronic bronchitis and recurrent infections of the respiratory tract, in particular sinusitis, rhinopharyngitis and middle ear infection, in adults and children. BRONCHO-VAXOM
Broncho-Vaxom ® prevents and/or reduces the severity of acute attacks of chronic bronchitis and recurrent infections of the respiratory tract, in particular .
72. Immunostimulating agent In animals, an increased resistance towards experimental infections, a stimulation of macrophages and B lymphocytes as well as an increase in immunoglobulins secreted by the respiratory mucosal cells have been reported. BRONCHO-VAXOM
Broncho-Vaxom ® prevents and/or reduces the severity of acute attacks of chronic bronchitis and recurrent infections of the respiratory tract, in particular .
73. Immunostimulating agent In humans, an increase in the rate of circulating T lymphocytes, in salivary IgA, in the non-specific response to polyclonal mitogens and in the mixed lymphocyte reaction have been observed. BRONCHO-VAXOM
Broncho-Vaxom ® prevents and/or reduces the severity of acute attacks of chronic bronchitis and recurrent infections of the respiratory tract, in particular .
74. Safety Extensive toxicity studies have not revealed any toxic effect. Effects on ability to drive and use machines:
Broncho-Vaxom is presumed to be safe and unlikely to produce an effect.
BRONCHO-VAXOM
Broncho-Vaxom ® prevents and/or reduces the severity of acute attacks of chronic bronchitis and recurrent infections of the respiratory tract, in particular .
75. Safety Reproduction studies in animals have not demonstrated any risk to the fetus, but controlled studies in pregnant women are not available. As regards breast-feeding, no specific studies have been performed and no data have been reported up to now. BRONCHO-VAXOM
Broncho-Vaxom ® prevents and/or reduces the severity of acute attacks of chronic bronchitis and recurrent infections of the respiratory tract, in particular .
76. Side effects The overall incidence of adverse effects in clinical trials lies between 3 and 4%. Gastrointestinal troubles (nausea, abdominal pain, vomiting), dermatologic reactions (rash, urticaria), and respiratory disorders (coughing, dyspnea, asthma), as well as generalized problems (fever, fatigue, allergic reactions) are the most frequent complaints reported. BRONCHO-VAXOM
Broncho-Vaxom ® prevents and/or reduces the severity of acute attacks of chronic bronchitis and recurrent infections of the respiratory tract, in particular .
77. Interaction No drug interaction is known up to now.. BRONCHO-VAXOM
Broncho-Vaxom ® prevents and/or reduces the severity of acute attacks of chronic bronchitis and recurrent infections of the respiratory tract, in particular .