The document discusses several studies on bronchiolitis. It finds that living near a major highway is associated with a 6% increased risk of hospitalization for bronchiolitis. Cigarette smoke exposure decreases apoptosis and increases viral load during RSV infection. High cord blood levels of IL-6 and IL-8 are associated with more severe bronchiolitis. Certain surfactant protein polymorphisms are also linked to increased disease severity and hospitalization risk. A recent study suggests nasal wash lactate dehydrogenase levels may help predict bronchiolitis severity and hospitalization need. Several treatments for bronchiolitis, including hypertonic saline, high-volume normal saline, and nebulized epinephrine or salbut
Recent Advances in the Treatment of Childhood Asthma - Robert LemanskeJuan Carlos Ivancevich
Congreso Latinoamericano de Alergia, Asma e Inmunología 2015
Presidente: Alfonso Mario Cepeda Sarabia
Comité Organizador Local: Edgardo Jares, Anahí Yañez, Estrella Asayag
Presidentes Sociedad Latinoamericana de Alergia, Asma e Inmunología, Slaai:
2013-2015: Alfonso Mario Cepeda Sarabia - 2015-2017: Juan Carlos Sisul Alvariza
Buenos Aires, marzo 14-16, 2015
Neonatal Fever: An Evidence Based Approachdpark419
1. The document discusses the evaluation and management of febrile infants, with a focus on avoiding unnecessary testing and procedures while not missing serious bacterial infections.
2. There is significant variation in the care of febrile neonates and young infants across pediatric emergency departments, with guidelines recommending full septic workups including blood, urine and CSF testing for infants under 28 days old.
3. Several clinical prediction rules or "low risk" criteria have been developed to determine which febrile infants can be safely managed as outpatients without antibiotics, including the Boston, Philadelphia and Rochester criteria. These criteria focus on patient history, exam findings and laboratory values.
GEMC- Fever in the Emergency Department: Special Considerations in Pediatrics...Open.Michigan
This is a lecture by Hannah Smith, MD from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
Thank you for the detailed case presentation and discussion. I do not actually need an electronic copy of the antibiotic spectrum chart. I am an AI assistant created by Anthropic to be helpful, harmless, and honest.
A 2 week old infant presented with fever, poor feeding, lethargy, and a bulging fontanelle. Cerebrospinal fluid analysis showed 2,000 white blood cells per mm3. Group B streptococcus (GBBS) is the most likely causative organism given the clinical presentation and lab findings. GBBS is a common cause of infection in neonates and accounts for 50-70% of neonatal infections.
This document discusses the epidemiology of neonatal early-onset sepsis (EOS). It reports that:
1) The incidence of EOS is 1-2 cases per 1,000 live births in the US, and 10 times higher for very low birthweight infants.
2) Group B Streptococcus (GBS) has historically been the primary cause of EOS but rates have decreased 80% since widespread use of preventative antibiotics for GBS.
3) Preterm infants now have higher rates of EOS caused by gram-negative bacteria like E. coli, reflecting the changing microbiology with antibiotic use.
This case presentation discusses a 2-year-old female child admitted to the pediatric intensive care unit (PICU) with pneumonia. She presented with a week of fever and wet cough. Initial tests showed left lung consolidation and pleural effusion. She received IV antibiotics and underwent VATS surgery to drain pus from her lungs. Over 10 days in the PICU with nursing care and treatments, her symptoms improved and she was discharged on oral antibiotics to complete her recovery at home.
Recent Advances in the Treatment of Childhood Asthma - Robert LemanskeJuan Carlos Ivancevich
Congreso Latinoamericano de Alergia, Asma e Inmunología 2015
Presidente: Alfonso Mario Cepeda Sarabia
Comité Organizador Local: Edgardo Jares, Anahí Yañez, Estrella Asayag
Presidentes Sociedad Latinoamericana de Alergia, Asma e Inmunología, Slaai:
2013-2015: Alfonso Mario Cepeda Sarabia - 2015-2017: Juan Carlos Sisul Alvariza
Buenos Aires, marzo 14-16, 2015
Neonatal Fever: An Evidence Based Approachdpark419
1. The document discusses the evaluation and management of febrile infants, with a focus on avoiding unnecessary testing and procedures while not missing serious bacterial infections.
2. There is significant variation in the care of febrile neonates and young infants across pediatric emergency departments, with guidelines recommending full septic workups including blood, urine and CSF testing for infants under 28 days old.
3. Several clinical prediction rules or "low risk" criteria have been developed to determine which febrile infants can be safely managed as outpatients without antibiotics, including the Boston, Philadelphia and Rochester criteria. These criteria focus on patient history, exam findings and laboratory values.
GEMC- Fever in the Emergency Department: Special Considerations in Pediatrics...Open.Michigan
This is a lecture by Hannah Smith, MD from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
Thank you for the detailed case presentation and discussion. I do not actually need an electronic copy of the antibiotic spectrum chart. I am an AI assistant created by Anthropic to be helpful, harmless, and honest.
A 2 week old infant presented with fever, poor feeding, lethargy, and a bulging fontanelle. Cerebrospinal fluid analysis showed 2,000 white blood cells per mm3. Group B streptococcus (GBBS) is the most likely causative organism given the clinical presentation and lab findings. GBBS is a common cause of infection in neonates and accounts for 50-70% of neonatal infections.
This document discusses the epidemiology of neonatal early-onset sepsis (EOS). It reports that:
1) The incidence of EOS is 1-2 cases per 1,000 live births in the US, and 10 times higher for very low birthweight infants.
2) Group B Streptococcus (GBS) has historically been the primary cause of EOS but rates have decreased 80% since widespread use of preventative antibiotics for GBS.
3) Preterm infants now have higher rates of EOS caused by gram-negative bacteria like E. coli, reflecting the changing microbiology with antibiotic use.
This case presentation discusses a 2-year-old female child admitted to the pediatric intensive care unit (PICU) with pneumonia. She presented with a week of fever and wet cough. Initial tests showed left lung consolidation and pleural effusion. She received IV antibiotics and underwent VATS surgery to drain pus from her lungs. Over 10 days in the PICU with nursing care and treatments, her symptoms improved and she was discharged on oral antibiotics to complete her recovery at home.
This document reviews the association between atopic conditions like asthma, allergic rhinitis, and atopic dermatitis with an increased risk of respiratory and non-respiratory tract infections. It discusses several potential mechanisms for this association, including dysfunction in innate immunity, humoral immunity, and cell-mediated immunity in atopic individuals. Specific examples are provided of impaired responses to pathogens like bacteria and viruses in those with asthma or allergies. The role of corticosteroid use and asthma severity/control in modifying infection risk is also examined.
The Febrile Neonate and Young Infant: An Evidence Based Reviewdpark419
Objectives:
1) Discuss the wide variation in management of this patient population
2) Review the low risk criteria for infants deemed safe to be discharged from the emergency room
3) Review the medical evaluation of the febrile neonate and young infant
4) Discuss several difficult clinical situations one may encounter when managing the febrile neonate/young infant (traumatic/dry LP, hyperpyrexia, neonatal mastitis, concomitant viral infection)
5) Answer the question: Can you safely withhold a lumbar puncture from a febrile young infant (4-8 week old)
The document discusses three studies related to reducing environmental allergens:
1) The Kingston Allergy Birth Cohort study found associations between parental reports of wheeze/cough in children and prenatal cigarette smoke exposure, mold/dampness in the home, and use of air fresheners. Breastfeeding and older siblings were associated with decreased respiratory symptoms.
2) A review of multifaceted and monofaceted interventions found that multifaceted interventions reducing exposure to multiple allergens reduced the likelihood of asthma diagnosis in children under 5 and over 5 compared to usual care. Mono-interventions did not produce statistically significant effects.
3) A study discusses emerging payment approaches for home
This document provides a case study on a 5-year old male patient diagnosed with pneumonia. It includes an introduction to pneumonia, the patient's data, health history, physical assessment findings, definitions of key terms, developmental tasks, anatomy and physiology of the respiratory system, and pathophysiology of pneumonia. The objectives are to understand the patient's condition, underlying causes, appropriate medical and nursing interventions, and formulate a nursing care plan.
This document discusses the evaluation and management of fever without source in infants and children. It defines fever without source and outlines the differential diagnosis. Key points include:
- Fever accounts for 20-35% of pediatric visits and 5-20% will have no apparent source after examination.
- Fever is regulated by the hypothalamus and results from pyrogens stimulating an increased set point.
- For infants under 3 months, a full sepsis workup is considered. Criteria like Rochester can help determine low risk for outpatient management.
- For children 3-36 months, the Yale Observation Scale can identify toxic-appearing children needing admission versus low-risk children who can be treated as out
1) A study of 225 asthmatic children exposed to secondhand smoke found that using HEPA air cleaners was associated with an 18% reduction in unscheduled asthma visits and a 25% reduction in particles larger than 0.3 micrometers over one year.
2) Latex avoidance in children with spina bifida prevented latex sensitization in 55% of a historic control group compared to 5% of a latex-free surgery group and prevented latex allergy in 37% versus 0.08% respectively.
3) A study of over 1,900 children with asthma found that comprehensive use of environmental control practices like air filters and pet avoidance, defined as using at least 5 of 8 practices, was associated
The document provides an overview of evaluating and managing febrile children, including guidelines for occult bacteremia, febrile seizures, and specific conditions like underlying illness, petechiae, and rare syndromes. It discusses the incidence and organisms involved in occult bacteremia as well as recommendations for blood cultures, antibiotics, and follow up based on a child's age, temperature, and risk factors. Evaluation and management may involve septic workup, imaging, lumbar puncture, and parenteral antibiotics depending on the child's presentation and risk of serious bacterial infection.
Is your dog vaccinated, re-vaccinated or immunised? Yotam Copelovitz
A simple serology test, namely Titer Test, can infect confirm if your dog/cat is immunised. And if they are, re-vaccination is only required once every 3 years.
This bombshell is presented in this article in further details by Anna Webb.
The document discusses various topics related to evaluating and managing febrile children, including:
1. Occult bacteremia is a potential cause of fever in young children, with a reported incidence of 1.9-5%. Common organisms include Streptococcus pneumoniae and Haemophilus influenzae.
2. Guidelines for evaluating febrile infants aged 0-3 months include the Philadelphia Protocol and Rochester Protocol, which aim to identify those at low risk of serious bacterial infection.
3. Fever in children with underlying illnesses requires consideration of infection risks specific to their condition, such as opportunistic infections in immunocompromised children.
4. Other conditions like Kawasaki syndrome
1) A study investigated whether administering a recombinant DNA plasmid expressing the Mycobacterial leprae heat shock protein 65 (Hsp65) could attenuate an established allergic airway response in mice.
2) Mice were first sensitized and challenged with ovalbumin to induce allergy, then treated with the recombinant Hsp65 plasmid.
3) The treatment inhibited eosinophilia, pulmonary inflammation, Th2 cytokines, and mucus production associated with the allergic response. This inhibition was dependent on increased production of the anti-inflammatory cytokine IL-10.
This document discusses fever without a clear source or focus of infection. It defines fever and describes how body temperature is regulated. Fever occurs when heat production exceeds heat loss. Common causes include infections, inflammation, and cancer. The pattern of fever can provide clues to the underlying cause. Management depends on the age of the child. For young infants, a full evaluation including lab tests and antibiotics is often needed due to the risk of serious bacterial infection. Older children have a lower risk but may still require testing and observation or empiric antibiotics depending on factors like vaccination history and appearance.
Fever is a common reason for pediatric visits. The hypothalamus regulates body temperature and fever occurs when its set point is elevated. Fever without a source is difficult to diagnose and can be caused by infections, inflammatory disorders, or malignancies. Evaluation involves history, exam, labs including blood cultures, and imaging if indicated. Lower risk children based on criteria like Rochester may be managed as outpatients without antibiotics. Higher risk children receive empiric antibiotics targeting common pathogens until diagnosis is made. Antipyretics and antivirals are also used for symptom relief in some cases.
Community Acquired Pneumonia- Comprehensive Reviewjamal turki
1) Biomarkers such as procalcitonin, C-reactive protein, pro-adrenomedullin, and genomic bacterial load can help determine the severity of community-acquired pneumonia and risk of adverse outcomes.
2) Studies have found that using procalcitonin levels to guide antibiotic treatment of community-acquired pneumonia can reduce antibiotic use by up to 50% without increasing adverse outcomes.
3) Macrolide-based antibiotic regimens for treatment of community-acquired pneumonia may reduce mortality compared to non-macrolide regimens or fluoroquinolone monotherapy according to systematic reviews.
This document discusses the historical perspective, epidemiology, pathogenesis, etiology, and immune responses related to allergic bronchopulmonary aspergillosis (ABPA). It notes that ABPA was first described in 1952 and involves an allergic response to the fungus Aspergillus, which commonly involves the lungs. The document outlines the involvement of innate immune responses like TLRs and acquired responses like specific antibodies and T cells. It also examines factors like genetic variants that can influence susceptibility.
immunization of children is essential to prevent childhood illness, morbidity and mortality. immunization or vaccination is the way of protecting child from infectious diseases.
This document summarizes guidelines for the diagnosis and management of pediatric community-acquired pneumonia (PCAP). It outlines risk factors for PCAP and clinical signs associated with bacterial vs. viral etiologies. Guidelines are provided for classifying patients based on risk, determining need for admission, appropriate diagnostic tests and empiric antibiotic therapy. Considerations for treatment failure and switching or adding therapy are also discussed.
Comparing parts of UK & US Healthcare systems, IgG explainedGraham Atherton
NAC consultant Eavan Muldoon introduces herself as our new medic and talks a little about her background, part of which was spent at Tufts Medical Centre, Boston, USA. Then Graham Atherton talks about IgG, what they are and how they work.
The document discusses the evaluation and management of difficult or severe asthma. It notes that in evaluating these patients, it is important to first establish an accurate diagnosis of asthma through objective measures like spirometry before and after bronchodilation. Studies have found that a substantial percentage of patients diagnosed with difficult asthma were later found to have an alternative or incorrect diagnosis after thorough evaluation. Assessing and addressing comorbidities, adherence, environmental factors, and phenotypes is also important for optimizing treatment of difficult asthma. Difficult asthma can be divided into cases where underlying problems can be addressed versus true therapy-resistant severe asthma.
1) A study of 651 children with pollen-related allergic rhinitis found that component-resolved diagnosis identified a lack of IgE antibodies to major allergens in a significant percentage of patients with skin prick test reactivity, calling into question the appropriateness of immunotherapy for some patients.
2) Without component-resolved diagnosis, immunotherapy would have been prescribed inappropriately in 37% of cases based on skin prick test alone.
3) Component-resolved diagnosis led European and American allergists to change their immunotherapy prescription decisions in 42-48% of cases compared to skin prick testing alone.
The document discusses several studies on asthma phenotypes and prognosis. One study identified 5 asthma clusters based on clinical characteristics like age of onset, atopy, lung function and treatment. Another study found that 11% of children with asthma-like symptoms at ages 0-4 still had asthma at ages 7-8, and identified 8 factors that predicted this outcome. A third study found similar rates of remitting, periodic and persistent asthma among treatment groups in a long-term study.
The document discusses several studies related to allergies and atopy. It summarizes that:
1) A study of over 8,000 people in the US found that total IgE levels were only associated with asthma in those who tested positive for at least one specific allergen.
2) Another study identified that testing for 10 common allergens allowed detection of over 95% of atopic subjects, but testing for 15 allergens was needed to identify all atopic individuals.
3) Parental allergen sensitization increases the likelihood that their 18-year-old offspring will be sensitized to the same allergens. Testing parents and children for six common allergens showed this relationship.
This document reviews the association between atopic conditions like asthma, allergic rhinitis, and atopic dermatitis with an increased risk of respiratory and non-respiratory tract infections. It discusses several potential mechanisms for this association, including dysfunction in innate immunity, humoral immunity, and cell-mediated immunity in atopic individuals. Specific examples are provided of impaired responses to pathogens like bacteria and viruses in those with asthma or allergies. The role of corticosteroid use and asthma severity/control in modifying infection risk is also examined.
The Febrile Neonate and Young Infant: An Evidence Based Reviewdpark419
Objectives:
1) Discuss the wide variation in management of this patient population
2) Review the low risk criteria for infants deemed safe to be discharged from the emergency room
3) Review the medical evaluation of the febrile neonate and young infant
4) Discuss several difficult clinical situations one may encounter when managing the febrile neonate/young infant (traumatic/dry LP, hyperpyrexia, neonatal mastitis, concomitant viral infection)
5) Answer the question: Can you safely withhold a lumbar puncture from a febrile young infant (4-8 week old)
The document discusses three studies related to reducing environmental allergens:
1) The Kingston Allergy Birth Cohort study found associations between parental reports of wheeze/cough in children and prenatal cigarette smoke exposure, mold/dampness in the home, and use of air fresheners. Breastfeeding and older siblings were associated with decreased respiratory symptoms.
2) A review of multifaceted and monofaceted interventions found that multifaceted interventions reducing exposure to multiple allergens reduced the likelihood of asthma diagnosis in children under 5 and over 5 compared to usual care. Mono-interventions did not produce statistically significant effects.
3) A study discusses emerging payment approaches for home
This document provides a case study on a 5-year old male patient diagnosed with pneumonia. It includes an introduction to pneumonia, the patient's data, health history, physical assessment findings, definitions of key terms, developmental tasks, anatomy and physiology of the respiratory system, and pathophysiology of pneumonia. The objectives are to understand the patient's condition, underlying causes, appropriate medical and nursing interventions, and formulate a nursing care plan.
This document discusses the evaluation and management of fever without source in infants and children. It defines fever without source and outlines the differential diagnosis. Key points include:
- Fever accounts for 20-35% of pediatric visits and 5-20% will have no apparent source after examination.
- Fever is regulated by the hypothalamus and results from pyrogens stimulating an increased set point.
- For infants under 3 months, a full sepsis workup is considered. Criteria like Rochester can help determine low risk for outpatient management.
- For children 3-36 months, the Yale Observation Scale can identify toxic-appearing children needing admission versus low-risk children who can be treated as out
1) A study of 225 asthmatic children exposed to secondhand smoke found that using HEPA air cleaners was associated with an 18% reduction in unscheduled asthma visits and a 25% reduction in particles larger than 0.3 micrometers over one year.
2) Latex avoidance in children with spina bifida prevented latex sensitization in 55% of a historic control group compared to 5% of a latex-free surgery group and prevented latex allergy in 37% versus 0.08% respectively.
3) A study of over 1,900 children with asthma found that comprehensive use of environmental control practices like air filters and pet avoidance, defined as using at least 5 of 8 practices, was associated
The document provides an overview of evaluating and managing febrile children, including guidelines for occult bacteremia, febrile seizures, and specific conditions like underlying illness, petechiae, and rare syndromes. It discusses the incidence and organisms involved in occult bacteremia as well as recommendations for blood cultures, antibiotics, and follow up based on a child's age, temperature, and risk factors. Evaluation and management may involve septic workup, imaging, lumbar puncture, and parenteral antibiotics depending on the child's presentation and risk of serious bacterial infection.
Is your dog vaccinated, re-vaccinated or immunised? Yotam Copelovitz
A simple serology test, namely Titer Test, can infect confirm if your dog/cat is immunised. And if they are, re-vaccination is only required once every 3 years.
This bombshell is presented in this article in further details by Anna Webb.
The document discusses various topics related to evaluating and managing febrile children, including:
1. Occult bacteremia is a potential cause of fever in young children, with a reported incidence of 1.9-5%. Common organisms include Streptococcus pneumoniae and Haemophilus influenzae.
2. Guidelines for evaluating febrile infants aged 0-3 months include the Philadelphia Protocol and Rochester Protocol, which aim to identify those at low risk of serious bacterial infection.
3. Fever in children with underlying illnesses requires consideration of infection risks specific to their condition, such as opportunistic infections in immunocompromised children.
4. Other conditions like Kawasaki syndrome
1) A study investigated whether administering a recombinant DNA plasmid expressing the Mycobacterial leprae heat shock protein 65 (Hsp65) could attenuate an established allergic airway response in mice.
2) Mice were first sensitized and challenged with ovalbumin to induce allergy, then treated with the recombinant Hsp65 plasmid.
3) The treatment inhibited eosinophilia, pulmonary inflammation, Th2 cytokines, and mucus production associated with the allergic response. This inhibition was dependent on increased production of the anti-inflammatory cytokine IL-10.
This document discusses fever without a clear source or focus of infection. It defines fever and describes how body temperature is regulated. Fever occurs when heat production exceeds heat loss. Common causes include infections, inflammation, and cancer. The pattern of fever can provide clues to the underlying cause. Management depends on the age of the child. For young infants, a full evaluation including lab tests and antibiotics is often needed due to the risk of serious bacterial infection. Older children have a lower risk but may still require testing and observation or empiric antibiotics depending on factors like vaccination history and appearance.
Fever is a common reason for pediatric visits. The hypothalamus regulates body temperature and fever occurs when its set point is elevated. Fever without a source is difficult to diagnose and can be caused by infections, inflammatory disorders, or malignancies. Evaluation involves history, exam, labs including blood cultures, and imaging if indicated. Lower risk children based on criteria like Rochester may be managed as outpatients without antibiotics. Higher risk children receive empiric antibiotics targeting common pathogens until diagnosis is made. Antipyretics and antivirals are also used for symptom relief in some cases.
Community Acquired Pneumonia- Comprehensive Reviewjamal turki
1) Biomarkers such as procalcitonin, C-reactive protein, pro-adrenomedullin, and genomic bacterial load can help determine the severity of community-acquired pneumonia and risk of adverse outcomes.
2) Studies have found that using procalcitonin levels to guide antibiotic treatment of community-acquired pneumonia can reduce antibiotic use by up to 50% without increasing adverse outcomes.
3) Macrolide-based antibiotic regimens for treatment of community-acquired pneumonia may reduce mortality compared to non-macrolide regimens or fluoroquinolone monotherapy according to systematic reviews.
This document discusses the historical perspective, epidemiology, pathogenesis, etiology, and immune responses related to allergic bronchopulmonary aspergillosis (ABPA). It notes that ABPA was first described in 1952 and involves an allergic response to the fungus Aspergillus, which commonly involves the lungs. The document outlines the involvement of innate immune responses like TLRs and acquired responses like specific antibodies and T cells. It also examines factors like genetic variants that can influence susceptibility.
immunization of children is essential to prevent childhood illness, morbidity and mortality. immunization or vaccination is the way of protecting child from infectious diseases.
This document summarizes guidelines for the diagnosis and management of pediatric community-acquired pneumonia (PCAP). It outlines risk factors for PCAP and clinical signs associated with bacterial vs. viral etiologies. Guidelines are provided for classifying patients based on risk, determining need for admission, appropriate diagnostic tests and empiric antibiotic therapy. Considerations for treatment failure and switching or adding therapy are also discussed.
Comparing parts of UK & US Healthcare systems, IgG explainedGraham Atherton
NAC consultant Eavan Muldoon introduces herself as our new medic and talks a little about her background, part of which was spent at Tufts Medical Centre, Boston, USA. Then Graham Atherton talks about IgG, what they are and how they work.
The document discusses the evaluation and management of difficult or severe asthma. It notes that in evaluating these patients, it is important to first establish an accurate diagnosis of asthma through objective measures like spirometry before and after bronchodilation. Studies have found that a substantial percentage of patients diagnosed with difficult asthma were later found to have an alternative or incorrect diagnosis after thorough evaluation. Assessing and addressing comorbidities, adherence, environmental factors, and phenotypes is also important for optimizing treatment of difficult asthma. Difficult asthma can be divided into cases where underlying problems can be addressed versus true therapy-resistant severe asthma.
1) A study of 651 children with pollen-related allergic rhinitis found that component-resolved diagnosis identified a lack of IgE antibodies to major allergens in a significant percentage of patients with skin prick test reactivity, calling into question the appropriateness of immunotherapy for some patients.
2) Without component-resolved diagnosis, immunotherapy would have been prescribed inappropriately in 37% of cases based on skin prick test alone.
3) Component-resolved diagnosis led European and American allergists to change their immunotherapy prescription decisions in 42-48% of cases compared to skin prick testing alone.
The document discusses several studies on asthma phenotypes and prognosis. One study identified 5 asthma clusters based on clinical characteristics like age of onset, atopy, lung function and treatment. Another study found that 11% of children with asthma-like symptoms at ages 0-4 still had asthma at ages 7-8, and identified 8 factors that predicted this outcome. A third study found similar rates of remitting, periodic and persistent asthma among treatment groups in a long-term study.
The document discusses several studies related to allergies and atopy. It summarizes that:
1) A study of over 8,000 people in the US found that total IgE levels were only associated with asthma in those who tested positive for at least one specific allergen.
2) Another study identified that testing for 10 common allergens allowed detection of over 95% of atopic subjects, but testing for 15 allergens was needed to identify all atopic individuals.
3) Parental allergen sensitization increases the likelihood that their 18-year-old offspring will be sensitized to the same allergens. Testing parents and children for six common allergens showed this relationship.
Format 2016: what is new in allergic & diseases respiratory 2016.Envicon Medical Srl
The document summarizes recent research in the fields of allergic and respiratory diseases from 2016. It includes summaries of multiple studies related to topics like drug allergy, food allergy, asthma, allergic rhinitis, and infectious respiratory diseases. The studies examined issues such as improving the effectiveness of penicillin allergy de-labeling through skin and drug testing, using drug provocation tests to diagnose non-immediate reactions to antibiotics like amoxicillin in children, and establishing reference doses for precautionary food labeling. One survey also found discrepancies between what health care professionals believe indicates risks of cross-contamination and what they consider to be best practices for precautionary allergen labeling.
Format 2016: how to get asthma control: from PubMed to the tricks of the trade.Envicon Medical Srl
This document discusses strategies for achieving asthma control. It begins by establishing the importance of a partnership between healthcare providers and patients. Effective self-regulation is key, which involves patients observing their condition, making judgments, and reacting appropriately. Motivational interviewing can help patients progress through stages of change. Active listening from providers helps address patients' cognitive and emotional needs. Both verbal and nonverbal communication impact the relationship and treatment outcomes. Involving children in their care can improve satisfaction and adherence.
This document summarizes established and emerging therapies for severe asthma exacerbations in children. It discusses the prevalence and severity of asthma, as well as standard therapies like oxygen, steroids, and beta agonists. It also reviews newer approaches like continuous albuterol, IV terbutaline, heliox, magnesium sulfate, and mechanical ventilation strategies. Highlights various clinical patterns of asthma and approaches to managing mild-moderate vs. severe exacerbations.
The document discusses several studies on drug allergies and the use of basophil activation tests (BAT) to diagnose hypersensitivity reactions:
- One study found that 5.1% of children with anaphylaxis reactions to beta-lactam antibiotics were due to cefaclor.
- BAT accurately identified IgE-mediated allergies to quinolones in patients who experienced immediate reactions.
- A separate study used BAT to evaluate patients with allergic reactions to dipyrone, finding the test remains positive in some patients for up to 6 months after the reaction.
- BAT is a reliable diagnostic tool for identifying IgE-mediated allergies to various drugs like
The document discusses several studies related to vaccines:
1. A study of 176 infant pertussis cases found most were vaccinated and exposed in households, suggesting promoting Tdap vaccination of household contacts.
2. A study found 15 children allergic to DT vaccine spontaneously resolved their allergy, with 3 still allergic on reevaluation.
3. A study of 1.8 million children found no increased risk of ITP after vaccines except MMR and possibly hepatitis A, varicella and Tdap vaccines in older children.
4. Residual casein was found in DTaP vaccines, possibly linking to reports of anaphylaxis in children with cow's milk allergy.
The document discusses several studies on asthma phenotypes and prognosis. One study of over 1300 teenagers found that 81% of asthmatics were also atopic. Another study identified 5 asthma clusters based on characteristics like age of onset, lung function, and medication use. A third study predicted long-term asthma in preschool children based on 8 clinical parameters.
This document discusses asthma, including its definition, pathophysiology, triggers, diagnosis, and treatment. Some key points:
- Asthma is a chronic inflammatory disease of the airways characterized by reversible airflow obstruction.
- It affects over 25 million Americans and its prevalence has been increasing since the 1980s.
- Asthma can be triggered by allergens, viruses, exercise, weather, irritants and other factors.
- Diagnosis involves assessing symptoms, lung function testing to detect reversible airflow obstruction, and ruling out other conditions.
- Proper treatment and care can help control asthma and prevent its potentially serious consequences like hospitalizations and death.
The document discusses several studies on lung function and spirometry. It provides details on techniques for performing spirometry tests and interpreting the results. It also summarizes some key findings from the studies, including that an FEV1 measurement 2 weeks after hospital discharge for asthma can identify patients at higher risk of subsequent acute asthma attacks, and lower FEV1 levels in smokers correlate with increased risk of lung cancer.
The document discusses several studies on risk factors for atopy and asthma. It summarizes the following key points:
1) A large international study found significant global variation in asthma prevalence among children aged 6-7 and 13-14, with rates ranging from under 5% to over 20% depending on location.
2) Studies of birth cohorts in the UK found that over 50% of children were diagnosed with at least one allergic condition by age 18, with the most common trajectory being eczema followed by asthma then rhinitis.
3) The prevalence of peanut allergy among children in the UK doubled between 1989-1990 and 2001-2002, suggesting an increasing trend.
4) Children
This document discusses masquerade syndromes in allergic diseases. It describes how primary immunodeficiencies (PIDs) can often present with symptoms that mimic common allergic conditions like eczema. Two examples of PIDs that frequently masquerade as allergies are discussed in detail - Omenn syndrome, a rare form of severe combined immunodeficiency that typically appears in infancy as erythroderma and diarrhea; and IPEX syndrome, an X-linked condition causing diarrhea, polyendocrinopathy, and fatal infections in male infants. The document emphasizes that a PID should be considered for patients with allergic-like symptoms that are treatment-resistant or associated with unusual clinical features.
Day 1 | CME- Trauma Symposium | Bronchiolitis pittengerNorton Healthcare
This document provides an overview and discussion of the diagnosis and management of bronchiolitis. It begins with a brief history of bronchiolitis and how our understanding and treatment of it has evolved over time. It then reviews the typical presentation and risk factors for severe disease. Current guidelines recommend supportive care rather than interventions like bronchodilators or steroids. The document discusses factors that may be influencing rising hospitalization rates and evaluates recent evidence regarding treatments. Implementing evidence-based clinical pathways and decision tools can help standardize care and reduce unnecessary testing and interventions.
The document discusses several studies on various forms of allergen immunotherapy:
1) A prospective study in Italy found that subcutaneous immunotherapy resulted in systemic reactions in 3.28% of patients and 1.56 reactions per 1000 injections.
2) A study of sublingual house dust mite immunotherapy in 30 patients found it reduced rhinitis and asthma symptoms and increased levels of TGF-β and regulatory T cells.
3) A study testing a sublingual grass tablet found it significantly reduced rhinitis symptoms from the first month of treatment compared to placebo.
Updates In Bronchiolitis 23 2 2010 Dr HumaidEM OMSB
This document summarizes recent evidence on the diagnosis and management of bronchiolitis. It defines bronchiolitis and discusses causes such as respiratory syncytial virus (RSV) and human metapneumovirus. Clinical features include fever, cough, wheezing and respiratory distress. Risk factors for severe disease are described. Treatment is generally supportive with oxygen, fluids and respiratory support as needed. Bronchodilators and corticosteroids are not routinely recommended but may be considered in some cases.
This document discusses asthma-COPD overlap syndrome (ACOS). It defines asthma and COPD, noting their differences and similarities. Both are chronic inflammatory airway diseases but COPD is characterized by persistent airflow limitation and progressive lung function decline while asthma is often reversible. The document then discusses clinical features that can help distinguish asthma from COPD. It notes that some patients have features of both diseases, termed ACOS. Spirometry, biomarkers, imaging and response to treatment are discussed to help identify ACOS. The inflammatory patterns in asthma and COPD are compared, showing that eosinophilic inflammation is more prominent in asthma while neutrophilic inflammation dominates in COPD.
Lets talk about ASTHMA by Haley Taylor SchlitzMyiesha Taylor
Asthma is a VERY common disease that affects many children in our country. This is a short talk by Haley geared towards sparking a peer to peer discussion targeted towards tweens and teens.
This document discusses bronchiolitis, a common lower respiratory tract infection in young children caused by viruses like RSV. It describes two cases of infants presenting with symptoms of bronchiolitis like nasal congestion, cough, poor feeding and respiratory distress. It covers assessing severity, investigations, management including oxygen, nutrition, monitoring and intensive care if needed. While bronchodilators and corticosteroids are often used, the document notes clinical trials have not found clear benefits for their use in viral bronchiolitis. Mild cases can be managed at home without specific therapy, while moderate to severe cases require admission.
Pediatric community acquired pneumoniaSamiaa Sadek
This document discusses pediatric community-acquired pneumonia (CAP). It defines CAP and outlines its key causes and risk factors. Pneumonia is a leading killer of children under 5 globally. While viruses are a common cause, bacteria like Streptococcus pneumoniae and Haemophilus influenzae also frequently cause pediatric CAP. Risk factors include malnutrition, HIV/AIDS, indoor air pollution, and crowding. The document describes presenting signs and symptoms and recommends diagnostic tests. Chest x-rays and testing for respiratory viruses can help determine the cause. Blood tests and cultures are also discussed. Hospitalization is suggested for pediatric CAP cases with hypoxemia, failure to improve after outpatient treatment, underlying conditions, or other complications.
This study assesses the cost-effectiveness of palivizumab (Synagis), a preventative treatment for respiratory syncytial virus (RSV) infection in high-risk children, from the perspective of the UK National Health Service. A decision tree model was developed using data from clinical trials, literature, and UK cost sources. The analysis found that palivizumab prophylaxis compared to no prophylaxis had an incremental cost-effectiveness ratio of £7042-16,720 per quality-adjusted life year gained for preterm infants and children with bronchopulmonary dysplasia, and £2427-6664 per QALY gained for children with congenital heart disease, suggesting pal
This document summarizes a study of 11 preterm infants with severe human rhinovirus (HRV) infections. Key findings include:
1) Nine of the 11 infants were preterm (median gestational age of 30 weeks) and 7 of the 9 preterm infants acquired HRV during their stay in the neonatal intensive care unit (NICU).
2) All infants presented with respiratory distress and required respiratory support like mechanical ventilation for a median of 6 days. Chest x-rays showed findings like perihilar streakiness and atelectasis.
3) HRV infection was diagnosed using real-time polymerase chain reaction testing of nasopharyngeal aspirates which showed high viral loads. All infants
This document summarizes recent findings on bronchopulmonary dysplasia (BPD). It discusses epidemiological studies that show gestational age and birth weight are most predictive of BPD. While excessive oxygen use can increase BPD risk, low oxygen targets may increase mortality. New evidence suggests combining less invasive care to avoid excessive oxygen/ventilation, decrease infections, and optimize nutrition may decrease BPD incidence and severity. The pathophysiology of BPD remains incompletely understood.
Bronchopulmonary dysplasia updates_and_prevention dr falakhagfalakha
The document discusses bronchopulmonary dysplasia (BPD) and strategies for prevention. It notes that BPD results from disrupted alveolar development and remodeling of the airways, vasculature, and smooth muscle. Risk factors include prematurity, genetics, chorioamnionitis, and exposures associated with resuscitation and mechanical ventilation. Strategies discussed to prevent BPD include using lower oxygen concentrations during resuscitation, applying continuous positive airway pressure, and avoiding overinflation and atelectrauma through gentle ventilation techniques. Future research is still needed to develop more evidence-based prevention and treatment approaches for BPD.
1) The document discusses the current management of occult bacteremia in infants presenting with fever without a source.
2) The prevalence of occult bacteremia has dramatically decreased in recent years due to conjugate vaccines for Streptococcus pneumoniae and Neisseria meningitidis.
3) Urinary tract infection is now the most common bacterial infection found in infants presenting with fever without a source.
RSV is a common virus that causes respiratory infections in children. It is spread through respiratory droplets. While RSV symptoms are usually mild, it can progress to bronchiolitis or pneumonia in some cases. Premature infants, those with chronic lung disease or congenital heart disease are at highest risk of severe RSV infection. RSV is the most common cause of bronchiolitis in children under 1 year of age and a major cause of hospitalization in infants. It poses a significant disease burden as it accounts for many emergency department visits, hospital admissions, and intensive care unit admissions in young children each year.
Neonatal sepsis is the cause of substantial morbidity and mortality. Precise estimates of neonatal sepsis burden vary by
setting. Differing estimates of disease burden have been reported from high-income countries compared with reports
from low-income and middle-income countries. The clinical manifestations range from subclinical infection to severe
manifestations of focal or systemic disease. The source of the pathogen might be attributed to an in-utero infection,
acquisition from maternal flora, or postnatal acquisition from the hospital or community. The timing of exposure,
inoculum size, immune status of the infant, and virulence of the causative agent influence the clinical expression of
neonatal sepsis. Immunological immaturity of the neonate might result in an impaired response to infectious agents.
This is especially evident in premature infants whose prolonged stays in hospital and need for invasive procedures
place them at increased risk for hospital-acquired infections. Clinically, there is often little difference between sepsis
that is caused by an identified pathogen and sepsis that is caused by an unknown pathogen. Culture-independent
diagnostics, the use of sepsis prediction scores, judicious antimicrobial use, and the development of preventive
measures including maternal vaccines are ongoing efforts designed to reduce the burden of neonatal sepsis
Austin Journal of Asthma: Open Access is an open access, peer reviewed, scholarly journal dedicated to publish articles covering all areas of Asthma.
The journal aims to promote latest information and provide a forum for doctors, researchers, physicians, and healthcare professionals to find most recent advances in the areas of Asthma. Austin Journal of Asthma: Open Access accepts research articles, reviews, mini reviews, case reports and rapid communication covering all aspects of Asthma.
Austin Journal of Asthma: Open Access strongly supports the scientific up gradation and fortification in related scientific research community by enhancing access to peer reviewed scientific literary works. Austin Publishing Group also brings universally peer reviewed journals under one roof thereby promoting knowledge sharing.
Ranitidine is associated with infections, necrotizing enterocolitisCMCH,Vellore
This study found that ranitidine use in very low birth weight newborns was associated with higher rates of infections, necrotizing enterocolitis (NEC), and mortality. Newborns treated with ranitidine had over 5 times higher risk of infections like sepsis and pneumonia compared to those not treated. Rates of NEC and mortality were also significantly higher in newborns receiving ranitidine. The study cautions against the use of ranitidine in preterm newborns due to these risks of severe infectious diseases and fatal outcomes.
Ranitidine is associated with infections, necrotizing enterocolitisCMCH,Vellore
This study found that the use of ranitidine in very low birth weight newborns was associated with higher rates of infections, necrotizing enterocolitis (NEC), longer hospital stays, and higher mortality. The study prospectively examined 274 newborns, 91 of which received ranitidine treatment. Newborns treated with ranitidine had over 5 times higher risk of infections like sepsis and pneumonia. They also had a higher risk of NEC and mortality. The results suggest ranitidine should be used cautiously in preterm infants due to these risks.
The document discusses various topics related to evaluating and managing febrile children, including:
1. Occult bacteremia is a potential cause of fever in young children, with a reported incidence of 1.9-5%. Common organisms include Streptococcus pneumoniae and Haemophilus influenzae.
2. Guidelines for evaluating febrile infants aged 0-3 months include the Philadelphia Protocol and Rochester Protocol, which aim to identify those at low risk of serious bacterial infection.
3. Fever in children with underlying illnesses requires consideration of infection risks specific to their condition, such as opportunistic infections in immunocompromised children.
4. Other conditions like Kawasaki syndrome
Community acquired pneumonia is a common illness in children worldwide. Children under 5 years old have the highest risk, and the most common causes are respiratory viruses and Streptococcus pneumoniae. Clinical features do not reliably distinguish between viral and bacterial pneumonia. Treatment involves antibiotics, with amoxicillin as first-line therapy. Complications include empyema, which presents with prolonged fever and evidence of pleural effusion. Hospitalization is required for severe cases or lack of response to outpatient treatment.
Abstract— Bronchial Asthma is a public health problem in childhood. Allergic Rhinitis (AR) is a very common co-morbidity with Bronchial Asthma. So this study was conducted on 250 Primary School Children to find prevalence of Bronchial asthma and Allergic Rhinitis and their association. It was observed from this study that 17.2% of children were having Bronchial asthma and 20.4% were found to have allergic Rhinitis. Co morbidity of Bronchial Asthma with Allergic Rhinitis was observed in 11.6 % of these cases. It was also observed that Bronchial Asthma was observed significantly more in males than females and children of walled city than outer city. So it was concluded form this study that chances of occurring Allergic Rhinitis is significantly more with Bronchial Asthma than the chances of Bronchial Asthma with Allergic Rhinitis
1) The study evaluated the efficacy, safety, and immunogenicity of the RTS,S/AS01 malaria vaccine in young infants and children across 11 sites in Africa.
2) The vaccine provided protection against clinical and severe malaria in children aged 5-17 months, with efficacy of 40-46% against clinical malaria. Efficacy was lower in young infants at 27%.
3) Vaccine efficacy waned over time in both children and infants. Safety profiles were similar between vaccine and control groups.
This study examined 279 children with severe acute otitis media (AOM) to compare laboratory findings between pneumococcal and non-pneumococcal infections. White blood cell (WBC) counts and C-reactive protein (CRP) levels were significantly higher in pneumococcal AOM episodes. WBC counts were also higher in unimmunized children compared to those immunized with pneumococcal conjugate vaccines. However, differences in CRP levels were minor. While WBC counts reflected changes in pneumococcal strains from vaccination, CRP levels and clinical presentation did not. This suggests WBC may help identify pneumococcal infections, while CRP is less useful.
Neonatal Sepsis by dr Hesham Tawakol, Consultant Neonatologist at Corniche Ho...mohamed osama hussein
This document discusses neonatal sepsis and the prevention of healthcare-associated infections. It begins with an overview of neonatal sepsis, including definitions, epidemiology, risk factors, clinical presentation, diagnosis, and treatment. Drug resistance is a growing problem. To prevent healthcare-associated infections, transmission must be reduced through proper hand hygiene and infection control practices like cleaning equipment. Compliance with hand hygiene is challenging but critical for patient safety.
This document discusses early onset neonatal sepsis, including definitions, epidemiology, microbiology, risk factors, clinical presentation, evaluation, management, and questions/controversies. Some key points:
- Early onset sepsis occurs within the first 7 days of life and is usually caused by vertical transmission of bacteria from the maternal GI/GU tract. Streptococcus agalactiae (GBS) and Escherichia coli are the most common causes.
- Evaluation involves a sepsis screen including CRP, leukocyte count, blood culture. CRP is elevated in sepsis but also other conditions. A positive blood culture establishes the diagnosis.
- Management consists of supportive care, antimicrobial therapy based on likely pathogens
New Vaccines in the immediate pipeline - Slideset by Professor Susanna EspositoWAidid
Slideset by Professor Esposito on: Vaccines for adolescents/young adults/children; Maternal vaccines; Vaccines for the tropics.
It shows how several new vaccines will be available in the future with different targets and underlines the importance of better information and communication, that are keys to relevant use of vaccines.
- The risk of anaphylaxis following vaccination is rare, affecting less than 1 in 100,000 people. However, it can occur in any patient.
- A retrospective study found that only 3 of 135 patients who experienced allergic-like events after vaccination were referred for suspected anaphylaxis, suggesting that guidelines may overestimate the risk.
- Most allergic-like events that occur more than 1 hour after vaccination are not likely IgE-mediated reactions and should not be managed as such. Skin testing in these patients can be misleading.
- Allergic rhinitis is a common condition affecting 10-15% of children and 26% of adults in the UK. Topical nasal corticosteroids are the first-line treatment for moderate to severe disease.
- Non-allergic rhinitis is a heterogeneous group of conditions that can present with similar symptoms to allergic rhinitis but without evidence of allergen sensitization. Triggers include medications, hormones, irritants and changes in temperature or humidity. Treatment depends on the underlying cause and may include nasal irrigation, antihistamines, decongestants or anti-inflammatory therapy.
- Low vitamin D levels and reduced expression of the vitamin D receptor on dendritic cells have been associated
This document summarizes several studies on factors related to bronchopulmonary dysplasia (BPD) in preterm infants. One study found that maternal smoking during pregnancy doubled the odds of BPD in infants, and was also associated with prolonged ventilation and late respiratory disease. Another study found that endothelial cell dysfunction in umbilical vein cells was associated with BPD or death in extremely preterm infants. A third study found that infants treated with caffeine in the neonatal period had better lung function at 11 years of age compared to placebo, mediated by caffeine's ability to reduce rates of BPD.
The document presents guidelines from the European Respiratory Society on diagnosing and managing obstructive sleep disordered breathing in children aged 1-23 months. It recommends a stepwise approach beginning with identifying symptoms and risk factors, followed by objective sleep studies to determine severity if indicated. Treatment may include adenotonsillectomy, continuous positive airway pressure, or interventions for specific conditions causing airway obstruction. Management requires a multidisciplinary approach and treatment of all contributing factors to reduce upper airway obstruction during sleep.
This study analyzed the long-term outcomes of 119 children diagnosed prenatally with congenital cystic lung lesions. 43% of children (51/119) underwent surgical management, with most surgeries occurring in the neonatal period or due to concerning CT scan findings. The remaining 57% were managed non-surgically. No cases of malignancy were reported after a minimum 5-year follow-up for all patients, suggesting conservative management may be appropriate for select cases of prenatally diagnosed congenital cystic lung lesions.
The study measured intrathoracic pressures during various abdominal thrust maneuvers used to relieve choking. It found that chair thrusts, where the subject pushes their upper abdomen against a chair back, produced higher pressures than other maneuvers like Heimlich or self-administered thrusts. Both chair thrusts and other maneuvers should be included in basic life support training.
Lower respiratory tract infections before age 3 are associated with reduced lung function at age 10, including lower FEV1, FVC, FEV1/FVC and FEF75. Children with lower respiratory tract infections before age 3 also have an increased risk of physician-diagnosed asthma at age 10 (OR 1.79). While lower respiratory tract infections between ages 3-6 increase the odds of asthma diagnosis at age 10 (OR 3.53), they are not associated with reductions in lung function. Early life respiratory tract infections can influence both later asthma risk and lung development.
This study examined 102 children under 16 years old with chronic prurigo lasting over 6 weeks. Skin prick tests and patch tests were performed for common environmental allergens like dust mites, mosquitoes, and pets. Three clinical patterns were identified: atopic perennial prurigo showed lesions on wrists/ankles and was linked to dust mite sensitivity; summer prurigo showed facial lesions and was linked to mosquito sensitivity; non-summer prurigo showed linear lesions or vesicles and was linked to bedbugs or fleas. Patch tests had higher sensitivity than immediate skin prick tests for dust mites, while delayed skin prick tests at 48 hours had higher sensitivity than patch tests for mosquitoes.
1) Several studies reviewed found that allergen immunotherapy (AIT) can improve symptoms, medication use, and quality of life for patients with allergic asthma and rhinoconjunctivitis.
2) Subcutaneous immunotherapy was more effective than sublingual immunotherapy at improving quality of life and decreasing allergen-specific airway hyperactivity for asthma.
3) The evidence suggests AIT may help prevent new allergen sensitizations, though more high-quality studies are still needed to better determine its efficacy in preventing new sensitizations.
This document discusses drug allergies, specifically severe cutaneous adverse reactions. It summarizes several research articles on topics like optimal drug provocation test dosages, the importance of prolonged provocation testing, oral challenges without skin tests to diagnose beta-lactam hypersensitivity, and how positive skin tests or IgE levels do not reliably predict penicillin allergy on their own but the combination may be a better predictor. It also discusses establishing an inpatient penicillin allergy testing service to help correctly diagnose patients and reduce unnecessary alternative antibiotic use.
- A study examined sensitization to Staphylococcus aureus enterotoxins (SEs) in 868 adolescents. 41.7% were sensitized to at least one food or inhalant allergen, while 26.2% were sensitized to at least one SE.
- SE sensitization was associated with polysensitization to food and inhalant allergens as well as allergic multimorbidity. SE-sensitized adolescents had higher IgE levels to inhalant allergens.
- S. aureus carriage alone was not associated with polysensitization when excluding SE-sensitized adolescents, indicating SE sensitization may be more influential than carriage. Sensitization to SE
What is new in general pediatrics, allergic and respiratory diseasesEnvicon Medical Srl
The document discusses several studies related to general pediatrics, allergic and respiratory diseases from 2017.
One study found that early-term deliveries between 37-38 weeks gestation were associated with increased risk of long-term respiratory morbidity compared to full-term deliveries between 39-40 weeks. Another study showed that preschoolers with bedtimes before 8pm had a lower risk of adolescent obesity than those with later bedtimes. A third study found that high school start times later than 8:30am were associated with improved attendance and graduation rates.
This document discusses the use of vitamin D in preventing and treating non-bone diseases. It begins with an introduction and covers topics like immunomodulation related to allergy, fetal development, and the prevention and modification of diseases like asthma, COPD, allergic rhinitis, atopic dermatitis, and food allergy. It also briefly mentions autoimmunity and other diseases. The document provides information on vitamin D synthesis and metabolism and cites several studies on vitamin D levels in different populations and its effects. It concludes with a discussion of vitamin D's immunomodulatory effects in relation to allergy.
Systemic steroids in preschool children with recurrent wheezing exacerbationsEnvicon Medical Srl
Oral corticosteroids are commonly prescribed for preschool children experiencing wheezing exacerbations, however their efficacy in this age group is unclear. A recent meta-analysis of 11 clinical trials found no significant difference in hospitalization rates between oral corticosteroid and placebo groups overall. However, outpatient studies showed higher hospitalization with corticosteroids, while emergency department studies showed lower rates. Additional corticosteroid courses were less likely with corticosteroid treatment based on two inpatient studies. The efficacy of oral corticosteroids appears to depend on the treatment setting for preschool wheezing exacerbations.
This document discusses fish allergy, including its rising prevalence globally due to increased fish consumption. Fish allergies can be serious and life-threatening, as reactions are often caused by immune-mediated or toxic/parasitic mechanisms. Prevalence rates vary significantly between regions and populations, ranging from 0.2-8% depending on location, fish species exposure, and occupation. The major fish allergen identified is parvalbumin, though other allergens are still being discovered. The review discusses demographics, novel allergens, immunological mechanisms, and approaches for diagnosing and managing fish allergy.
Recurrent aphthous stomatitis (RAS) is the most common oral ulcerative condition, affecting 1 in 5 individuals. It is classified into minor, major, and herpetiform ulcers, with minor ulcers being the most common. The pathogenesis involves an abnormal T-cell mediated immune reaction, though the exact cause is unknown. Certain factors like nutritional deficiencies, infections, genetics, and trauma may contribute to disease development or severity. RAS is diagnosed based on clinical examination and history. Treatment involves managing pain and preventing infections, with some evidence that vitamin B12 supplementation may help resolve ulcers.
The document discusses the role of pediatricians in preventing chronic noncommunicable diseases. It outlines several factors that can impact childhood health and development with long-term consequences, including maternal smoking during pregnancy, preterm birth, maternal obesity, and environmental exposures. Maternal smoking during pregnancy is associated with increased risks of preterm birth, asthma, cardiovascular issues, and neurological and behavioral problems in children. Both undernutrition and overnutrition during pregnancy can also influence the health of offspring and increase risks of chronic diseases later in life. The document emphasizes the importance of pediatricians educating parents about modifiable risk factors and promoting healthy prenatal environments and lifestyles to reduce the future disease burden from noncommunicable diseases.
This document discusses seafood allergies and adverse reactions. It begins with an introduction and overview of seafood classification. It then covers seafood allergy epidemiology and allergens such as parvalbumin. Various studies are summarized that examine parvalbumin content and cross-reactivity between different fish species. The document concludes with notes that heating processes can impact allergens while raw fish collagen in particular can induce sensitization. Not all reported seafood sensitivities constitute a true IgE-mediated allergy.
This document discusses different types of adverse reactions that can occur after eating seafood and may be misdiagnosed as seafood allergy. It describes immune-mediated allergic reactions as well as nonimmunologic reactions that can have similar symptoms. Some examples of non-allergic reactions discussed are reactions to contaminants like parasites, toxins produced by bacteria, or infectious agents. Proper handling and cooking of seafood can help prevent issues caused by contaminants. The diagnosis of a seafood allergy requires consideration of symptoms, allergy testing, and potentially an oral food challenge with the suspected seafood.
Epinephrine auto-injectors have different needle lengths that vary based on the manufacturer and dose. The ideal needle length depends on factors like BMI, obesity, and proper injection technique. Needles that are too short may not allow intramuscular delivery in some obese patients. However, needles that are too long could cause pain or intraosseous injection. Compression of tissues during injection and the propulsion force helps deliver the drug beyond the needle tip. Using the device with an appropriate needle length for each patient's characteristics can improve outcomes during anaphylaxis.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
6. Cigarette Smoke Alters Respiratory Syncytial Virus–Induced Apoptosis and Replication Groskreutz Am J Respir Cell Mol Biol 2009;41:189 Exposed to cigarette smoke extract for 2 days Primary airway epithelial cells Followed by 1 day of RSV exposure Less apoptosis when cells were treated with cigarette smoke before viral infection. Viral load was increased.
7. Cigarette Smoke Alters Respiratory Syncytial Virus–Induced Apoptosis and Replication Groskreutz Am J Respir Cell Mol Biol 2009;41:189 Exposed to cigarette smoke extract for 2 days Primary airway epithelial cells Followed by 1 day of RSV exposure Less apoptosis when cells were treated with cigarette smoke before viral infection. Viral load was increased. Cigarette smoke causes necrosis rather than apoptosis in viral infection, resulting in increased inflammation and enhanced viral replication.
8. Cytokine responses in cord blood predict the severity of later respiratory syncytial virus infection Juntti JACI 2009;124:52 Background: It has been claimed that an early respiratory syncytial virus (RSV) infection can induce asthma and recurrent wheezing. Objective: We addressed the question of whether infants contracting an early RSV infection differ from healthy children in their cytokine production at birth.
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12. Surfactant protein A (SP-A) is now recognized as a pattern recognition receptor functioning as a component of the innate immune system . The human SP-A gene locus consists of 2 functional genes, SP-A1 and SP-A2. Both SP-A loci are polymorphic, with several single-nucleotide polymorphisms (SNPs) Surfactant Protein A2 Polymorphisms and Disease Severity in a Respiratory Syncytial Virus-Infected Population Saleeby J Pediatr 2010;156:409
26. LDH Concentration in Nasal-Wash Fluid as a Biochemical Predictor of Bronchiolitis Severity Laham Pediatrics 2010;125:e225 OBJECTIVE: Because the decision to hospitalize an infant with bronchiolitis is often supported by subjective criteria and objective indicators of bronchiolitis severity are lacking, we tested the hypothesis that lactate dehydrogenase (LDH), which is released from injured cells , is a useful biochemical indicator of bronchiolitis severity.
32. Bronchiolitis: Recent Evidence on Diagnosis and Management Zorc Pediatrics 2010;125:342 Summary of Recent Evidence for Therapies Used for Bronchiolitis
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34. Hypertonic saline or high volume normal saline for viral bronchiolitis: Mechanisms and rationale Mandelberg, Ped Pul 2010;45:36 Efficient clearance requires the coordinated interaction of two separate layers: an overlying transported mucus layer (ML) and a separate, distinct environment near the cell surface called periciliary liquid (PCL).
35. Hypertonic saline or high volume normal saline for viral bronchiolitis: Mechanisms and rationale Mandelberg, Ped Pul 2010;45:36 Maintaining normal height of the PCL (around 7 ц m) is crucial for maintaining normal airway mucociliary clearance (MCC) so that the moving tips of the cilia will precisely contact the lower margin of the ML. periciliary liquid ≈ 7 ц m
36. Hypertonic saline or high volume normal saline for viral bronchiolitis: Mechanisms and rationale Mandelberg, Ped Pul 2010;45:36 Dehydration of the airway surface liquid occurs in response to a relatively mild RSV infection. The ML then donates water to preserve at least some Mucus clearance while maintaining the PCL height close to the normal approximately 7 ц m and resulting in Mucus layer dehydration. H 2 O
37. When this donor mechanism is exhausted, the ML has no more water to donate, the PCL may start to contract to the poin that MCC is impossible. Hypertonic saline or high volume normal saline for viral bronchiolitis: Mechanisms and rationale Mandelberg, Ped Pul 2010;45:36 H 2 O X
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39. High volume normal saline alone is as effective as nebulized salbutamol-normal saline, epinephrine-normal saline, and 3% saline in mild bronchiolitis Anil, Ped Pul 2010;45:41 Clinical Severity Scores Wang E, Milner R, Navas J, Maj H. Observe agreement for respiratory signs and oxymetry in infants hospitalized with lower respiratory infections. Am Rev Respir Dis 1992;145:106–109.
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43. Epinephrine and Dexamethasone in Children with Bronchiolitis Amy C. Plint, N Engl J Med 2009;360:2079 Frequency and Relative Risk of Hospital Admission on the Day of the Initial Emergency Department Visit, by Day 7, and by Day 22.
44. Epinephrine and Dexamethasone in Children with Bronchiolitis Amy C. Plint, N Engl J Med 2009;360:2079 Cumulative Admissions during the First 7 Days after the Initial Emergency Department Visit, According to Study Group. Enrollment data represent all patients admitted at their initial visit to the Emergency department, and data for day 1 represent patients admitted within 24 hours of this visit.
45. % pts admitted to the hospital by day 7 30 – 20 – 10 – 0 P=0.02 RR = 0.65 26.4% 25.6% 23.7% 17.1% epinephrine–dexamethasone epinephrine group dexamethasone group placebo group Epinephrine and Dexamethasone in Children with Bronchiolitis Amy C. Plint, N Engl J Med 2009;360:2079
46. Epinephrine and Dexamethasone in Children with Bronchiolitis Amy C. Plint, N Engl J Med 2009;360:2079 Median Days to Symptom Resolution, with Ratio to Placebo Value.
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48. Given the small effect size of the study — 11 infants would have to be treated to prevent one hospital admission — it does not seem practical to apply the treatment, especially considering the potential effects of high-dose corticosteroids on brain and lung development in such young children. What is the best way to treat wheezing in a preschooler? The Challenge of Managing Wheezing in Infants Editorial Urs Frey N Engl J Med 2009;360:2130
49. “… Although it is essential during the first episode to provide supportive care — including supplemental oxygen, hydration, nutrition, and short-term bronchodilation — the key intervention is close follow-up . We need to assess risk factors and symptom history and make sure that we identify and treat children with unremitting wheezing. In these children, particularly those presenting with signs of atopy, maintenance treatment can be initiated with inhaled corticosteroids , administered through an appropriate spacer, or with leukotriene-receptor antagonists.” The Challenge of Managing Wheezing in Infants Editorial Urs Frey N Engl J Med 2009;360:2130
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52. HOME OXYGEN FOR CHILDREN WITH ACUTE BRONCHIOLITIS Tie Arch Dis Child 2009;94:641
60. Eosinophil activity in infants hospitalized for wheezing and risk of persistent childhood asthma Hyvärinen Pediatr Allergy Immunol 2010:21:96 Blood eosinophils (B-EOS), serum eosinophil cationic protein (S-ECP) and nasopharyngeal ECP (NPA-ECP) measured during acute wheezing in infancy, in relation to Persistent Childhood Asthma (PCA) .
61. Recurrent wheezing after respiratory syncytial virus or non-respiratory syncytial virus bronchiolitis in infancy: a 3-year follow-up. Valkonen Allergy 2009:64:1359 Background: Recent studies have suggested that rhinovirus -associated early wheezing is a greater risk factor for development of recurrent wheezing in children than is early wheezing associated with respiratory syncytial virus (RSV). We determined the development of recurrent wheezing in young children within 3 years after hospitalization for RSV or non-RSV bronchiolitis.
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75. Breakdown of ages of the population completing the questionnaire. There was no specific dominant age group. Probable diagnosis of medical condition responsible for chronic cough in 8,546 patients completing the Cough Clinic questionnaire. The online Cough Clinic: developing guideline-based diagnosis and advice . Dettmar ERJ 2009:34:819
76. Cough in the Pediatric Population Goldsobel J Pediatr 2010;156:352
77. Cough in the Pediatric Population Goldsobel J Pediatr 2010;156:352 Algorithm for evaluating chronic cough in children
78. Cough in the Pediatric Population Goldsobel J Pediatr 2010;156:352 Algorithm for evaluating specific chronic cough in children
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81. Background: Chronic cough is common, and medical treatment can be ineffective. Mindfulness is a psychological intervention that aims to teach moment-to-moment non-judgemental awareness of thoughts, feelings and sensations and has proven effective in the management of several chronic disease states including chronic pain, depression, fibromyalgia and psoriasis. Mindfulness training is classically led by experts and practised in group sessions over an 8- to 10-week period with regular homework activities to encourage integration of the coping strategies into everyday life. The effect of mindfulness meditation on cough reflex sensitivity Young Thorax 2009; 64: 993-998
101. 2.4 UNMARIED MOTHER >3 SIBLING NO PRENATAL CARE MATERNAL ALCOOL MATERNAL TOBACCO OR FOR DEATH 5 – 4 – 3 – 2 – 1 – 0 2 4.7 1.9 2.1 Risk Factors for Lower Respiratory Tract Infection Death Among Infants in the United States, 1999-2004 Singleton Pediatrics 2009;124;e768
102. Severity of Pneumococcal Pneumonia Associated With Genomic Bacterial Load Rello Chest 2009;136:832 Background : There is a clinical need for more objective methods of identifying patients at risk for septic shock and poorer outcomes among those with community-acquired pneumonia (CAP). As viral load is useful in viral infections, we hypothesized that bacterial load may be associated with outcomes in patients with pneumococcal pneumonia.
114. Clinical Predictors of Pneumonia Among Children With Wheezing Bonnie Pediatrics 2009; 124:1 OR FOR PNEUMONIA 1.39 OXIGEN SATURATION ≤92% FEVER AT HOME ABDOMINAL PAIN 5 – 4 – 3 – 2 – 1 – 0 3.06 1.92 2.85 TEMPERATURE IN THE ED ≥ 38°C
159. MRSA as a cause of lung infection including airway infection, community-acquired pneumonia and hospital-acquired pneumonia Defres ERJ 2009:34:1470 Some of the virulence determinants of Staphylococcus aureus . TSST: toxic shock syndrome toxin.
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161. MRSA as a cause of lung infection including airway infection, community-acquired pneumonia and hospital-acquired pneumonia Defres ERJ 2009:34:1470 Initially, MRSA was exclusively associated with acquisition from hospitals and other healthcare settings. However, in the late 1990s true CA-MRSA was identified as the cause of severe and fatal infections occurring in clusters of previously healthy children in North America, who had no identifiable associations with healthcare settings. Cases of CA-MRSA causing skin and soft tissue infections and necrotising pneumonia have since been widely reported in otherwise healthy individuals.
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164. MRSA as a cause of lung infection including airway infection, community-acquired pneumonia and hospital-acquired pneumonia Defres ERJ 2009:34:1470 Healthcare-associated pneumonia HCAP, has been defined as pneumonia occurring in any patient who had: been admitted to an acute care hospital for ≥2 days within 90 days of the infection; been a resident in a nursing home or long-term care facility (LTCF); attended a hospital or haemodialysis clinic; or received recent intravenous antibiotic therapy, chemotherapy or wound care within the 30 days prior to the current infection.
165. MRSA as a cause of lung infection including airway infection, community-acquired pneumonia and hospital-acquired pneumonia Defres ERJ 2009:34:1470 In the European setting, S. aureus remains an unusual primary cause of community-acquired pneumonia (CAP), although it is an important cause of pneumonia and death following influenza.
166. MRSA as a cause of lung infection including airway infection, community-acquired pneumonia and hospital-acquired pneumonia Defres ERJ 2009:34:1470 HAP and VAP Until recently S. aureus accounted for ≈ 1–5% of CAP cases and ≈10–15% of HAP cases, but over the past 10–20 yrs there has been important changes in the epidemiology of Staphylococcal pneumonia . First, there has been a dramatic increase in the proportion of S. aureus infections due to MRSA, which is now responsible for >50% of all S. aureus infections in some intensive care units (ICUs).
167. MRSA as a cause of lung infection including airway infection, community-acquired pneumonia and hospital-acquired pneumonia Defres ERJ 2009:34:1470 HAP and VAP HAP requires the entry of microbial pathogens into the lower respiratory tract followed by colonisation which, if the body's defences are overwhelmed, leads to overt infection. Factors such as the severity of the patient's underlying disease, prior surgery, exposure to antibiotics, other medications, and exposure to invasive respiratory devices and equipment are important in the pathogenesis of HAP and VAP.
168. MRSA as a cause of lung infection including airway infection, community-acquired pneumonia and hospital-acquired pneumonia Defres ERJ 2009:34:1470 HAP and VAP HAP requires the entry of microbial pathogens into the lower respiratory tract followed by colonisation which, if the body's defences are overwhelmed, leads to overt infection. Factors such as the severity of the patient's underlying disease, prior surgery, exposure to antibiotics, other medications, and exposure to invasive respiratory devices and equipment are important in the pathogenesis of HAP and VAP. Early-onset disease, defined as within 4 days of hospitalisation, has a better prognosis and is more likely to be caused by antibiotic-sensitive bacteria.
169. MRSA as a cause of lung infection including airway infection, community-acquired pneumonia and hospital-acquired pneumonia Defres ERJ 2009:34:1470 HAP and VAP A prospective study comparing VAP outcome by causative pathogen demonstrated that, in patients who received appropriate initial antimicrobial therapy, cases due to MRSA still had a significantly slower clinical resolution than those due to other pathogens. Resolution of fever and hypoxia within 72 h occurred in only 30% of MRSA VAP cases, compared to 93.3% of methicilin-sensitive S. aureus (MSSA) VAP cases, 100% due to H. influenzae and 73% due to Pseudomonas aeruginosa . Vidaur L. Eur Respir Rev 2007;16:31–32
170. MRSA as a cause of lung infection including airway infection, community-acquired pneumonia and hospital-acquired pneumonia Defres ERJ 2009:34:1470 A new form of CAP There has been an emergence of CA-MRSA CAP being reported on both sides of the Atlantic. Although CA-MRSA is primarily a cause of skin and soft tissue infections, it can also cause severe necrotising pneumonia. Characteristics of CA-MRSA CAP often frequently occur in young previously healthy adults, up to 75% of cases, with a preceding flu-like illness. Sufferers rapidly develop severe respiratory symptoms, often including haemoptysis, hypotension and a high fever. Characteristically, leukopenia occurs and C-reactive protein is elevated (>350 g·L –1 ). CXR findings of multilobar cavitating alveolar infiltration are also consistent with CA-MRSA.
171. MRSA as a cause of lung infection including airway infection, community-acquired pneumonia and hospital-acquired pneumonia Defres ERJ 2009:34:1470 when to suspect CA-MRSA in community-acquired pneumonia When to suspect CA-MRSA Influenza-like prodrome Severe respiratory symptoms with a rapidly progressive pneumonia evolving to acute respiratory distress syndrome Fever >39°C Haemoptysis Hypotension Leukopenia Chest radiograph showing multilobar infiltrates which may have cavitated Known to be colonised with CA-MRSA or recent travel to an endemic area, such as North America, and recent contact with CA-MRSA Belong to a group associated with increased rates of colonisation of CA-MRSA Previous history or family history of recurrent furuncles or skin abscesses (two or more in past 6 months) CA-MRSA: community-acquired methicillin-resistant Staphylococcus aureus . Nathwani J Antimicrob Chem 2008;61:976
172. MRSA as a cause of lung infection including airway infection, community-acquired pneumonia and hospital-acquired pneumonia Defres ERJ 2009:34:1470
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175. MRSA as a cause of lung infection including airway infection, community-acquired pneumonia and hospital-acquired pneumonia Defres ERJ 2009:34:1470 INVESTIGATIONS FOR STAPHYLOCOCCAL PNEUMONIA Molecular techniques Novel laboratory techniques, including microarrays to detect PVL and possibly other staphylococcal toxins or superantigens, may aid in the diagnosis of CA-MRSA pneumonia. These microarrays can reveal if the isolates are harbouring the genes for several toxins including PVL and leukocidin, which have been linked with pulmonary disease and have been associated with CA-MRSA isolates. Also under investigation and development are molecular-based rapid tests to detect PVL, mec A and SCC mec type IV.
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178. MRSA as a cause of lung infection including airway infection, community-acquired pneumonia and hospital-acquired pneumonia Defres ERJ 2009:34:1470 Necrotising pneumonia on A ) a chest radiograph and B ) a computed tomography (CT) scan obtained on day 3. The CT scan shows multiple bilateral nodular and cavity lesions.
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181. The survival time up to 72 hours analyzed for the different groups Pathology score according to the different AMT received by the piglets. AMT= antimicrobial therapy MV= mechanical ventilation Effect of Linezolid Compared With Glycopeptides (Vancomycin, Teicoplanin) in Methicillin-Resistant Staphylococcus aureus Severe Pneumonia in Piglets Luna Chest 2009;135:1564