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Query: UMLS:C0032285 (pneumonia)
 54,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The use of the indicator "years of potential life lost" (YPLL) highlights the extent to which premature mortality in Puerto Rico is a predominantly male phenomenon. While men accounted for 58.6% of all deaths in 1987, they represented fully 71.8% of all YPLL attributed to the thirteen leading causes of death. The breakdown of YPLL by gender also underlines sex-specific differences in the causes of mortality. While accidents constitute the leading cause of premature death among men, malignant neoplasms take the lead among women. Similarly, homicides and cirrhosis are significant sources of years of life lost among males, while pneumonia/influenza and diabetes are higher priorities among females. These findings suggest that health promotion strategies need to be gender-specific in order to reach the right targets.
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PMID:The death divide: differentials in premature mortality by gender in Puerto Rico. 150 82

The oral cavity is responsible for two essential functions: the production of speech and the initiation of alimentation. All of the specialized oral tissues and sensory systems that allow for the execution of these functions are susceptible to age-, disease-, and treatment-related changes, and alterations in any one or more function may result in deleterious consequences to the host and impact on the quality of life. Oral physiology is generally believed to be age-stable in healthy individuals; however, in the presence of single or multiple medical diseases and their treatment, these functions deteriorate. This article focuses on the influence of common geriatric diseases, disorders, and impairments on oral health and function. Data are presented to suggest that oral health is altered in the presence of heart, cerebrovascular, liver, and renal diseases, cancer, COPD, diabetes, pneumonia, and influenza. Arthritic, hearing, visual, orthopedic, and speech impairments multiple medical problems. Finally, adjustments in treatment and management strategies may be necessary for older patients with these diseases and impairments.
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PMID:Oral sequelae of common geriatric diseases, disorders, and impairments. 150 40

Different proteases from various microorganisms present in the respiratory tract were capable of enhancing influenza virus infectivity and pathogenicity in mice by proteolytic activation of hemagglutinin (HA). Aerococcus viridans, isolated from a patient with pneumonia, secreted a protease that could activate HA directly, similarly to some Staphylococcus aureus strains. The protease of Pseudomonas aeruginosa could not activate HA directly, but combined application of P. aeruginosa protease and virus into mice enhanced virus titers and pathogenicity. Generation of trypsin-like activity in bronchoalveolar lavage fluids resulting from this combination treatment may be responsible for HA activation. A similar indirect effect on HA activation was induced by streptokinase and staphylokinase, which are known to generate plasmin by plasminogen activation. It was concluded that plasminogen-activating streptococci and staphylococci facilitate viral replication and pathogenicity of plasmin-sensitive influenza virus strains by amplification of the plasminogen/plasmin system.
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PMID:Interactions between bacteria and influenza A virus in the development of influenza pneumonia. 152 12

Acute inflammatory processes are extremely complex, containing sets of activated cells that may be difficult to categorize. The interface between two methodologies for characterizing the involvement of gamma delta T cells, in situ hybridization to detect T cell receptor (TCR) mRNA and flow cytometric analysis of surface TCR expression, is utilized here to study the pneumonia caused by intranasal (i.n.) infection of mice with influenza A viruses. Substantial numbers of cells expressing mRNA for the gamma and delta TCR chains are present in bronchoalveolar lavage (BAL) populations obtained either late in the course of primary infection with an H3N2 virus or within a few days of secondary challenge with an H1N1 virus. The majority of the gamma delta TCR mRNA+ cells detected in FACS-separated BAL populations partition to the Thy1+ gamma delta TCR+ subset, while relatively few (less than 10%) C delta mRNA transcripts are found in cells that phagocytose latex particles. However, an additional set of gamma delta TCR mRNA+ cells is also located in a high side scatter (H-SSC) population, which stains nonspecifically with monoclonal antibodies (mAbs) and is normally gated out in the process of flow cytometric analysis. This H-SSC population tends to be enriched for cells expressing C gamma 1/2 rather than C gamma 4 mRNA. While some gamma delta TCR+ lymphocytes can be demonstrated by in vitro stimulation of the CD3 epsilon+ subset within this H-SSC population, the majority of the gamma delta T cell precursors that can be expanded in culture demonstrate a low side scatter (L-SSC) profile more characteristic of normal T lymphocytes. The possibility that subsets of activated, granular (H-SSC) alpha beta TCR+ and C gamma 1/2 mRNA+ gamma delta T cells are being missed when conventional FACS analysis is used to study this viral pneumonia is discussed.
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PMID:Analyzing the distribution of cells expressing mRNA for T cell receptor gamma and delta chains in a virus-induced inflammatory process. 153 34

The clinical course of Influenza type A virus infections in 47 hospitalized children aged 0-9 years was assessed retrospectively. The infection was diagnosed by demonstration of the virus in the nasopharyngeal secretion during the acute phase of the illness. Out of 21 Influenza A strains in which the subtype was determined, one was found to be H1- and 20 were H3-subtype. Lower respiratory tract disease was the main diagnosis in 21 children, 16 of whom had pneumonia; 14 of these patients were under three years of age. Gastro-intestinal symptoms occurred in 40% of the children over three years of age. Eight patients had febrile convulsions, a girl aged nine years had double vision and vertigo and a female infant aged two months had periodic apnoea and bradycardia. The reasons for hospitalization were febrile convulsions, abdominal pain, lower respiratory tract symptoms and high pyrexia.
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PMID:[Varying clinical pictures among young children with influenza virus type A infections]. 153 90

Cigarette smoking has significant detrimental effects on both the structure and function of the lung; it is the single most important risk factor for the development of COPD. Uncertainty remains concerning the mechanisms by which smokers develop obstructive lung disease. It is speculated, however, that an imbalance between proteolytic and antiproteolytic forces in the lung or an increase in heightened airways responsiveness is responsible. Population-based studies have documented lower levels of FEV1, accelerated loss of ventilatory function, and increased respiratory symptoms and infections among smokers compared with nonsmokers. Data from both prospective and retrospective studies have consistently shown increased mortality from COPD, pneumonia, and influenza among cigarette smokers compared with nonsmokers.
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PMID:The health consequences of cigarette smoking. Pulmonary diseases. 154 66

To investigate the role of CD8+ T lymphocytes in recovery from influenza pneumonia, we used transgenic mice either homozygous (-/-) or heterozygous (+/-) for beta 2-microglobulin (beta 2-M) gene disruption. These mice lack major histocompatibility complex-restricted class I (CD8+) T cells. We found that after challenge with a nonlethal influenza virus, the beta 2-M (-/-) mice had significantly delayed pulmonary viral clearance. Furthermore, after challenge with a more virulent influenza virus, the beta 2-M (-/-) mice had a significantly higher mortality rate than did control mice. Thus, CD8+ T cells are important in recovery from virulent influenza infections, but other host defense mechanisms can clear the respiratory tract of more benign infections.
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PMID:Transgenic mice lacking class I major histocompatibility complex-restricted T cells have delayed viral clearance and increased mortality after influenza virus challenge. 155 85

The purpose of this study was to determine the microbial etiology of pneumonia by using strict criteria among a group of hospitalized patients. Patients with acute community-acquired or hospital-acquired pneumonia were studied in a systematic and comprehensive manner for bacterial, viral, chlamydial, mycobacterial, and fungal pathogens. A total of 198 patients with 204 episodes of pneumonia were evaluated. Despite 100 percent follow-up of all surviving patients, a specific etiologic agent could be found in only 103 episodes. Among 154 episodes of community-acquired pneumonia, a diagnosis was made in 79; the most common pathogen was from the genus Legionella, followed by various Gram-negative enteric bacteria, Gram-positive cocci, influenza A virus, and Mycoplasma pneumoniae. The etiologic agent was found in 24 of the 50 patients with hospital-acquired pneumonia; no pathogen predominated. We conclude that even when elaborate diagnostic studies are done, including many invasive procedures, the etiology can be determined in only about half of the patients with acute pneumonia. The pathogens of pneumonia in this study are not markedly different between community-acquired and hospital-acquired infection.
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PMID:Microbial etiology of acute pneumonia in hospitalized patients. 832 73

Significant levels of older-adult mortality and morbidity are associated with vaccine-preventable diseases, specifically influenza and pneumococcal disease. Even though current guidelines for this age group recommend a single vaccination against pneumococcal pneumonia, an annual influenza vaccination and a combined tetanus-diphtheria toxoid booster every 10 years after completion of a primary series, immunization levels remain extremely low. This article presents information regarding usage, efficacy and cost-effectiveness of these vaccines. Physician non-compliance and misinformation, negative patient attitudes and a shortage of effective programs for vaccine delivery account for vaccine underutilization. Recommendations from health care providers significantly affect whether a person will be immunized. Increased vaccine usage was noted in clinic-based programs that initiated organizational or administrative interventions, such as patient and physician reminders, physician-performance feedback, medical-record checklists and the use of non-physician health care staff to monitor patient vaccination status and to dispense vaccines. Providing organized education and vaccination programs in institutional and public settings may also help target the older-adult population. The future success of adult immunization will depend not only on increased professional and public awareness but also on the development of new approaches to vaccine delivery.
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PMID:Recommendations, usage and efficacy of immunizations for the elderly. 156 2

During the 11 influenza seasons from 1977 through 1988, more than 10,000 excess deaths attributed to pneumonia and influenza (P&I) were reported during each of seven seasons, and approximately 45,000 deaths were reported during each of two seasons (CDC, unpublished data, 1992). The most important strategy for preventing influenza-associated morbidity and mortality is vaccination of persons in high-risk groups with vaccine closely matched to circulating strains. In collaboration with state and local health departments, CDC conducts surveillance to monitor influenza activity and to detect antigenic changes in the circulating strains of influenza virus. This report summarizes surveillance for influenza in the United States and worldwide during the 1991-92 season and describes the composition of the 1992-93 influenza vaccine.
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PMID:Update: influenza activity--United States and worldwide, and composition of the 1992-93 influenza vaccine. 156 15


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