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

To assess the meaning of hospital-associated death rates, we studied whether mortality within 30 days of hospital admission (30-day mortality) is more informative than inpatient mortality and whether detailed assessment of additional discharge diagnoses helps in understanding death rates. We examined hospitalizations for elderly Medicare patients with principal diagnoses of stroke, bacterial pneumonia, myocardial infarction, and congestive heart failure; these conditions account for 30.8% of Medicare 30-day mortality. Average hospital stays for these conditions were 99.0% longer, and inpatient mortality was 25.0% higher in New York than in California, but 30-day mortality was 1.6% higher in California. We conclude that inpatient death rates depend on length-of-stay patterns and give a biased picture of mortality. Additional diagnoses such as shock and pneumonia were strongly associated with increased mortality, but Medicare data do not reveal which patients had these conditions at the time of admission. Recorded diagnoses of chronic diseases such as hypertension, diabetes mellitus, obesity, benign prostatic hypertrophy, and osteoarthritis were commonly associated with reduced risk of death; such reduced risk is not clinically plausible. Several lines of evidence suggest that chronic disorders are underreported for patients with life-threatening disorders. We recommend great caution in using discharge diagnoses of comorbid conditions to adjust hospital death rates for clinical differences in the patient populations.
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PMID:Assessing hospital-associated deaths from discharge data. The role of length of stay and comorbidities. 270 88

We investigated the clinical efficiency and safety of ofloxacin, a new fluoroquinolone, for the treatment of various documented bacterial infections in 26 patients (10 females, 16 males) aged 17 to 84 years. Ofloxacin monotherapy was given orally in a dose of 200 mg twice (25) or three times (1) a day. Antibiotic levels and serum bactericidal activity were measured using a microbiological method on the second and sixth days, before and 2 and 6 hours after a single dose. The infectious episode treated was enterocolitis in 7 cases (5 Shigella, 2 Salmonella), Salmonella septicemia in 9 (7 typhoid fevers and 2 Salmonella minor infections), chronic osteoarthritis in 3 (1 E. coli, 2 S. aureus + P. aeruginosa), a soft tissue infection in 3 (2 S. aureus, 1 E. coli), acute pleuropneumonia in 2 (2 Klebsiella pneumoniae), pyelonephritis with bacteremia in 1 (Klebsiella pneumoniae), and pneumococcal pneumonia with septicemia in 1. Mean duration of therapy was ten days for 23 patients (range 7 to 30 days). The three patients with osteoarthritis were treated for 35, 95 and 270 days respectively. 24 patients recovered free of sequelae or germ carriage. Treatment failed in 1 case of chronic osteitis (S. aureus + P. aeruginosa) and in 1 staphylococcal soft tissue infection. No adverse reactions were observed except a slight increase in transaminases in 3 patients. Peak and through serum ofloxacin levels were 3.70 micrograms/ml and 0.95 micrograms/ml respectively on the second day and 3.25 micrograms/ml and 0.80 microgram/ml respectively on the sixth day.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Evaluation of the use of ofloxacin in the treatment of various infections]. 353 24

Skeletal infection involving Torulopsis glabrata is extremely rare. A 66-year-old woman developed Torulopsis glabrata osteomyelitis during a course of prolonged antibiotic therapy for staphylococcal pneumonia that occurred as a postoperative complication of a total knee arthroplasty for osteoarthritis. Roentgenograms and a biopsy sample revealed a destructive inflammatory lesion of the vertebrae. The presence of the yeast organism in the lesion was demonstrated definitively by culture and tissue pathology, removing any doubt about the pathogenicity of the organism. The disease was successfully treated with 5-fluorocytosine, and the patient recovered without functional impairments.
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PMID:Torulopsis glabrata osteomyelitis. A case report. 358 74

A therapeutic trial of transfusions with polymorphonuclear leukocyte concentrates was performed in newborn infants with bacterial sepsis proven by blood culture. With each transfusion, 20 ml/kg of a preparation obtained by continuous flow filtration leukapheresis, and containing 0.5 to 1 x 10(9) WBC, with less than 6% lymphocytes, was administered. Twenty newborn infants with sepsis received from 2 to 15 PMN transfusions. Results were compared with findings in 18 newborn infants with sepsis admitted during the trial period, and not treated because of unavailability of the PMN preparation (Group B). Infants with fulminant illness were excluded from both groups. Groups A and B were similar with respect to clinical characteristics and to etiology (in the majority cases a highly antibiotic-resistant Klebsiella). The mortality rate was significantly lower in Group A than in Group B in the whole series (10% vs 72%, P < 0.001), and also in the subgroups with birth weight equal or below 1,500 gm (10% vs 91%, P < 0.001). Major complications and associated conditions (i.e., necrotizing enterocolitis, meningitis, pneumonia, peritonitis, osteoarthritis, disseminated intravascular coagulation) were observed in 12 patients of Group B, and in only three infants of Group A. Untoward effects attributable to PMN transfusions were never observed. PMN transfusion was a highly effective therapeutic tool in our population of infected newborn infants.
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PMID:Polymorphonuclear leukocyte transfusion for the treatment of sepsis in the newborn infant. 745 87

The life expectancy of women currently exceeds that of men by almost seven years, yet women spend approximately twice as many years disabled prior to death as their male counterparts. The diseases that account for death and health care utilization in older women (heart disease, cancer, stroke, fracture, pneumonia, osteoarthritis, cataracts) are also major contributors to disability. This paper reviews the scientific evidence that supports specific recommendations for older women that may prevent or delay these conditions for as long as possible. Risk factors for falls and fractures should be assessed and, where possible, modified. Adequate intakes of calcium, vitamin D, fruits, and vegetables should be encouraged. Weight should be monitored and weight loss discouraged for most women. Screening for B12 deficiency is recommended. Engaging women in a shared decision-making process about the use of hormone replacement therapy for longterm prevention of heart disease and fractures is important, as is regular screening for breast and colo-rectal cancer. Women should be encouraged to engage in enjoyable physical activities, including walking, for 30 minutes daily. These interventions have the potential to delay the onset and improve the course of many chronic conditions that prevail in later life.
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PMID:Healthy aging. A women's issue. 934 51

A woman with a 20-year history of alcohol abuse and chronic pancreatitis developed an osteoarticular involvement of her right ankle in association with subcutaneous nodules. Histopathological examination of the tissue samples obtained during surgical revision of the ankle showed necrotic fat and connective tissue. Microbiological cultures remained negative. The patient was administered long-term antimicrobial treatment without any apparent benefit. Four months later, she died of pancreatic insufficiency and pneumonia. Postmortem examination showed numerous foci of intra-abdominal fat necrosis. Histopathological examination of the bone samples from the right ankle showed fat necrosis with lipophages. Based on these findings, we consider that the osteoarticular involvement in this patient was caused by intraosseous fat necrosis. This case reminds us of the importance of considering the possibility of this condition whenever a patient with chronic pancreatic disease develops sterile osteoarthritis.
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PMID:Intraosseous fat necrosis simulating septic arthritis and osteomyelitis in a patient with chronic pancreatitis. 993 96

The major causes of death and disability in women include in order: heart disease, cancer, stroke, fractures, pneumonia, osteoarthritis, and cataracts. This paper discusses common preventive approaches that have the potential to reduce women's risk of atherosclerotic cardiovascular disease as well as cancer, osteoporosis, and fractures. These preventive approaches include smoking cessation or prevention, physical activity, weight control and consuming a healthy diet.
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PMID:Women's heart health--an integrated approach to prevention. 1033 40

Twenty to 50% of community elderly suffer from pain. Up to 80% of the institutionalized elderly report at least one pain problem. Multiple pain etiologies that occur in elderly patients may be the occurrence of multiple chronic diseases: osteoarthritis, RA, cancer, DJD, bone/joint disorders, osteoporosis, surgical pain, trauma, neuropathic pain, and nociceptive pain. The incidence of unrelieved pain inhibits respiration, decreases mobility, and decreases their functional status, which may lead to iatrogenic events, which include pneumonia, constipation and deep vein thrombosis. Prolonged inpatient stays and extended care facilities or nursing homes may decrease the elderly patient's expectations of quality of life and initiate social isolation. There exists some roadblocks or barriers to the detection of pain in the elderly client. These include social, emotional, cognitive, and subjective issues with the patient.
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PMID:Perception, assessment, treatment, and management of pain in the elderly. 1591 Dec 2

We report here a case of osteoarticular infection associated with Panton-Valentine leukocidin-producing Staphylococcus aureus. The 3-year-old child presented osteoarthritis associated with toxic shock syndrome, which was complicated by thrombosis, pneumonia, and diaphysitis, despite appropriate antibiotic treatment. Osteitis associated with toxinogenic S. aureus is rarely described. This case highlights the need of early and aggressive surgical treatment, in addition to appropriate antimicrobial therapy.
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PMID:Severe osteoarticular infection associated with Panton-Valentine leukocidin-producing Staphylococcus aureus. 1667 76

Immune-mediated pathways have been recognized to be of importance in the pathogenesis of chronic lymphocytic leukaemia (CLL). We assessed a broad variety of immune-related and inflammatory conditions and subsequent CLL development among 4 million adult male veterans admitted to VA hospitals. We identified 3,680 CLL cases with up to 27 years of follow-up. Using Poisson regression analyses restricted to immune-related or inflammatory conditions that occurred more than one year before CLL, we estimated relative risk (RR) and 95% confidence intervals for CLL risk. Elevated CLL risk was found among individuals with prior chronic sinusitis (RR = 1.27, 1.01-1.61). Pneumonia had a borderline (RR = 1.13, 1.00-1.27) association with CLL; the risk was further elevated (RR = 1.35, 1.07-1.72) for latency <5 years. Conversely, chronic non-rheumatic valvular heart disease was associated with 0.76-fold (0.58-0.99) decreased risk. Herpes zoster and simplex were associated with increased (RR = 1.98, 1.40-2.79) and borderline increased (RR = 1.69, 0.96-2.98) CLL risk. There was no general association between autoimmunity and CLL; however, autoimmune haemolytic anaemia was associated with 3.86-fold (1.93-7.74) elevated CLL risk. Individuals with chronic osteoarthritis and prostatitis had 1.14-fold (1.03-1.25) and 1.64-fold (1.14-2.37) elevated CLL risk. These association patterns suggest primary focus on infectious agents rather than autoantigens for future aetiologic CLL studies.
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PMID:Acquired immune-related and inflammatory conditions and subsequent chronic lymphocytic leukaemia. 1794 50


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