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Query: UMLS:C0032285 (pneumonia)
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A pathomorphological study of antiviral chemotherapeutic activity of benaphthon was carried out in tests involving intranasal inoculation of mice with influenza A2 (Hong Kong) 68 viruses (infection doses of 1 DL75 and 10 DL75) and of rabbits with herpetic keratitis, provoked by the herpes simplex virus (strain Ela-5699). A single prophylactic introduction of bonaphthon with subsequent 4-day treatment of experimental influenzal pneumonia of mice was found to produce a significant diminution in the frequency of the pneumonia development in experimental animals, a reduction in the number of severe and lethal forms of the malady and, by preventing the development of morphologically grave forms, to improve the prognosis. The use of bonaphthon in experimental herpetic keratitis of rabbits, irrespective of the mode of its administration (locally or by mouth) cuts down the period of the keratitis cure almost in half, contributes to a speedier epithelization of the ulcerated surface and to the disappearance of inflammatory manifestations in the very substance of the cornea.
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PMID:[Pathomorphological study of antiviral chemotherapeutic effectiveness of bonaphthon under experimental conditions]. 102 19

The most prominent respiratory diseases of American Indian adults are pneumonia, cancer of the lung, chronic obstructive pulmonary disease (COPD), and tuberculosis. Mortality and hospitalization rates of these diseases were compared with those for the rest of the U.S. population and between Indian groups in the various Indian Health Service Areas. Pneumonia and influenza constitute the sixth leading cause of death among Indians and the fifth leading cause of death among the U.S. All Races population. Chronic obstructive pulmonary disease is the fourth leading cause of death among U.S. All Races, but only the tenth leading cause of death among Indians. Pneumonia and tuberculosis are more significant causes of death and disability for Indians than are COPD and cancer of the lung. The explanation for these differences in mortality rates between Indians and the general population are not known. Respiratory system diseases are responsible for 10.6% of Indian hospitalizations. The most frequent is pneumonia, which accounts for approximately 4% of all Indian hospitalizations. Differences in respiratory diseases between Indian groups are sometimes striking, with a sharp increase in mortality and hospitalization in the Areas across the northern border of the lower 48 states. There is also a much higher prevalence of cigarette smoking in those same Areas.
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PMID:The major respiratory diseases of American Indians. 217 26

Earlier studies of mortality of psychiatric patients are reviewed, and agreements and inconsistencies related to age, sex, diagnosis and cause of death are noted. The authors then analyze 5,268 deaths during a 5-year period of current or former patients in Missouri public psychiatric hospitals and mental health clinics, calculating mortality ratios that are simultaneously age-, sex-, diagnostic-, and cause-specific. The results are used to construct a quantitative model. The ratios vary most with cause, then diagnosis, least with sex. Influenza and pneumonia contribute most to patient mortality; patient death rates for cancer are lower than population rates at all ages. There are substantial interactions of diagnosis with cause and sex. Among those diagnosed organic brain syndrome, who have the highest overall ratios, the ratios are extra high for females and for influenza and pneumonia, relatively low for external causes.
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PMID:Mortality variations among public mental health patients. 407 18

Pneumonia and influenza, combined, are the sixth leading causes of death in the US. The age-adjusted mortality rate for these diseases increased by 20% between 1979 and 1993, perhaps as a result of the emergence of multi-drug-resistant and penicillin-resistant strains of bacteria that cause pneumonia. Of the approximately $US23 billion annual cost of community-acquired pneumonia, pneumococcal pneumonia is currently estimated to account for up to $US18 billion. Considering the clinical and economic consequences of pneumococcal disease, vaccination appears to be a valuable preventive strategy. However, despite Medicare coverage and the recommendations of the Advisory Committee on Immunisation Practices (ACIP), only 28% of elderly and high-risk patients received the pneumococcal vaccine in 1993. This article reviews the epidemiology and economic factors that determine the cost effectiveness of pneumococcal vaccination strategies. The strategies are taken from a review of 10 published economic analyses of the pneumococcal vaccine. Cost savings and favourable cost-effectiveness ratios are associated with key factors that increase vaccination programme benefits by maximising averted direct medical costs as well as reducing vaccination programme costs, such as through public vaccination campaigns.
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PMID:The cost effectiveness of pneumococcal vaccination strategies. 1016 68

Pneumonia and influenza represent a significant public health burden in Canada and abroad. Knowledge of how this burden varies geographically provides clues to understanding the determinants of these illnesses, and insight into the effective management of health-care resources. We conducted a retrospective, population-based, ecological-level study to assess age- and gender-specific spatial patterns of pneumonia and influenza hospitalizations in the province of Ontario, Canada from 1992 to 2001. Results revealed marked variability in hospitalization rates by age, as well as clear and statistically significant patterns of high rates in northern rural counties and low rates in southern urban counties. A moderate yet significant level of positive spatial autocorrelation (Moran's I=0.21, P<0.05) was found in the global data, with significant, age-specific clusters of high values or 'hot spots' identified in several northern counties. Findings illustrate the need for geographically focused prevention strategies, and resource and service allocation policies informed by regional and population-specific demands.
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PMID:An exploratory spatial analysis of pneumonia and influenza hospitalizations in Ontario by age and gender. 1682 52

Pneumonia and influenza represent a significant public health and health care system burden that is expected to increase with the aging of developed nations' populations. The burden of these illnesses is far from uniform however, with recent studies showing that they are both highly spatially and temporally variable. We have combined spatial and time-series analysis techniques to examine pneumonia and influenza hospitalizations in the province of Ontario, Canada, to determine how temporal patterns vary over space, and how spatial patterns of hospitalizations vary over time. Knowledge of these patterns can provide clues to disease aetiology and inform the effective management of health care system resources. Spatial analysis revealed significant clusters of high hospitalization rates in northern and rural counties (Moran's I = 0.186; P <0.05), while county level time series analysis demonstrated significant upward trends in rates in almost a quarter of the counties (P <0.05), and significant seasonality in all but one county (Fisher-Kappa and Barlett Kolmogorov Smirnov tests significant at the level P <0.01). Areas of weak seasonality were typically seen in rural areas with high rates of hospitalizations. The highest levels of spatial clustering of pneumonia and influenza hospitalizations were found to occur in months when rates were lowest. The findings provide evidence of spatio-temporal interaction over the study period, with marked spatial variability in temporal patterns, and temporal variability in spatial patterns. Results point to the need for the effective allocation of services and resources based on regional and seasonal demands, and more regionally focused prevention strategies. This research represents an important step towards understanding the dynamic nature of these illnesses, and sets the stage for the application of spatio-temporal modelling techniques to explain them.
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PMID:Spatio-temporal analysis of pneumonia and influenza hospitalizations in Ontario, Canada. 1868 68

The testicular changes in pneumonia are without clinical manifestations, are non-specific, focal in character, independent of the infecting organisms or the antecedent disease, and vary in severity directly with the total length of the illness. The process is a continuous one, divisible into stages in which the following features are recognizable: (1) cessation of spermatogenesis; (2) degeneration of preformed spermatocytes, spermatids, and spermatozoa; (3) desquamation of altered cells and fragments of the same; (4) formation of giant cells in the tubule walls with subsequent liberation into the lumen; (5) disappearance of all desquamated cells and all those derived from the spermatogonia by mitosis; (6) in some instances thickening of the hyaline layer of the basement membrane. Older lesions are frequently found which continue the structural alteration of the tubules by hyalinosis and destruction of cells until they ultimately disappear. These lesions are not believed to be connected with the present illness. Edema may represent the acute injury in another form, and round cell infiltration suggests that possibly other factors than toxins may have a part in the tissue alterations. In the absence of definite evidence to the contrary, the cause is assumed to be circulating toxins, as Wolbach (12) claims for influenzal cases. The hemolytic streptococcus produced more extensive changes, both epithelial and interstitial, in primary pneumonia occurring during the measles epidemic than when pneumonia followed as a secondary infection; in the latter cases the pulmonary complications covered a relatively shorter period. Measles and epidemic influenza had little apparent effect upon the testes, except that the former caused mild inhibition of spermatogenesis; evidence regarding the latter is inconclusive. The Pfeiffer bacillus was always associated with other organisms, in primary infections and in those following measles. It occurred alone in a few cases after epidemic influenza, but the testicular lesion was not distinctive. The pneumococcus when alone in primary infections or after an epidemic disease produced a uniformly mild picture which was not intensified when associated with the influenza bacillus. Giant cells were much more frequent after influenzal pneumonia regardless of its cause and were associated with large numbers of other desquamated cells. They are formed in the walls of tubules by futile mitotic effort and incomplete protoplasmic separation, the abnormality of the process being further suggested by the early severing of cytoplasmic attachments and rapid desquamation. The series is unique in its uniformity, in the care exercised in the bacteriological examinations, and in the relative freedom from complicating factors.
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PMID:THE PATHOLOGICAL CHANGES IN THE TESTES IN EPIDEMIC PNEUMONIA. 1986 74

Twelve normal monkeys inoculated on the mucous membranes of the nose or nose and mouth with a strain of Bacillus influenzae; originally isolated in pure culture from the pleural exudate of a case of empyema following influenzal pneumonia in man and subsequently raised in virulence by animal passage, developed an acute self-limited respiratory disease of from 3 to 5 days duration, characterized by sudden onset with profound prostration, the development of rhinitis and tracheobronchitis, with sneezing, cough, and the outpouring of a scanty mucoid, or mucopurulent exudate, a variable febrile reaction, and either a leucopenia or no significant change in the leucocyte count. This disease was complicated in five instances by purulent sinusitis of one or both antra, in three by bronchopneumonia. Bacillus influenzae was recovered at autopsy from the lesions of the disease either in pure culture or in association with organisms that are normal inhabitants of the upper respiratory tract of monkeys. Of ten normal monkeys injected intratracheally with the same strain of Bacillus influenzae, seven developed bronchopneumonia, two developed tracheobronchitis without pneumonia, and one resisted infection. The general symptoms and duration of the disease were similar to those of the preceding group. There were a severe cough and accelerated respirations. Bacillus influenzae was recovered in pure culture from the lungs, bronchi, or trachea in the animals killed during the active stage of the disease. It disappeared promptly from the respiratory tract with recovery. The significance of the first series of experiments in which monkeys were inoculated in the upper respiratory tract is twofold. First, they establish the fact that Bacillus influenzae can initiate in monkeys an acute infection of the normal mucous membranes of the upper respiratory tract; that is, it can act as a primary incitant of respiratory infection without the assistance of a preceding or concomitant contributing cause. In this respect it differs radically from the pneumococcus and Streptococcus haemolyticus, since experiments previously reported(2, 4) have shown that neither of these organisms possesses the property of initiating an infection of the normal mucous membranes of the upper respiratory tract of monkeys, even though the strains used were incalculably more virulent for monkeys than the strain of Bacillus influenzae used in the foregoing experiments. Secondly, the experiments show that Bacillus influenzae infection of the mucous membranes of the upper respiratory tract may spread by continuity to the paranasal sinuses, setting up an acute sinusitis, that it spreads readily to the lower respiratory tract, producing a tracheobronchitis and permitting the ready invasion of secondary bacteria, and that it may penetrate as far as the terminal bronchioles, alveolar ducts, atria, and alveoli, there setting up a bronchiolitis and true bronchopneumonia. In these respects it likewise differs radically from the pneumococcus and Streptococcus haemolyticus which do not possess these pathogenic properties as previous experiments have shown.(2, 4) The bearing of these facts on the possible etiologic relation of Bacillus influenzae to influenza is important, since they show that Bacillus influenzae possesses certain definite primary pathogenic properties which distinguish it and therefore separate it from the group of recognized secondary organisms in influenzal complications, of which the pneumococcus and the streptococcus are the most frequent. The possible etiologic relation of Bacillus influenzae to influenza is further supported by the character of the respiratory disease that occurred in the monkeys. The sudden onset with profound prostration, the absence of leucocytosis or often a leucopenia, the congestion of the mucous membranes of the respiratory tract, the development on the 2nd or 3rd day of an irritative cough due to an inflammatory tracheitis or tracheobronchitis, the brief self-limited course of the infection, and the irregular febrile reactions are all characteristic of influenza. Many of these symptoms were in striking contrast with the symptoms and course of pneumococcus or streptococcus infections in monkeys in which there were no prostration at onset, invariable leucocytosis, and infrequent cough developing only late in the disease. While all the above features of the disease produced in monkeys are characteristic of influenza in man, none are pathognomonic and, in fact, it is doubtful whether uncomplicated influenza possesses any pathognomonic features by which it may be diagnosed certainly in the absence of an epidemic. Even during epidemic times many respiratory infections arise which, though presumably influenza, it is impossible to diagnose as such with certainty. Nor does pathology help in this respect, since there would appear to be no established distinctive lesions of uncomplicated influenza in man, nor for that matter of the complications of influenza, apart from the complications which have been ascribed by Pfeiffer,(5) MacCallum,(6) Wolbach,(7) and others to infection with Bacillus influenzae because of the association of Bacillus influenzae in pure culture with these complications. For these reasons, although the disease produced in monkeys appears to be essentially identical with influenza in man with respect to its clinical course and complications, it is impossible to determine certainly whether it is actually so. The experiments are advanced, therefore, as evidence in favor of the etiologic relation of Bacillus influenzae to influenza, though they do not permit of a definite conclusion in this respect. Their bearing upon the relation of Bacillus influenzae to certain of the complications of influenza would appear to be reasonably conclusive. The recovery of Bacillus influenzae in pure culture at autopsy from the antra, from the trachea and bronchi, and from the lungs in some of the animals developing sinusitis, bronchiolitis, and a characteristic type of bronchopneumonia confirms by animal experiment the etiologic relation of Bacillus influenzae to these complications of influenza, which hitherto has rested solely upon the frequent association of the influenza bacillus with these lesions in man. The production of tracheobronchitis and the same type of bronchopneumonia by the intratracheal injection of Bacillus influenzae in the second series of experiments serves as additional confirmation of this, but has no direct bearing on the etiologic relation of Bacillus influenzae to uncomplicated influenzae.
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PMID:STUDIES ON EXPERIMENTAL PNEUMONIA : IX. PRODUCTION IN MONKEYS OF AN ACUTE RESPIRATORY DISEASE RESEMBLING INFLUENZA BY INOCULATION WITH BACILLUS INFLUENZAE. 1986 70

Significant increases in neutralizing antibodies were demonstrated in 42 of a total of 69 persons with a clinical diagnosis of primary atypical pneumonia. Detailed titrations of virus-neutralizing antibodies in a representative group of 28 patients are presented. Increases of four- to 64-fold were demonstrated. Acute-phase titers were 4 or less in 83 per cent and convalescent titers were 16 or over in 86 per cent of these cases. Only about half of the number of patients having increases in neutralizing antibodies also developed cold agglutinins and agglutinins for the indifferent streptococcus No. 344. Patients from the Eastern United States as well as those from the Pacific Coast were shown to develop virus-neutralizing antibodies. Patients with pneumococcal pneumonia and pneumonias caused by influenza virus type A or viruses of the psittacosis group did not have significant increases in neutralizing antibodies for the virus of atypical pneumonia. Cold agglutinins appeared in 3 cases of type A influenzal pneumonia. Sera from persons with atypical pneumonia, when tested against the 3 most prevalent respiratory viruses isolated from cotton rats and hamsters, failed to neutralize these agents or showed no significant change in neutralization titer.
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PMID:STUDIES ON THE ETIOLOGY OF PRIMARY ATYPICAL PNEUMONIA : III. SPECIFIC NEUTRALIZATION OF THE VIRUS BY HUMAN SERUM. 1987 4

To determine the burden of community-acquired pneumonia (CAP) affecting adults in North America, a comprehensive literature review was conducted to examine the incidence, morbidity and mortality, etiology, antibiotic resistance, and economic impact of CAP in this population. In the United States, there were approximately 4.2 million ambulatory care visits for pneumonia in 2006. Pneumonia and influenza continue to be a common cause of death in the United States (ranked eighth) and Canada (ranked seventh). In 2005, there were >60,000 deaths due to pneumonia in persons aged>or=15 years in the United States alone. The hospitalization rate for all infectious diseases increased from 1525 hospitalizations per 100 000 persons in 1998 to 1667 per 100 000 persons in 2005. Admission to an intensive care unit was required in 10% to 20% of patients hospitalized with pneumonia. The mean length of stay for pneumonia was >or=5 days and the 30-day rehospitalization rate was as high as 20%. Mortality was highest for CAP patients who were hospitalized; the 30-day mortality rate was as high as 23%. All-cause mortality for CAP patients was as high as 28% within 1 year. Streptococcus pneumoniae continues to be the most frequently identified pathogen associated with CAP, and pneumococcal resistance to antimicrobials may make treatment more difficult. The economic burden associated with CAP remains substantial at >$17 billion annually in the United States. Despite the availability and widespread adherence to recommended treatment guidelines, CAP continues to present a significant burden in adults. Furthermore, given the aging population in North America, clinicians can expect to encounter an increasing number of adult patients with CAP. Given the significance of the disease burden, the potential benefit of pneumococcal vaccination in adults is substantial.
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PMID:Burden of community-acquired pneumonia in North American adults. 2020 64

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