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

We studied 108 patients undergoing clean-contaminated and dirty surgical procedures to determine whether daily C-reactive protein (CRP) measurements for 14 days postoperatively could predict the occurrence of septic complications prior to clinical diagnosis. Diagnostic criteria for septic complications and positive CRP response were defined in advance of the study. The CRP assays were carried out using an automated laser nephelometer system after the patient's discharge from the hospital. Forty-six septic complications were diagnosed in 40 patients. These complications consisted of wound infection (23), urinary tract infection (11), pneumonia (six), upper respiratory tract infection (three), intra-abdominal abscess (one), and other (two). The CRP testing was found to have a positive predictive value of 69% and a negative predictive value of 78%. We conclude that serial CRP measurements may be a valuable adjunct to surgical care in patients at high risk of postoperative septic complications.
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PMID:C-reactive protein levels predict postoperative septic complications. 380 Jun 52

Serum levels of carcinoembryonic antigen (CEA) were analysed in patients with pneumonia of different etiology. Significant (p less than 0.01) increases in blood CEA levels occurred in all groups of pneumonia of bacterial etiology, i.e., pneumococcal, gram-negative or chlamydial. In viral pneumonia similar increases were observed, but the changes were not statistically significant, probably due to the small number of patients. In pneumonia of unknown etiology CEA behaved as in bacterial pneumonias. Maximal values between 5 and 15 micrograms/l CEA were common in pneumonia, the basal level usually being less than 5 micrograms/l. The severity of pneumonia, as judged by maximal erythrocyte sedimentation rate, correlated weakly with CEA levels in the bacterial group (p less than 0.05). In pneumonias of unknown etiology white blood cell counts and C-reactive protein levels correlated significantly with maximal CEA (p less than 0.01). In conclusion we have demonstrated, that in pneumonias of different etiology strongly but transiently increased blood CEA levels are the rule. The severity of pneumonia is not clearly correlated with CEA levels.
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PMID:Carcinoembryonic antigen (CEA) in blood in cases of pneumonia. 381 48

The aetiology of community-acquired pneumonia was studied by use of new bacterial and established viral serological methods besides blood culture in 162 patients. Evidence for a specific aetiology was obtained in 79 patients (49.4%). The pneumococcus was the most common aetiological agent, identified in 25.6% of cases. Other bacteria, Haemophilus influenzae, Branhamella catarrhalis, Neisseria meningitidis and Chlamydia spp. were demonstrated in 23.5%, Mycoplasma pneumonia in 1.2% and viruses in 7.4% patients. In 58% those with viral pneumonia there was evidence of mixed infection with bacteria. The predictive value of rapid laboratory tests, erythrocyte sedimentation rate, white blood cell count and C-reactive protein (CRP), was evaluated in relation to the aetiological diagnosis. They all differentiated viral from bacterial pneumonia, with CRP having the best predictive value. On the basis of these tests, most cases in which our serological tests remained negative would appear to have a bacterial aetiology also.
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PMID:The aetiology of pneumonia. Application of bacterial serology and basic laboratory methods. 381 55

A total of 813 patients from the years 1976 to 1980 who had a bacteremic Haemophilus influenzae infection were analyzed. Special attention was paid to disease entities (16.5% of the total) other than meningitis (60.5%) or epiglottitis (23.0%). Ninety-six cases in the nonmeningitis, nonepiglottitis (NMNE) group showed the following distribution: 25 patients with septicemia without specific focus, 21 arthritis, 19 cellulitis, 17 pneumonia, six otitis, four local abscess, two laryngotracheobronchitis, and two with an eye infection. Eighty-eight percent of the cases were children who were less than 5 years old; in the septicemia and pneumonia groups, however, 33 percent were 15 years of age and older, and 10 percent were over 60 years of age. All diseases in the NMNE group were acute; 51 percent of the patients sought medical advice within two days. C-reactive protein (CRP) was elevated constantly at presentation, erythrocyte sedimentation rate (ESR) was increased (greater than 20 mm/hr) in 87 percent, high fever greater than 38.5 degrees C (101.3 degrees F) was measured in 85 percent, and leukocytosis (greater than 15 X 10(9)/l) was present in 71 percent. Various antimicrobial agents were given for an average of 17 days. The mean period of hospitalization was 13 days. Case fatality rate was 4 percent; all deaths occurred among patients with an underlying disease. No permanent damage was observed.
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PMID:Systemic Haemophilus influenzae infection in Finland. 670 35

Serum levels of C-reactive protein (CRP) were measured within 96 hours of birth in 55 neonates with respiratory distress syndrome (RDS), 19 neonates with no significant medical illness other than an unstable cardiovascular state, and 13 neonates with a variety of pulmonary and extra-pulmonary problems either alone or in combination with RDS. The median serum CRP level in patients with RDS (2 micrograms/ml) was neither elevated nor different from CRP levels in infants with unstable cardiovascular systems (median CRP level, 2 micrograms/ml); however, neonates with other problems including pneumonia, aspiration, and extrapulmonary sepsis had significantly elevated serum CRP values (median 24 micrograms/ml). CRP levels are not elevated in neonatal RDS. Measurement of this acute phase reactant provides a rapid and reliable means of helping to distinguish infants with uncomplicated RDS from those with other serious pulmonary and extrapulmonary disease.
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PMID:Serum levels of C-reactive protein in neonatal respiratory distress syndrome. 672 84

Serum C-reactive protein levels become elevated coincident with the onset of the rash in patients with measles. Serum C-reactive protein elevations are prolonged in measles complicated by pneumonia and may show a second elevation in measles complicated by encephalitis.
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PMID:Changes in serum C-reactive protein during complicated and uncomplicated measles virus infections. 687 77

The hospital records of 150 patients with viral, mycoplasma and bacteraemic pneumococcal pneumonia were analyzed retrospectively to ascertain the discriminative value, regarding the aetiological diagnosis, of the information obtained on admission from the patient history, physical examination, simple laboratory tests and chest X-ray. With stepwise multiple discriminant analysis, the five best variables led to correct classification of 92% of bacteraemic pneumococcal, 88% of mycoplasmal, 76% of viral, and 85% of all pneumonias. Addition of a further nine variables increased the total discriminating capacity to only 89%. The best discriminating variables were the C-reactive protein determination, the presence or absence of predisposing disease or previous antibiotic treatment, the erythrocyte sedimentation rate, the presence of lymphocytosis and the band neutrophile count.
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PMID:Differential diagnosis of viral, mycoplasmal and bacteraemic pneumococcal pneumonias on admission to hospital. 688 48

Viral diagnosis was performed using radioimmunoassay (RIA) for virus antigen in nasopharyngeal secretions (NPS) and complement-fixation (CF) tests of paired sera from specimens of 90 children hospitalized for acute respiratory infection. Major respiratory viruses sought for by both methods (adenoviruses, influenza A and B viruses, parainfluenza virus type 3, respiratory syncytial virus) were detected in 40 (44%) of the patients; 15% of the diagnoses were made by NPS-RIA alone. Serologic diagnosis of other viral infections was confirmed in six additional cases. In the different clinical entities a viral diagnosis was established as follows: pneumonia, 50%; upper or middle respiratory infection with no wheezing, 43%; acute laryngitis, 54%; and wheezing bronchitis, 29%. In each clinical entity the virus-positive and virus-negative patients had similar total leukocyte counts, mean C-reactive protein levels and mean erythrocyte sedimentation rates. There was no difference in the duration of hospitalization between the patients with positive and negative viral studies. It was not possible to divide the patients into clinical subgroups according to the presence or absence of detectable viral infection.
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PMID:Clinical evaluation of radioimmunoassay of nasopharyngeal secretions and serology for diagnosis of viral infections in children hospitalized for respiratory infections. 716 28

In order to study predictors of fever response in children with radiologic pulmonary infiltrates treated with antibiotics, 156 children with pneumonia were evaluated with slide test C-reactive protein (CRP), white blood cell count (WBC), erythrocyte sedimentation rate (ESR), blood cultures, acute and convalescent viral and mycoplasma titers, and then followed clinically. Both CRP (+) at a serum dilution of 1:50 and WBC greater than or equal to 15,000 were better predictors of rapid resolution of fever while the patient was receiving antibiotics than were ESR greater than or equal to 30 or temperature greater than or equal to 40 C. WBC greater than or equal to 15,000 was nearly as specific but more sensitive than CRP (+) 1:50 for resolution of fever in either 8, 12 or 24 hours. Positive blood or lung bacterial cultures, but not four-fold or greater viral or mycoplasma titer increases, were also associated with rapid resolution of fever. WBC greater than or equal to 15,000 is useful in predicting rapid fever response in children with pneumonia treated with antibiotics.
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PMID:Predicting fever response of children with pneumonia treated with antibiotics. 742 54

We monitored the plasma elastase alpha 1-proteinase inhibitor complex levels in 21 patients with primary lung cancer who received combination chemotherapy with or without recombinant human granulocyte colony-stimulating factor (rhG-CSF), and 15 normal nonsmokers as controls. Of the 21 patients, 14 received combination chemotherapy without rhG-CSF (among them, 6 developed pneumonia) and 7 received combination chemotherapy with rhG-CSF (among them, 1 developed pneumonia). We measured peripheral WBC counts, C-reactive protein (CRP) levels, plasma elastase alpha 1-proteinase inhibitor complex (complex) levels, and complex/WBC values during cancer chemotherapy. In patients who received cancer chemotherapy without rhG-CSF and had no complications (n = 8), WBC values decreased after chemotherapy, and then gradually increased. Complex levels also decreased slightly after chemotherapy and gradually recovered. The value obtained from dividing the complex concentration by WBC count (complex/WBC value) remained stable during cancer chemotherapy. In patients who received cancer chemotherapy with rhG-CSF and had no complications (n = 6), WBC values decreased after chemotherapy, and then rapidly increased to abnormally high values. Complex levels also decreased slightly after chemotherapy and rapidly increased to abnormally high values together with the WBC counts. The complex/WBC values remained stable during cancer chemotherapy. In patients who developed pneumonia during cancer chemotherapy with or without rhG-CSF (n = 7), their complex levels, complex/WBC values, and CRP levels were elevated at the onset of pneumonia. The maximum complex levels (the highest levels during chemotherapy) were significantly higher in patients who received cancer chemotherapy with rhG-CSF and did not develop pneumonia (583.1 +/- 114.5 ng/mL) and in patients who developed pneumonia during cancer chemotherapy (516.7 +/- 113.2 ng/mL), compared with normal nonsmokers (130.2 +/- 5.5, p < 0.01) and patients who received cancer chemotherapy without rhG-CSF and did not develop complications (211.5 +/- 23.3, p < 0.01). The maximum complex/WBC values were not increased in patients who received cancer chemotherapy with rhG-CSF (0.08 +/- 0.01) and patients who received cancer chemotherapy without rhG-CSF (0.092 +/- 0.01, p < 0.01). The maximum complex/WBC values were significantly higher in patients with pneumonia (0.56 +/- 0.12) compared with normal nonsmokers (0.026 +/- 0.002, p < 0.01) and patients without complications. These findings suggest that although rhG-CSF increases total plasma elastase burden, increased release of neutrophil elastase from individual neutrophils does not take place in vivo in the absence of pneumonia.
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PMID:Measurements of plasma elastase alpha 1-proteinase inhibitor complexes in patients receiving cancer chemotherapy with granulocyte colony-stimulating factor. 753 56


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