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

Intratracheal application of Bleomycin (Bleo) in rats induces interstitial pneumonitis followed by progressive fibrosis. As the presence of high levels of acute-phase proteins (= reactants = APR), especially alpha 2-macroglobulin of the rat (alpha 2M), enhances liver fibrosis, we investigated whether this phenomenon also occurs in rats with Bleo-induced lung fibrosis. The experiments showed that this is the case; lung fibrosis assessed by measuring hydroxyproline, hexosamine, and prolyl-4-hydroxylase was enhanced when just before Bleo application an acute-phase reaction was induced. This effect can be explained by the inhibitory effect of alpha 2M on collagenase. The experiments showed a significant positive correlation between alpha 2M and parameters of fibrosis. This is especially the case in the third week after Bleo application. Bleo itself does not induce a strong acute-phase reaction, notwithstanding the pneumonitis during the first weeks. The increased fibrosis is accompanied by progressive ventilatory disturbances demonstrated by high arterial pCO2 and low pO2. In patients undergoing Bleo treatment, varying levels of APR can be expected, and this could explain the rapid development of fibrosis in individual cases.
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PMID:Relation between acute-phase proteins and enhanced bleomycin-induced pulmonary fibrosis in the rat. 246 73

We have previously shown that the fall in lung compliance in radiation pneumonitis is mainly due to abnormality of the alveolar surface lining layer and speculated that this, in turn, is due to an increased amount of protein in the alveolar lining fluid layer. In the present study, this extra protein has been partially characterized, and the kinetics of permeation from the blood to the lung and the AF have been investigated by using intravenously injected of 125I-labeled albumin. Mice which had received 3000 rads to the thorax were used. A fourfold to fivefold increase in the total protein in AF obtained by pulmonary lavage was again found in mice irradiated 4 months previously, as compared to control littermates. With immunologic techniques and polyacrylamide disc-gel electrophoresis the excess protein in the alveolar lavage fluid was shown to be derived from the circulation. Following injection of 125I-labeled albumin into the tail vein, APR in the perfused, lavaged lung relative to radioactivity in simultaneously obtained blood rose to a plateau at 6 hr, which was approximately twice as high in irradiated mice as in controls. APR in the AF relative to that in simultaneously obtained blood rose rapidly and continued to rise throughout the period of study, reaching a level which was six times that in control mice at 24 hr. A major abnormality in radiation pneumonitis appears to be a large increase in permeability of the capillary and alveolar membranes to both small and large protein molecules. These abnormalities are not acute terminal events but probably persist for some weeks before death. It is speculated that leakage of plasma proteins onto the alveolar surface is responsible for the fall in compliance of the AF lining layer in radiation pneumonitis.
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PMID:Experimental radiation pneumonitis. IV. Leakage of circulatory proteins onto the alveolar surface. 735 Feb 39

Inpatient mortality has increasingly been used as an hospital outcome measure. Comparing mortality rates across hospitals requires adjustment for patient risks before making inferences about quality of care based on patient outcomes. Therefore it is essential to dispose of well performing severity measures. The aim of this study is to evaluate the ability of the All Patient Refined DRG system to predict inpatient mortality for congestive heart failure, myocardial infarction, pneumonia and ischemic stroke. Administrative records were used in this analysis. We used two statistics methods to assess the ability of the APR-DRG to predict mortality: the area under the receiver operating characteristics curve (referred to as the c-statistic) and the Hosmer-Lemeshow test. The database for the study included 19,212 discharges for stroke, pneumonia, myocardial infarction and congestive heart failure from fifteen hospital participating in the Italian APR-DRG Project. A multivariate analysis was performed to predict mortality for each condition in study using age, sex and APR-DRG risk mortality subclass as independent variables. Inpatient mortality rate ranges from 9.7% (pneumonia) to 16.7% (stroke). Model discrimination, calculated using the c-statistic, was 0.91 for myocardial infarction, 0.68 for stroke, 0.78 for pneumonia and 0.71 for congestive heart failure. The model calibration assessed using the Hosmer-Leme-show test was quite good. The performance of the APR-DRG scheme when used on Italian hospital activity records is similar to that reported in literature and it seems to improve by adding age and sex to the model. The APR-DRG system does not completely capture the effects of these variables. In some cases, the better performance might be due to the inclusion of specific complications in the risk-of-mortality subclass assignment.
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PMID:[Evaluation of the capacity of the APR-DRG classification system to predict hospital mortality]. 1240 5

The study objective was to examine hospital mortality outcomes and structure using 2008 patient-level discharges from general community hospitals. Discharges from Florida administrative files were merged to the state mortality registry. A cross-sectional analysis of inpatient mortality was conducted using Inpatient Quality Indicators (IQIs) for acute myocardial infarction (AMI), congestive heart failure (CHF), stroke, pneumonia, and all-payer 30-day postdischarge mortality. Structural characteristics included bed size, volume, ownership, teaching status, and system affiliation. Outcomes were risk adjusted using 3M APR-DRG. Volume was inversely correlated with AMI, CHF, stroke, and 30-day mortality. Similarities and differences in the direction and magnitude of the relationship of structural characteristics to 30-day postdischarge and IQI mortality measures were observed. Hospital volume was inversely correlated with inpatient mortality outcomes. Other hospital characteristics were associated with some mortality outcomes. Further study is needed to understand the relationship between 30-day postdischarge mortality and hospital quality.
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PMID:Examination of hospital characteristics and patient quality outcomes using four inpatient quality indicators and 30-day all-cause mortality. 2272 70

Introduction. In Ethiopia diarrhea is the second cause for clinical presentation among under five-year child population next to pneumonia and it is also more common in rural than in urban areas. Methods. A community based cross-sectional study was conducted in Arba Minch District. Data were collected using structured questionnaire by trained data collectors. To identify predictors of diarrhea the negative binomial regression model was used to predict and control the effect of confounders. Results. The prevalence of diarrhea among under-five children was 30.5%. This study showed children whose mothers did not attend any formal education were 89% more likely to develop diarrhea (APR = 1.89, [95% CI: 1.35, 2.53]) compared to their counterparts. Similarly, children's being in age category 6-23 months (APR = 2.78 [95% CI: 1.72, 4.55]) and mothers' poor hand washing practice (APR = 2.33 [95% CI: 1.80, 4.15]) were found predictors of diarrhea. The study also showed that, out of 180 mothers whose child had got diarrhea, about 31% of mothers could not give anything to manage the diarrhea. Conclusions. In this study the prevalence of diarrhea was high which was significantly associated with maternal education level, age of the child, and personal hygiene practices. Therefore, women's education level of at least primary school and enhancing community based behavioral change communications using multiple channels (radio) and community health workers are recommended to reduce the occurrence and consequences of childhood diarrhea in the study area.
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PMID:The Burden of Diarrheal Diseases among Children under Five Years of Age in Arba Minch District, Southern Ethiopia, and Associated Risk Factors: A Cross-Sectional Study. 2743 86