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[PMID]:29443771
[Au] Autor:Yanagiya M; Matsumoto J; Nagano M; Kusakabe M; Matsumoto Y; Furukawa R; Ohara S; Usui K
[Ad] Endereço:Department of General Thoracic Surgery, NTT Medical Center Tokyo.
[Ti] Título:Endoscopic bronchial occlusion for postoperative persistent bronchopleural fistula with computed tomography fluoroscopy guidance and virtual bronchoscopic navigation: A case report.
[So] Source:Medicine (Baltimore);97(7):e9921, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: The development of postoperative bronchopleural fistula (BPF) remains a challenge in thoracic surgery. We herein report a case of BPF successfully treated with endoscopic bronchial occlusion under computed tomography (CT) fluoroscopy and virtual bronchoscopic navigation (VBN). PATIENT CONCERNS: A 63-year-old man underwent right upper lobectomy with concomitant S6a subsegmentectomy for lung adenocarcinoma. On postoperative day 24, he complained of shaking chills with high fever. DIAGNOSES: BPF with subsequent pneumonia and empyema. INTERVENTIONS: Despite aggressive surgical interventions for the BPF, air leakage persisted postoperatively. On days 26 and 34 after the final operation, endobronchial occlusions were performed under CT fluoroscopy and VBN. OUTCOMES: The air leaks greatly decreased and the patient was discharged. LESSONS: CT fluoroscopy and VBN can be useful techniques for endobronchial occlusion in the treatment of BPF.
[Mh] Termos MeSH primário: Fístula Brônquica/terapia
Broncoscopia/métodos
Fluoroscopia
Doenças Pleurais/terapia
Complicações Pós-Operatórias/terapia
Tomografia Computadorizada por Raios X
[Mh] Termos MeSH secundário: Adenocarcinoma/cirurgia
Fístula Brônquica/diagnóstico por imagem
Fístula Brônquica/etiologia
Empiema/etiologia
Seres Humanos
Neoplasias Pulmonares/cirurgia
Masculino
Meia-Idade
Doenças Pleurais/diagnóstico por imagem
Doenças Pleurais/etiologia
Pneumonectomia/efeitos adversos
Pneumonia/etiologia
Complicações Pós-Operatórias/diagnóstico por imagem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180215
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009921


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[PMID]:28885373
[Au] Autor:Ho CH; Chen YC; Chu CC; Wang JJ; Liao KM
[Ad] Endereço:aDepartment of Medical Research, Chi Mei Medical Center bDepartment of Hospital and Health Care Administration, Chia-Nan University of Pharmacy and Science cDepartment of Anesthesiology, Chi Mei Medical Center dDepartment of Internal Medicine, Chi Mei Medical Center, Chiali, Taiwan.
[Ti] Título:Age-adjusted Charlson comorbidity score is associated with the risk of empyema in patients with COPD.
[So] Source:Medicine (Baltimore);96(36):e8040, 2017 Sep.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Patients with chronic obstructive pulmonary disease (COPD) have a higher risk of pneumonia than the general population due to their impaired lung defense. They also have a higher risk of empyema and more comorbidities than patients without COPD. This study aimed to evaluate the risk of empyema in patients with COPD after adjusting for age and comorbidities using the age-adjusted Charlson comorbidity index (ACCI).Data were retrieved from the National Health Insurance Research Database. COPD patients were defined as inpatients aged >40 years with an International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code for COPD. In total, 558,660 COPD patients were enrolled and separated into 3 groups by ACCI score to represent the severity of comorbidity (≤2, 3-5, and >5). Other comorbidities assessed included autoimmune diseases, gastroesophageal reflux disease, dyslipidemia, chest wall injury, and thoracostomy.Of the 558,660 patients, 36,556 (6.54%) had low ACCI scores (≤2), 208,292 (37.28%) had moderate ACCI scores (3-5), and 313,812 (56.17%) had high ACCI scores (>5). The mean ages of the low, moderate, and high groups were 50.66, 70.62, and 78.05 years, respectively. The hazard ratio (HRs) for empyema were 1.26 (95% confidence interval (CI) = 1.13-1.40) in the moderate ACCI group and 1.55 (95% CI = 1.39-1.72) in the high ACCI group compared with the low ACCI group. The overall incidence of empyema in COPD patients was 2.57 per 1000 person-years.This is the first study to use ACCI scores to analyze the risk of empyema in patients with COPD. Patients with high ACCI scores were older and had more complicated comorbidities, resulting in a higher risk of empyema and poor prognosis. The subgroup analysis indicated that COPD patients with comorbid autoimmune disease, gastroesophageal reflux disease, chest wall injury, or history of thoracostomy did not have a higher risk of empyema than patients without these comorbidities.Empyema is an important issue in patients with COPD and is associated with significant morbidity and mortality. Awareness of the risk factors for empyema, close monitoring, and early intervention may improve patient outcomes and decrease mortality.
[Mh] Termos MeSH primário: Empiema/diagnóstico
Empiema/epidemiologia
Doença Pulmonar Obstrutiva Crônica/diagnóstico
Doença Pulmonar Obstrutiva Crônica/epidemiologia
[Mh] Termos MeSH secundário: Fatores Etários
Idoso
Comorbidade
Bases de Dados Factuais
Feminino
Seres Humanos
Incidência
Estimativa de Kaplan-Meier
Masculino
Meia-Idade
Modelos de Riscos Proporcionais
Medição de Risco
Fatores de Risco
Medicina Estatal
Taiwan
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170909
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008040


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[PMID]:28683957
[Au] Autor:Ballivet de Régloix S; Maurin O; Crambert A; Genestier L; Bonfort G; Pons Y
[Ad] Endereço:Hôpital d'instruction des Armées-Percy, service d'ORL et de chirurgie cervico-faciale, 101, avenue Henri-Barbusse, 92140 Clamart, France. Electronic address: stanbdr@msn.com.
[Ti] Título:[Complications of sinusitis].
[Ti] Título:Complications des sinusites..
[So] Source:Presse Med;46(7-8 Pt 1):655-659, 2017 Jul - Aug.
[Is] ISSN:2213-0276
[Cp] País de publicação:France
[La] Idioma:fre
[Ab] Resumo:The complications of sinusitis are essentially secondary to ethmoidal and frontal sinusitis, occurring in patients weakened, particularly in case of immunodeficiency or anatomical defects. The gravity is due to the risk of spreading infection in intracranial tissues and orbital cavity. The diagnosis is always to discuss any symptomatology resistant to treatment and the appearance of orbital or neurological signs. The scanner and MRI contribute greatly to the orientation and diagnostic evaluation of the extent of the lesions. Treatment is based on prolonged antibiotic therapy and surgery and requires a multidisciplinary approach involving ENT, ophthalmologist, neurosurgeon and anesthesiologist resuscitator.
[Mh] Termos MeSH primário: Sinusite/complicações
[Mh] Termos MeSH secundário: Abscesso Encefálico/etiologia
Empiema/etiologia
Seres Humanos
Meningite/etiologia
Mucocele/etiologia
Celulite Orbitária/etiologia
Osteomielite/etiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170911
[Lr] Data última revisão:
170911
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170708
[St] Status:MEDLINE


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[PMID]:28222677
[Au] Autor:Ganesh K; Allam M; Wolter N; Bratcher HB; Harrison OB; Lucidarme J; Borrow R; de Gouveia L; Meiring S; Birkhead M; Maiden MC; von Gottberg A; du Plessis M
[Ad] Endereço:National Institute for Communicable Diseases (NICD), A division of the National Health Laboratory Service (NHLS), Johannesburg, South Africa. karisthag@nicd.ac.za.
[Ti] Título:Molecular characterization of invasive capsule null Neisseria meningitidis in South Africa.
[So] Source:BMC Microbiol;17(1):40, 2017 Feb 21.
[Is] ISSN:1471-2180
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The meningococcal capsule is an important virulence determinant. Unencapsulated meningococci lacking capsule biosynthesis genes and containing the capsule null locus (cnl) are predominantly non-pathogenic. Rare cases of invasive meningococcal disease caused by cnl isolates belonging to sequence types (ST) and clonal complexes (cc) ST-845 (cc845), ST-198 (cc198), ST-192 (cc192) and ST-53 (cc53) have been documented. The clinical significance of these isolates however remains unclear. We identified four invasive cnl meningococci through laboratory-based surveillance in South Africa from 2003 through 2013, which we aimed to characterize using whole genome data. RESULTS: One isolate [NG: P1.7-2,30: F1-2: ST-53 (cc53)] contained cnl allele 12, and caused empyema in an adult male with bronchiectasis from tuberculosis, diabetes mellitus and a smoking history. Three isolates were NG: P1.18-11,42-2: FΔ: ST-192 (cc192) and contained cnl allele 2. One patient was an adolescent male with meningitis. The remaining two isolates were from recurrent disease episodes (8 months apart) in a male child with deficiency of the sixth complement component, and with the exception of two single nucleotide polymorphisms, contained identical core genomes. The ST-53 (cc53) isolate possessed alleles for NHBA peptide 191 and fHbp variant 2; whilst the ST-192 (cc192) isolates contained NHBA peptide 704 and fHbp variant 3. All four isolates lacked nadA. Comparison of the South African genomes to 61 additional cnl genomes on the PubMLST Neisseria database ( http://pubmlst.org/neisseria/ ), determined that most putative virulence genes could be found in both invasive and carriage phenotypes. CONCLUSIONS: Although rare, invasive disease by cnl meningococci may be associated with host immunodeficiency and such patients may benefit from protein-based meningococcal vaccines.
[Mh] Termos MeSH primário: Cápsulas Bacterianas/genética
Genes Bacterianos/genética
Infecções Meningocócicas/microbiologia
Neisseria meningitidis/genética
[Mh] Termos MeSH secundário: Adesinas Bacterianas/genética
Adolescente
Alelos
Antígenos de Bactérias/genética
Proteínas da Membrana Bacteriana Externa/genética
Proteínas de Bactérias/genética
Sequência de Bases
Bronquiectasia/complicações
Proteínas de Transporte/genética
Criança
Pré-Escolar
Complicações do Diabetes
Diabetes Mellitus
Empiema/microbiologia
Loci Gênicos
Marcadores Genéticos/genética
Seres Humanos
Masculino
Meningite Meningocócica/epidemiologia
Infecções Meningocócicas/epidemiologia
Vacinas Meningocócicas/imunologia
Meia-Idade
Anotação de Sequência Molecular
Neisseria meningitidis/citologia
Neisseria meningitidis/isolamento & purificação
Neisseria meningitidis/patogenicidade
Fenótipo
Filogenia
Polimorfismo de Nucleotídeo Único
Análise de Sequência de DNA
Fumar
África do Sul/epidemiologia
Tuberculose/complicações
Virulência/genética
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Adhesins, Bacterial); 0 (Antigens, Bacterial); 0 (Bacterial Outer Membrane Proteins); 0 (Bacterial Proteins); 0 (Carrier Proteins); 0 (Genetic Markers); 0 (Meningococcal Vaccines); 0 (NHBA protein, Neisseria meningitidis); 0 (NadA protein, Neisseria meningitidis); 0 (factor H-binding protein, Neisseria meningitidis)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170831
[Lr] Data última revisão:
170831
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170223
[St] Status:MEDLINE
[do] DOI:10.1186/s12866-017-0942-5


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[PMID]:28163299
[Au] Autor:Huang YC; Cheng CY; Liao CY; Hsueh C; Tyan YS; Ho SY
[Ad] Endereço:Department of Medical Imaging, Changhua Christian Hospital, Changhua, Taiwan.
[Ti] Título:A Rare Case of Acute Phlegmonous Esophagogastritis Complicated with Hypopharyngeal Abscess and Esophageal Perforation.
[So] Source:Am J Case Rep;18:125-130, 2017 Feb 06.
[Is] ISSN:1941-5923
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND Acute phlegmonous esophagogastritis is a life-threatening disease that may be combined with serious complications. We present the classical radiological and endoscopic features and treatment strategy of a middle-aged female patient suffering from acute phlegmonous esophagogastritis complicated with hypopharyngeal abscess, esophageal perforation, mediastinitis, and empyema. CASE REPORT A 60-year-old Taiwanese female presented at our hospital due to fever, fatigue, painful swallowing, and vague chest pain for 5 days. She had a past history of uncontrolled type 2 diabetes mellitus. On physical examination, general weakness, chest pain, odynophagia, and a fever up to 38.9°C were found. Positive laboratory findings included leukocytosis (leukocyte count of 14.58×10³/µL, neutrophils 76.8%) and serum glucose 348 mg/dL (HbA1c 11.3%). A diagnosis of acute phlegmonous esophagogastritis with hypopharyngeal abscess was made based on typical computed tomography image features and clinical signs of infection. The patient received empirical antibiotic therapy initially; however, esophageal perforation with mediastinitis and empyema developed after admission. Emergency surgery with drainage and debridement was performed and antibiotics were administered. She was discharged in a stable condition on the 56th day of hospitalization. Six months later, a delayed esophageal reconstruction was performed. The patient has performed well for 9 months to date since the initial diagnosis. CONCLUSIONS Acute phlegmonous esophagogastritis complicated with hypopharyngeal abscess and esophageal perforation is extremely rare, and requires immediate medical attention. This report serves to remind physicians of this rare entity and the potential complications that may manifest with acute phlegmonous esophagogastritis.
[Mh] Termos MeSH primário: Abscesso/etiologia
Perfuração Esofágica/complicações
Perfuração Esofágica/diagnóstico
Esofagite/complicações
Gastrite/complicações
Doenças Faríngeas/complicações
[Mh] Termos MeSH secundário: Abscesso/diagnóstico
Abscesso/terapia
Doença Aguda
Antibacterianos/uso terapêutico
Desbridamento/métodos
Empiema/etiologia
Perfuração Esofágica/etiologia
Perfuração Esofágica/terapia
Feminino
Seres Humanos
Mediastinite/etiologia
Meia-Idade
Doenças Faríngeas/diagnóstico
Doenças Faríngeas/terapia
Sucção/métodos
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents)
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170324
[Lr] Data última revisão:
170324
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170207
[St] Status:MEDLINE


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[PMID]:28041618
[Au] Autor:Headley SA; Pretto-Giordano LG; Nóbrega DF; Altrão CS; Villas-Boas LA; Alfieri AA; Bracarense APFRL
[Ad] Endereço:Laboratory of Animal Pathology, Department of Veterinary Preventive Medicine, Brazil. Electronic address: selwyn.headley@uel.br.
[Ti] Título:Pyogenic Ventriculitis and Ventricular Empyema associated with Staphylococcus pseudintermedius in a Puppy.
[So] Source:J Comp Pathol;156(2-3):152-157, 2017 Feb - Apr.
[Is] ISSN:1532-3129
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:A 40-day-old male, blue heeler puppy with hindlimb ataxia, nystagmus, apathy, motor incoordination and hyperaesthesia of the forelimbs died 3 days after the onset of clinical signs. Significant gross findings included cerebellar herniation, cerebral oedema and dilation of the third and right lateral cerebral ventricles due to the accumulation of a purulent exudate. Histopathological examination revealed pyogenic ventriculitis and purulent meningoencephalitis. Pure colonies of a coagulase-positive Staphylococcus were isolated from the purulent cerebral exudate. A polymerase chain reaction assay that targeted the 16S rRNA gene of bacteria amplified the desired product from bacterial colonies. Direct sequencing revealed the organism to be Staphylococcus pseudintermedius. Phylogenetic analyses showed that the organism was antigenically similar to Staphylococcus intermedius and Staphylococcus delphini, being part of the S. intermedius group of bacteria. These findings confirmed the participation of S. pseudintermedius in the development of the pathological manifestations and lesions observed in this puppy.
[Mh] Termos MeSH primário: Ventriculite Cerebral/veterinária
Empiema/veterinária
Infecções Estafilocócicas/veterinária
[Mh] Termos MeSH secundário: Animais
Cães
Masculino
Filogenia
RNA Ribossômico 16S
Staphylococcus intermedius/genética
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (RNA, Ribosomal, 16S)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170821
[Lr] Data última revisão:
170821
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170103
[St] Status:MEDLINE


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[PMID]:28034636
[Au] Autor:Nagaoka K; Yanagihara K; Morinaga Y; Kohno S
[Ad] Endereço:Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; Second Department of Internal Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; First Department of Internal Medicine, Hokkaido University Hospital, Ho
[Ti] Título:Detection of Fusobacterium nucleatum in two cases of empyema and lung abscess using paromomycin-vancomycin supplemented Brucella HK agar.
[So] Source:Anaerobe;43:99-101, 2017 Feb.
[Is] ISSN:1095-8274
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Fusobacterium nucleatum was found in patients with empyema or pulmonary abscess, using paromomycin-vancomycin Brucella HK agar. In vitro examination revealed that growth of the strains differed significantly in different media. Clinicians should be aware that suboptimal F. nucleatum cultivation methods may result in an underestimation of its frequency.
[Mh] Termos MeSH primário: Meios de Cultura
Empiema/microbiologia
Infecções por Fusobacterium/microbiologia
Fusobacterium nucleatum/isolamento & purificação
Abscesso Pulmonar/microbiologia
[Mh] Termos MeSH secundário: Ágar
Antibacterianos
Técnicas Bacteriológicas
Brucella
Empiema/diagnóstico
Infecções por Fusobacterium/diagnóstico
Fusobacterium nucleatum/genética
Fusobacterium nucleatum/crescimento & desenvolvimento
Seres Humanos
Abscesso Pulmonar/diagnóstico
Masculino
Meia-Idade
Paromomicina
Análise de Sequência de DNA
Vancomicina
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Culture Media); 61JJC8N5ZK (Paromomycin); 6Q205EH1VU (Vancomycin); 9002-18-0 (Agar)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170515
[Lr] Data última revisão:
170515
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161231
[St] Status:MEDLINE


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[PMID]:27890417
[Au] Autor:Blair P; Moshgriz M; Siegel M
[Ad] Endereço:Division of Infectious Diseases, Department of Medicine, Johns Hopkins University, Baltimore, MD, USA. Electronic address: pblair6@jhmi.edu.
[Ti] Título:Mycobacterium fortuitum empyema associated with an indwelling pleural catheter: Case report and review of the literature.
[So] Source:J Infect Chemother;23(3):177-179, 2017 Mar.
[Is] ISSN:1437-7780
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Mycobacterium fortuitum is a rapidly growing mycobacterium (RGM) that is an uncommon cause of healthcare-associated infections. The most common infections caused by M. fortuitum include skin, soft tissue, and catheter-related infections. Although occasionally cultured from sputum samples, M. fortuitum is a rare cause of pulmonary disease. We report a case of M. fortuitum empyema associated with an infected pleural catheter and review M. fortuitum pulmonary infections.
[Mh] Termos MeSH primário: Infecções Relacionadas a Cateter/microbiologia
Cateteres de Demora/microbiologia
Infecções por Micobactéria não Tuberculosa/etiologia
Infecções por Micobactéria não Tuberculosa/microbiologia
Mycobacterium fortuitum/isolamento & purificação
Pleura/microbiologia
Infecções Respiratórias/microbiologia
[Mh] Termos MeSH secundário: Idoso
Infecção Hospitalar/etiologia
Infecção Hospitalar/microbiologia
Empiema/etiologia
Empiema/microbiologia
Seres Humanos
Pneumopatias/etiologia
Pneumopatias/microbiologia
Masculino
Infecções Respiratórias/etiologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170523
[Lr] Data última revisão:
170523
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161129
[St] Status:MEDLINE


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[PMID]:27865324
[Au] Autor:McElnay PJ; Lim E
[Ad] Endereço:Department of Cardiothoracic Surgery, James Cook University Hospital, Marton Road, Middlesbrough, TS4 3BW, UK.
[Ti] Título:Modern Techniques to Insert Chest Drains.
[So] Source:Thorac Surg Clin;27(1):29-34, 2017 Feb.
[Is] ISSN:1558-5069
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Both physicians and surgeons insert chest drains by various techniques-including Seldinger and "wide-bore" methods. The indications include hemothorax, pneumothorax, pleural effusion, and postoperative care in thoracic surgery. Given their invasive nature, there is significant potential for complications; however, this can be minimized by following a meticulous technique, which is herein described for both Seldinger and "wide-bore" drain insertion.
[Mh] Termos MeSH primário: Tubos Torácicos
Drenagem/métodos
Cuidados Pós-Operatórios/métodos
Procedimentos Cirúrgicos Torácicos
[Mh] Termos MeSH secundário: Tubos Torácicos/efeitos adversos
Drenagem/efeitos adversos
Drenagem/instrumentação
Empiema/etiologia
Hemotórax/etiologia
Hemotórax/cirurgia
Seres Humanos
Derrame Pleural/cirurgia
Pneumotórax/etiologia
Pneumotórax/cirurgia
Cuidados Pós-Operatórios/efeitos adversos
Cuidados Pós-Operatórios/instrumentação
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1612
[Cu] Atualização por classe:161230
[Lr] Data última revisão:
161230
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161121
[St] Status:MEDLINE


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[PMID]:27686179
[Au] Autor:Payeras A; Peñaranda M; Iñigo A; Garau M; Luis Pérez J; Gallegos C; Riera M
[Ad] Endereço:a Infectious Diseases Unit, Internal Medicine Department , Hospital Son Llàtzer , Palma de Mallorca , Spain.
[Ti] Título:Pneumococcal infections in elderly patients attending hospital since PCV-13 authorization in Spain.
[So] Source:Infect Dis (Lond);49(1):71-80, 2017 Jan.
[Is] ISSN:2374-4243
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: To study the characteristics and outcomes of pneumococcal infections in patients aged ≥65 years since the authorization of the 13-valent pneumococcal conjugate vaccine (PCV-13) in Spain. METHODS: All pneumococcal pneumonias, empyemas or primary bacteraemias treated at two hospitals in Majorca from 2010 to 2015 were included. Clinical variables, serotypes, and antibiotic susceptibility were collected. RESULTS: Two hundred and forty-nine pneumonias, 11 primary bacteraemias, and 2 empyemas in 243 patients were studied; 181 (69.1%) men, median age 76 years (range: 66-99). Seven (2.6%) were pneumococcal-vaccinated. Bacteraemia was present in 127 (61.9%) cases and related to a higher severity, p= 0.02, and not having chronic lung disease, p = 0.002. Ninety-seven (37%) episodes involved complications and 30 (11.5%) patients died. Mortality was related with the presence of complications at admission, p < 0.001. Only septic shock was more frequent in patients ≥65 years during the period 2010-2015 compared to the period 2006-2010: 38 of 262 (14.5%) vs. 17 of 212 (8%), p = 0.02. Most infections (57.6%) were due to PCV-13 serotypes but were not related to a worse prognosis. The proportion of PCV-13 serotypes tended to decrease from 61% (non-invasive) and 80% (invasive) in 2010-2011 to 33% and 47% in 2014-2015. The antibiotic susceptibility remained stable. CONCLUSIONS: Rates of pneumococcal vaccination in elderly patients with pneumococcal infections were very low. Except for septic shock, the main outcome variables (including mortality) were similar to the ones observed in the period preceding PCV-13 authorization. PCV-13 serotypes were responsible for most infections although they showed a decreasing trend.
[Mh] Termos MeSH primário: Infecções Pneumocócicas/epidemiologia
Vacinas Pneumocócicas
Pneumonia Pneumocócica/epidemiologia
Vacinação/estatística & dados numéricos
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Bacteriemia/tratamento farmacológico
Bacteriemia/epidemiologia
Bacteriemia/microbiologia
Empiema/epidemiologia
Feminino
Mortalidade Hospitalar
Seres Humanos
Masculino
Registros Médicos
Infecções Pneumocócicas/complicações
Infecções Pneumocócicas/microbiologia
Infecções Pneumocócicas/prevenção & controle
Pneumonia Pneumocócica/complicações
Pneumonia Pneumocócica/prevenção & controle
Pneumonia Pneumocócica/virologia
Estudos Prospectivos
Sorogrupo
Choque Séptico/epidemiologia
Choque Séptico/etiologia
Espanha/epidemiologia
Streptococcus pneumoniae/classificação
Streptococcus pneumoniae/imunologia
Streptococcus pneumoniae/isolamento & purificação
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (13-valent pneumococcal vaccine); 0 (Pneumococcal Vaccines)
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161001
[St] Status:MEDLINE



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