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[PMID]:29245357
[Au] Autor:Chen CF; Chu KA; Tseng YC; Wu CC; Lai RS
[Ad] Endereço:aDivision of Chest Medicine, Department of Internal MedicinebDivision of Thoracic Surgery, Department of SurgerycInstitute of Clinical Medicine, National Yang-Ming University, TaipeidDepartment of Pathology and Laboratory Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, TaiwaneFaculty of Medicine, National Yang-Ming University, Taipei, Taiwan.
[Ti] Título:IgG4-related lung disease presenting as interstitial lung disease with bronchiolitis: A case report.
[So] Source:Medicine (Baltimore);96(49):e9140, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: IgG4-related disease is a rare and novel disease entity that tends to involve multiple organs. The pulmonary manifestation of this disease is highly variable and may mimic lung cancer, pneumonia, interstitial lung disease (ILD), sarcoidosis, and so forth. Small airway disease is rarely reported in IgG4-related lung disease (IgG4-RLD). In the current study, we describe a rare case of IgG4-RLD with patterns of ILD and bronchiolitis. PATIENT CONCERN: A 43-year-old man had chronic cough and dyspnea on exertion for 4 years. Initial chest radiography showed diffuse interstitial infiltration. Follow-up chest computed tomography 4 years later revealed bilateral diffuse centrilobular nodules with tree-in-bud pattern, bronchial wall thickening, and mediastinal lymph nodes. Bilateral diffuse multifocal ground-glass opacities and mosaic attenuation were also observed. Pulmonary function test revealed mixed restrictive and obstructive ventilatory impairment. DIAGNOSES: Video-assisted thoracoscopic surgery (VATS) lung biopsy showed interstitial fibrosis with lymphoplasmacytic infiltration rich in IgG4-positive plasma cells. Serum IgG4 level also showed remarkable elevation. Therefore, IgG4-RLD is confirmed. INTERVENTION: VATS wedge resection of right upper lobe and mediastinal lymph node. OUTCOMES: The patient responded well to steroid and immunosuppression therapy, and was regular followed-up in outpatient clinic. LESSONS: IgG4-RLD should be considered not only in ILD, but also in small airway disease. Serum IgG4 level may be a useful tool for screening.
[Mh] Termos MeSH primário: Imunoglobulina G/imunologia
Pneumopatias/diagnóstico
Pneumopatias/imunologia
[Mh] Termos MeSH secundário: Adulto
Bronquiolite/complicações
Bronquiolite/diagnóstico
Diagnóstico Diferencial
Seres Humanos
Imunossupressores/uso terapêutico
Pneumopatias/tratamento farmacológico
Pneumopatias/patologia
Doenças Pulmonares Intersticiais/complicações
Doenças Pulmonares Intersticiais/diagnóstico
Masculino
Testes de Função Respiratória
Cirurgia Torácica Vídeoassistida
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Immunoglobulin G); 0 (Immunosuppressive Agents)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180105
[Lr] Data última revisão:
180105
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171217
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009140


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[PMID]:29184035
[Au] Autor:Schuh S; Babl FE; Dalziel SR; Freedman SB; Macias CG; Stephens D; Steele DW; Fernandes RM; Zemek R; Plint AC; Florin TA; Lyttle MD; Johnson DW; Gouin S; Schnadower D; Klassen TP; Bajaj L; Benito J; Kharbanda A; Kuppermann N; Pediatric Emergency Research Networks (PERN)
[Ad] Endereço:Division of Paediatric Emergency Medicine and.
[Ti] Título:Practice Variation in Acute Bronchiolitis: A Pediatric Emergency Research Networks Study.
[So] Source:Pediatrics;140(6), 2017 Dec.
[Is] ISSN:1098-4275
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND OBJECTIVES: Studies characterizing hospitalizations in bronchiolitis did not identify patients receiving evidence-based supportive therapies (EBSTs). We aimed to evaluate intersite and internetwork variation in receipt of ≥1 EBSTs during the hospital management of infants diagnosed with bronchiolitis in 38 emergency departments of pediatric emergency research networks in Canada, the United States, Australia, New Zealand, the United Kingdom, Ireland, Spain, and Portugal. We hypothesized that there would be significant variation, adjusted for patient characteristics. METHODS: Retrospective cohort study of previously healthy infants aged <12 months with bronchiolitis. Our primary outcome was that hospitalization occurred with EBST (ie, parenteral fluids, oxygen, or airway support). RESULTS: Out of 3725 participants, 1466 (39%) were hospitalized, and 1023 out of 1466 participants (69.8%) received EBST. The use of EBST varied by site ( < .001; range 6%-99%, median 23%), but not by network ( = .2). Significant multivariable predictors and their odds ratios (ORs) were as follows: age (0.9), oxygen saturation (1.3), apnea (3.4), dehydration (3.2), nasal flaring and/or grunting (2.4), poor feeding (2.1), chest retractions (1.9), and respiratory rate (1.2). The use of pharmacotherapy and radiography varied by network and site ( < .001), with respective intersite ranges 2% to 79% and 1.6% to 81%. Compared with Australia and New Zealand, the multivariable OR for the use of pharmacotherapy in Spain and Portugal was 22.7 (95% confidence interval [CI]: 4.5-111), use in Canada was 11.5 (95% CI: 3.7-36), use in the United States was 6.8 (95% CI: 2.3-19.8), and use in the United Kingdom was 1.4 (95% CI: 0.4-4.2). Compared with United Kingdom, OR for radiography use in the United States was 4.9 (95% CI 2.0-12.2), use in Canada was 4.9 (95% CI 1.9-12.6), use in Spain and Portugal was 2.4 (95% CI 0.6-9.8), and use in Australia and New Zealand was 1.8 (95% CI 0.7-4.7). CONCLUSIONS: More than 30% of infants hospitalized with bronchiolitis received no EBST. The hospital site was a source of variation in all study outcomes, and the network also predicted the use of pharmacotherapy and radiography.
[Mh] Termos MeSH primário: Bronquiolite/terapia
Serviço Hospitalar de Emergência/estatística & dados numéricos
Hospitalização/estatística & dados numéricos
Padrões de Prática Médica/estatística & dados numéricos
[Mh] Termos MeSH secundário: Doença Aguda
Austrália
Bronquiolite/diagnóstico
Canadá
Estudos de Coortes
Feminino
Seres Humanos
Lactente
Irlanda
Masculino
Nova Zelândia
Portugal
Estudos Retrospectivos
Espanha
Reino Unido
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171211
[Lr] Data última revisão:
171211
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171130
[St] Status:MEDLINE


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[PMID]:29070533
[Au] Autor:Bakel LA; Hamid J; Ewusie J; Liu K; Mussa J; Straus S; Parkin P; Cohen E
[Ad] Endereço:Section of Pediatric Hospital Medicine and the Clinical Effectiveness Team, Department of Pediatrics, Children's Hospital Colorado, Aurora, Colorado; leighanne.bakel@childrenscolorado.org.
[Ti] Título:International Variation in Asthma and Bronchiolitis Guidelines.
[So] Source:Pediatrics;140(5), 2017 Nov.
[Is] ISSN:1098-4275
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND OBJECTIVES: Guideline recommendations for the same clinical condition may vary. The purpose of this study was to determine the degree of agreement among comparable asthma and bronchiolitis treatment recommendations from guidelines. METHODS: National and international guidelines were searched by using guideline databases (eg, National Guidelines Clearinghouse: December 16-17, 2014, and January 9, 2015). Guideline recommendations were categorized as (1) recommend, (2) optionally recommend, (3) abstain from recommending, (4) recommend against a treatment, and (5) not addressed by the guideline. The degree of agreement between recommendations was evaluated by using an unweighted and weighted κ score. Pairwise comparisons of the guidelines were evaluated similarly. RESULTS: There were 7 guidelines for asthma and 4 guidelines for bronchiolitis. For asthma, there were 166 recommendation topics, with 69 recommendation topics given in ≥2 guidelines. For bronchiolitis, there were 46 recommendation topics, with 21 recommendation topics provided in ≥2 guidelines. The overall κ for asthma was 0.03, both unweighted (95% confidence interval [CI]: -0.01 to 0.07) and weighted (95% CI: -0.01 to 0.10); for bronchiolitis, it was 0.32 unweighted (95% CI: 0.16 to 0.52) and 0.15 weighted (95% CI: -0.01 to 0.5). CONCLUSIONS: Less agreement was found in national and international guidelines for asthma than for bronchiolitis. Additional studies are needed to determine if differences are based on patient preferences and values and economic considerations or if other recommendation-level, guideline-level, and condition-level factors are driving these differences.
[Mh] Termos MeSH primário: Asma/terapia
Bronquiolite/terapia
Bases de Dados Factuais/normas
Internacionalidade
Guias de Prática Clínica como Assunto/normas
[Mh] Termos MeSH secundário: Asma/diagnóstico
Bronquiolite/diagnóstico
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171027
[St] Status:MEDLINE


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[PMID]:28987219
[Au] Autor:Jartti T; Gern JE
[Ad] Endereço:Department of Paediatrics, Turku University Hospital and University of Turku, Turku, Finland. Electronic address: tuomas.jartti@utu.fi.
[Ti] Título:Role of viral infections in the development and exacerbation of asthma in children.
[So] Source:J Allergy Clin Immunol;140(4):895-906, 2017 Oct.
[Is] ISSN:1097-6825
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Viral infections are closely linked to wheezing illnesses in children of all ages. Respiratory syncytial virus (RSV) is the main causative agent of bronchiolitis, whereas rhinovirus (RV) is most commonly detected in wheezing children thereafter. Severe respiratory illness induced by either of these viruses is associated with subsequent development of asthma, and the risk is greatest for young children who wheeze with RV infections. Whether viral illnesses actually cause asthma is the subject of intense debate. RSV-induced wheezing illnesses during infancy influence respiratory health for years. There is definitive evidence that RSV-induced bronchiolitis can damage the airways to promote airway obstruction and recurrent wheezing. RV likely causes less structural damage and yet is a significant contributor to wheezing illnesses in young children and in the context of asthma. For both viruses, interactions between viral virulence factors, personal risk factors (eg, genetics), and environmental exposures (eg, airway microbiome) promote more severe wheezing illnesses and the risk for progression to asthma. In addition, allergy and asthma are major risk factors for more frequent and severe RV-related illnesses. Treatments that inhibit inflammation have efficacy for RV-induced wheezing, whereas the anti-RSV mAb palivizumab decreases the risk of severe RSV-induced illness and subsequent recurrent wheeze. Developing a greater understanding of personal and environmental factors that promote more severe viral illnesses might lead to new strategies for the prevention of viral wheezing illnesses and perhaps reduce the subsequent risk for asthma.
[Mh] Termos MeSH primário: Asma/imunologia
Microbiota/imunologia
Vírus Sinciciais Respiratórios/imunologia
Rhinovirus/imunologia
Viroses/imunologia
[Mh] Termos MeSH secundário: Animais
Anti-Inflamatórios/uso terapêutico
Asma/tratamento farmacológico
Bronquiolite
Criança
Progressão da Doença
Seres Humanos
Palivizumab/uso terapêutico
Sons Respiratórios
Vírus Sinciciais Respiratórios/patogenicidade
Rhinovirus/patogenicidade
Risco
Virulência
Viroses/tratamento farmacológico
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Anti-Inflammatory Agents); DQ448MW7KS (Palivizumab)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171023
[Lr] Data última revisão:
171023
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171009
[St] Status:MEDLINE


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[PMID]:28871880
[Au] Autor:Nazif JM; Taragin BH; Azzarone G; Rinke ML; Liewehr S; Choi J; Esteban-Cruciani N
[Ad] Endereço:1 Children's Hospital at Montefiore, Bronx, NY, USA.
[Ti] Título:Clinical Factors Associated With Chest Imaging Findings in Hospitalized Infants With Bronchiolitis.
[So] Source:Clin Pediatr (Phila);56(11):1054-1059, 2017 Oct.
[Is] ISSN:1938-2707
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Despite recommendations against routine imaging, chest radiography (CXR) is frequently performed on infants hospitalized for bronchiolitis. We conducted a review of 811 infants hospitalized for bronchiolitis to identify clinical factors associated with imaging findings. CXR was performed on 553 (68%) infants either on presentation or during hospitalization; 466 readings (84%) were normal or consistent with viral illness. Clinical factors significantly associated with normal/viral imaging were normal temperature (odds ratio = 1.66; 95% CI = 1.03-2.67) and normal oxygen saturation (odds ratio = 1.77; 95% CI = 1.1-2.83) on presentation. Afebrile patients with normal oxygen saturations were nearly 3 times as likely to have a normal/viral CXR as patients with both fever and hypoxia. Our findings support the limited role of radiography in the evaluation of hospitalized infants with bronchiolitis, especially patients without fever or hypoxia.
[Mh] Termos MeSH primário: Bronquiolite/diagnóstico por imagem
Pacientes Internados/estatística & dados numéricos
Radiografia Torácica/métodos
[Mh] Termos MeSH secundário: Bronquíolos/diagnóstico por imagem
Estudos de Coortes
Feminino
Hospitalização
Seres Humanos
Lactente
Masculino
Razão de Chances
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170913
[Lr] Data última revisão:
170913
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170906
[St] Status:MEDLINE
[do] DOI:10.1177/0009922817698802


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[PMID]:28864214
[Au] Autor:Xu H; Sun Q; Lu L; Luo F; Zhou L; Liu J; Cao L; Wang Q; Xue J; Yang Q; Yang P; Lu J; Xiang Q; Liu Q
[Ad] Endereço:Institute of Toxicology, School of Public Health, Nanjing Medical University, Nanjing 211166, Jiangsu, People's Republic of China; The Key Laboratory of Modern Toxicology, Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, Jiangsu, People's Republic of China.
[Ti] Título:MicroRNA-218 acts by repressing TNFR1-mediated activation of NF-κB, which is involved in MUC5AC hyper-production and inflammation in smoking-induced bronchiolitis of COPD.
[So] Source:Toxicol Lett;280:171-180, 2017 Oct 05.
[Is] ISSN:1879-3169
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Dysregulation of microRNAs (miRNAs) has been implicated in the pathogenesis of chronic obstructive pulmonary disease (COPD), which is largely attributable to cigarette smoke (CS). However, little is known about the effect of miRNAs on CS-induced mucus hypersecretion and the inflammatory response in the airway epithelium, which are pathological characteristics of COPD-related chronic bronchiolitis. As determined in the present investigation, population-based data indicate that smokers with COPD had serious airflow obstruction and inflammation, whereas smokers without COPD had mild airflow obstruction and inflammation. Moreover, levels of serum miR-218 positively correlated with FEV /FVC% and negatively correlated with levels of serum IL-6 and IL-8. In human bronchial epithelial (HBE) cells, cigarette smoke extract (CSE) decreased miR-218 levels and increased levels of MUC5AC, interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor receptor 1 (TNFR1), and p-p65. Enhancement of miR-218 levels by an miR-218 mimic blocked these CSE-induced changes. Moreover, luciferase reporter assays confirmed that miR-218 bound to the 3'UTR region of TNFR1 mRNA. Down-regulation of TNFR1 blocked the CSE-induced increases of MUC5AC, IL-6, and IL-8 and the activation of NF-κB. Furthermore, over-expression of miR-218 attenuated the CSE-induced overproduction of MUC5AC, IL-6, and IL-8, effects that were reversed by elevated expression of TNFR1. In sum, our findings provide a mechanism by which miR-218 regulates CSE-induced MUC5AC hyper-production and inflammation by targeting TNFR1-mediated activation of NF-κB, indicating that overexpression of miR-218 may be a strategy against cigarette smoking-induced bronchiolitis in COPD.
[Mh] Termos MeSH primário: Bronquiolite/etiologia
MicroRNAs/metabolismo
Mucina-5AC/metabolismo
NF-kappa B/metabolismo
Receptores Tipo I de Fatores de Necrose Tumoral/metabolismo
Fumar/efeitos adversos
[Mh] Termos MeSH secundário: Idoso
Bronquiolite/patologia
Sistemas CRISPR-Cas
Feminino
Regulação da Expressão Gênica/fisiologia
Seres Humanos
Inflamação/metabolismo
Masculino
MicroRNAs/genética
Meia-Idade
Mucina-5AC/genética
NF-kappa B/genética
Doença Pulmonar Obstrutiva Crônica/complicações
Doença Pulmonar Obstrutiva Crônica/patologia
Receptores Tipo I de Fatores de Necrose Tumoral/genética
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (MIRN218 microRNA, human); 0 (MUC5AC protein, human); 0 (MicroRNAs); 0 (Mucin 5AC); 0 (NF-kappa B); 0 (Receptors, Tumor Necrosis Factor, Type I)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171017
[Lr] Data última revisão:
171017
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170903
[St] Status:MEDLINE


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[PMID]:28828759
[Au] Autor:McCallum GB; Plumb EJ; Morris PS; Chang AB
[Ad] Endereço:Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia, 0810.
[Ti] Título:Antibiotics for persistent cough or wheeze following acute bronchiolitis in children.
[So] Source:Cochrane Database Syst Rev;8:CD009834, 2017 08 22.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Bronchiolitis is a common acute respiratory condition with high prevalence worldwide. This clinically diagnosed syndrome is manifested by tachypnoea (rapid breathing), with crackles or wheeze in young children. In the acute phase of bronchiolitis (≤ 14 days), antibiotics are not routinely prescribed unless the illness is severe or a secondary bacterial infection is suspected. Although bronchiolitis is usually self-limiting, some young children continue to have protracted symptoms (e.g. cough and wheezing) beyond the acute phase and often re-present to secondary care. OBJECTIVES: To compare the effectiveness of antibiotics versus controls (placebo or no treatment) for reducing or treating persistent respiratory symptoms following acute bronchiolitis within six months of acute illness. SEARCH METHODS: We searched the following databases: the Cochrane Airways Group Register of Trials, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (Ovid), Embase (Ovid), the World Health Organization (WHO) trial portal, the Australian and New Zealand Clinical Trials Registry, and ClinicalTrials.gov, up to 26 August 2016. SELECTION CRITERIA: We included randomised controlled trials (RCTs) comparing antibiotics versus controls (placebo or no treatment) given in the post-acute phase of bronchiolitis (> 14 days) for children younger than two years with a diagnosis of bronchiolitis. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed studies against predefined criteria, and selected, extracted, and assessed data for inclusion. We contacted trial authors for further information. MAIN RESULTS: In this review update, we added one study with 219 children. A total of two RCTs with 249 children (n = 240 completed) were eligible for inclusion in this review. Both studies contributed to our primary and secondary outcomes, but we assessed the quality of evidence for our three primary outcomes as low, owing to the small numbers of studies and participants; and high attrition in one of the studies. Data show no significant differences between treatment groups for our primary outcomes: proportion of children (n = 249) who had persistent symptoms at follow-up (odds ratio (OR) 0.69, 95% confidence interval (CI) 0.37 to 1.28; fixed-effect model); and number of children (n = 240) rehospitalised with respiratory illness within six months (OR 0.54, 95% CI 0.05 to 6.21; random-effects model). We were unable to analyse exacerbation rate because studies used different methods to report this information. Data showed no significant differences between treatment groups for our secondary outcome: proportion of children (n = 240) with wheeze at six months (OR 0.47, 95% CI 0.06 to 3.95; random-effects model). One study reported bacterial resistance, but only at 48 hours (thus with limited applicability for this review). Another study reported adverse events from which all children recovered and remained in the study. AUTHORS' CONCLUSIONS: Current evidence is insufficient to inform whether antibiotics should be used to treat or prevent persistent respiratory symptoms in the post-acute bronchiolitis phase. Future RCTs are needed to evaluate the efficacy of antibiotics for reducing persistent respiratory symptoms. This is particularly important in populations with high acute and post-acute bronchiolitis morbidity (e.g. indigenous populations in Australia, New Zealand, and the USA).
[Mh] Termos MeSH primário: Antibacterianos/uso terapêutico
Bronquiolite/complicações
Claritromicina/uso terapêutico
Tosse/tratamento farmacológico
Sons Respiratórios/efeitos dos fármacos
Infecções por Vírus Respiratório Sincicial/tratamento farmacológico
[Mh] Termos MeSH secundário: Doença Aguda
Bronquiolite/virologia
Tosse/etiologia
Seres Humanos
Lactente
Ensaios Clínicos Controlados Aleatórios como Assunto
Sons Respiratórios/etiologia
Infecções por Vírus Respiratório Sincicial/complicações
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); H1250JIK0A (Clarithromycin)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170919
[Lr] Data última revisão:
170919
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170823
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD009834.pub3


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[PMID]:28771405
[Au] Autor:Nakamura MM; Zaslavsky AM; Toomey SL; Petty CR; Bryant MC; Geanacopoulos AT; Jha AK; Schuster MA
[Ad] Endereço:Divisions of General Pediatrics and mari.nakamura@childrens.harvard.edu.
[Ti] Título:Pediatric Readmissions After Hospitalizations for Lower Respiratory Infections.
[So] Source:Pediatrics;140(2), 2017 Aug.
[Is] ISSN:1098-4275
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND OBJECTIVE: Lower respiratory infections (LRIs) are among the most common reasons for pediatric hospitalization and among the diagnoses with the highest number of readmissions. Characterizing LRI readmissions would help guide efforts to prevent them. We assessed variation in pediatric LRI readmission rates, risk factors for readmission, and readmission diagnoses. METHODS: We analyzed 2008-2009 Medicaid Analytic eXtract data for patients <18 years of age in 26 states. We identified LRI hospitalizations based on a primary diagnosis of bronchiolitis, influenza, or community-acquired pneumonia or a secondary diagnosis of one of these LRIs plus a primary diagnosis of asthma, respiratory failure, or sepsis/bacteremia. Readmission rates were calculated as the proportion of hospitalizations followed by ≥1 unplanned readmission within 30 days. We used logistic regression with fixed effects for patient characteristics and a hospital random intercept to case-mix adjust rates and assess risk factors. RESULTS: Of 150 590 LRI hospitalizations, 8233 (5.5%) were followed by ≥1 readmission. The median adjusted hospital readmission rate was 5.2% (interquartile range: 5.1%-5.4%), and rates varied across hospitals ( < .0001). Infants (patients <1 year of age), boys, and children with chronic conditions were more likely to be readmitted. The most common primary diagnoses on readmission were LRIs (48.2%), asthma (10.0%), fluid/electrolyte disorders (3.4%), respiratory failure (3.3%), and upper respiratory infections (2.7%). CONCLUSIONS: LRI readmissions are common and vary across hospitals. Multiple risk factors are associated with readmission, indicating potential targets for strategies to reduce readmissions. Readmission diagnoses sometimes seem related to the original LRI.
[Mh] Termos MeSH primário: Bronquiolite/economia
Bronquiolite/terapia
Infecções Comunitárias Adquiridas/economia
Infecções Comunitárias Adquiridas/terapia
Influenza Humana/economia
Influenza Humana/terapia
Medicaid/economia
Patient Protection and Affordable Care Act/economia
Readmissão do Paciente/economia
Pneumonia/economia
Pneumonia/terapia
[Mh] Termos MeSH secundário: Fatores Etários
Bronquiolite/prevenção & controle
Infecções Comunitárias Adquiridas/prevenção & controle
Controle de Custos
Custos de Cuidados de Saúde
Hospitais Pediátricos/economia
Seres Humanos
Lactente
Recém-Nascido
Doenças do Prematuro/economia
Doenças do Prematuro/prevenção & controle
Doenças do Prematuro/terapia
Influenza Humana/prevenção & controle
Pneumonia/prevenção & controle
Fatores de Risco
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:171110
[Lr] Data última revisão:
171110
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170804
[St] Status:MEDLINE


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[PMID]:28719504
[Au] Autor:Eskola V; Xu M; Söderlund-Venermo M
[Ad] Endereço:From the *Department of Pediatrics, Tampere University Hospital, and †Department of Virology, University of Helsinki, Helsinki, Finland.
[Ti] Título:Severe Lower Respiratory Tract Infection Caused by Human Bocavirus 1 in an Infant.
[So] Source:Pediatr Infect Dis J;36(11):1107-1108, 2017 Nov.
[Is] ISSN:1532-0987
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:We report a case of human bocavirus 1 (HBoV1) bronchiolitis that led to life-threatening respiratory failure in a 9-month-old boy with no other pathogens detected. The virus-specific diagnosis was confirmed with the detection of HBoV1 DNA in respiratory samples and both DNA and IgM and IgG to HBoV1 in serum samples.
[Mh] Termos MeSH primário: Bocavirus Humano
Infecções por Parvoviridae
Infecções Respiratórias
[Mh] Termos MeSH secundário: Albuterol/uso terapêutico
Anti-Inflamatórios/uso terapêutico
Bronquiolite/diagnóstico por imagem
Bronquiolite/patologia
Bronquiolite/terapia
Bronquiolite/virologia
Tubos Torácicos
Cuidados Críticos
Seres Humanos
Lactente
Masculino
Infecções por Parvoviridae/diagnóstico por imagem
Infecções por Parvoviridae/patologia
Infecções por Parvoviridae/terapia
Infecções por Parvoviridae/virologia
Respiração Artificial
Infecções Respiratórias/diagnóstico por imagem
Infecções Respiratórias/patologia
Infecções Respiratórias/terapia
Infecções Respiratórias/virologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Inflammatory Agents); QF8SVZ843E (Albuterol)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171024
[Lr] Data última revisão:
171024
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170719
[St] Status:MEDLINE
[do] DOI:10.1097/INF.0000000000001681


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[PMID]:28693067
[Au] Autor:Lin JT; Zhang YM; Zhou X; Wang CZ; Huang M; Liu CT; Wu CG; Wan HY; Yu WC; Dai YR
[Ad] Endereço:Department of Respiratory and Critical Care Medicine, China-Japan Friendship Hospital, Beijing 100029, China.
[Ti] Título:[Chinese expert consensus for non-antiinfective effects and clinical use of macrolides].
[So] Source:Zhonghua Nei Ke Za Zhi;56(7):546-557, 2017 Jul 01.
[Is] ISSN:0578-1426
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:Important/potential value of macrolides has been proved in the management of chronic respiratory diseases by increasing basic and clinical trials.Through three face-to-face discussions, 10 experts examined important data and drafted this consensus related to macrolides: (1) mechanism of non-antiinfective effects; (2) clinical use in chronic respiratory diseases; (3) cautions of long-term use.The mechanism out of non-antiinfective effects includes anti-inflammatory effect, modifying airway secretion, immune-regulation related to antibacterial effect, corticoid saving effect and anti-viral effect.The efficacy of long-term use of low-dose macrolides is definitely confirmed in diffuse panbronchiolitis, chronic rhinosinusitis. It is considerably used in bronchiectasia, cystic fibrosis, severe asthma and chronic obstructive pulmonary disease. Further studies should be conducted in cryptogenic organizing pneumonia and respiratory viral infection. It should be paid attention to its possible adverse effects (including drug interactions, cardiac toxicity, ototoxicity and disturbance of intestinal flora) and drug resistance in long-term use.A Chinese consensus for non-antiinfective effects and clinical use of macrolides is developed for the first time, which aims to expand their rational use and the further research.
[Mh] Termos MeSH primário: Anti-Infecciosos/uso terapêutico
Consenso
Prova Pericial
Macrolídeos/uso terapêutico
Guias de Prática Clínica como Assunto
[Mh] Termos MeSH secundário: Corticosteroides
Asma/tratamento farmacológico
Bronquiectasia/tratamento farmacológico
Bronquiolite
Doença Crônica/tratamento farmacológico
Infecções por Haemophilus
Seres Humanos
Macrolídeos/efeitos adversos
Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Adrenal Cortex Hormones); 0 (Anti-Infective Agents); 0 (Macrolides)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170904
[Lr] Data última revisão:
170904
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170711
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.0578-1426.2017.07.015



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