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Background: Community-acquired pneumonia remains the leading cause of death in children worldwide, and current diagnostic guidelines in resource-poor settings are neither sensitive nor specific. We sought to determine the ability to correctly diagnose radiographically confirmed clinical pneumonia when diagnostics tools were added to clinical signs and symptoms in a cohort of children with acute respiratory illnesses in Peru.Methods: Children < 5 years of age with an acute respiratory illness presenting to a tertiary hospital in Lima, Peru, were enrolled. The ability to predict radiographically confirmed clinical pneumonia was assessed using logistic regression under four additive scenarios: clinical signs and symptoms only, addition of lung auscultation, addition of oxyhemoglobin saturation (Spo2), and addition of lung ultrasound.Results: Of 832 children (mean age, 21.3 months; 59% boys), 453 (54.6%) had clinical pneumonia and 221 (26.6%) were radiographically confirmed. Children with radiographically confirmed clinical pneumonia had lower average Spo2 than those without (95.9% vs 96.6%, respectively; P < .01). The ability to correctly identify radiographically confirmed clinical pneumonia using clinical signs and symptoms was limited (area under the curve [AUC] = 0.62; 95% CI, 0.58-0.67) with a sensitivity of 66% (95% CI, 59%-73%) and specificity of 53% (95% CI, 49%-57%). The addition of lung auscultation improved classification (AUC = 0.73; 95% CI, 0.69-0.77) with a sensitivity of 75% (95% CI, 69%-81%) and specificity of 53% (95% CI, 49%-57%) for the presence of crackles. In contrast, the addition of Spo2 did not improve classification (AUC = 0.73; 95% CI, 0.69-0.77) with a sensitivity of 40% (95% CI, 33%-47%) and specificity of 72% (95% CI, 68%-75%) for an Spo2 ≤ 92%. Adding consolidation on lung ultrasound was associated with the largest improvement in classification (AUC = 0.85; 95% CI, 0.82-0.89) with a sensitivity of 55% (95% CI, 48%-63%) and specificity of 95% (95% CI, 93%-97%).Conclusions: The addition of lung ultrasound and auscultation to clinical signs and symptoms improved the ability to correctly classify radiographically confirmed clinical pneumonia. Implementation of auscultation- and ultrasound-based diagnostic tools can be considered to improve diagnostic yield of pneumonia in resource-poor settings. [ABSTRACT FROM AUTHOR]

The article presents the findings of the study that comprehensively evaluates the ability and reliability of the representative oxyghemoglobin indexes from the prediction of the severity of obstructive sleep apnea hypopnea syndrome (OSAHS). The study use three kinds of oxyghemoglobin indexes including oxyhemoglobin desaturation index (ODI), time-domain index, and frequency-domain index. It reveals that ODI does better diagnostics having higher correlation with apnea-hypopnea index (AHI).

The article presents a study involving obstructive sleep apnea. This sleep disorder is known for its association with recurrent episodes of respiration discomfort such as upper way obstruction leading to recurrent arousals and oxyhemoglobin desaturations when sleeping. The authors note various clinical impact of the sleep apnea including hypersomnolence, neurocognitive and metabolic dysfunction, and cardiovascular complications.

The article presents information on the oxyhemoglobin dissociation curve (ODC) in patients with liver cirrhosis. A study was performed in a cohort of cirrhotic patients, who were candidates for orthotopic liver transplantation (OLT). 50 cirrhotic candidates for OLT at a large academic hospital were traced for ODC in whole blood in standard conditions of temperature and pH. Mixed venous blood was also obtained from these patients. The results revealed that in the two groups, mean ODC was same. It was concluded that factors other than pH, temperature, carbon dioxide, and inorganic phosphates are acting on the position of the ODC.

The article discusses the significant impact of pulse oximetry, a noninvasive method for monitoring a person's oxygen saturation, in the fields of perioperative and intensive care medicine. Topics discussed include principles of exercise testing and interpretation; meta-analysis of arterial oxygen saturation monitoring by pulse oximetry in adults; and kinetics of changes in oxyhemoglobin saturation during walking and cycling tests in COPD.

An abstract of the article "2-Year-Old Male With Recurrent Pericardial and Pleural Effusions" by Christine Gould and colleagues is presented.