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Copyright of Revista Española de Quimioterapia is the property of Sociedad Espanola de Quimioterapia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Ciencias de la Salud is the property of Colegio Mayor de Nuestra Senora del Rosario and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

El caso clínico presenta a un varón de 46 años con antecedentes alérgicos e hipercolesterolemia, que acude a urgencias tras experimentar un síncope repentino con episodio de repetición. Durante el episodio, no se observan movimientos tónico-clónicos ni síntomas respiratorios. La evaluación revela una frecuencia cardíaca elevada, pero sin anomalías en la auscultación pulmonar y cardíaca. Tras el ingreso, se inicia tratamiento empírico con antibióticos, y las pruebas indican una condensación pulmonar multilobar compatible con neumonía atípica. Los picos febriles y las pruebas complementarias sin diagnóstico claro enfatizan la necesidad de considerar la neumonía atípica en casos con presentaciones clínicas inusuales, lo cual destaca la importancia de un enfoque terapéutico empírico y futuras investigaciones.

Objetivo: desarrollar un puntaje predictivo de mortalidad para pacientes con covid-19. Materiales y métodos: estudio retrospectivo, analítico, observacional y transversal, realizado en dos fases. Se revisaron 620 historias clínicas con una cohorte de derivación de 320 pacientes y una de validación de 300 pacientes. Las variables se analizaron con test de Anova, chi cuadrado de Pearson y análisis multivariante con regresión binaria, que determinaron sensibilidad, especificidad y valor predictivo negativo y positivo. Los puntajes se compararon mediante curvas cor con los scores news y hews. Resultados: los dos puntajes obtenidos incluyeron valores de edad, conteo de linfocitos, SatO2 /FiO2, leucocitos, plaquetas, ausencia de síntomas, hipertensión arterial, epid y dhl. El área bajo la curva (abc) fue de 0.838 para el puntaje con dhl, con una mortalidad del 100% para 7.75 puntos o más, y un abc de 0.826 para el primer puntaje. En la cohorte de validación, el abc para el primer puntaje fue de 0.831 y para el score con dhl fue 0.855. El puntaje hews obtuvo un abc de 0.451, y el news, un abc de 0.396. Conclusiones: se desarrollaron dos herramientas para predecir mortalidad en pacientes con covid-19, con alto poder de discriminación, superior a los puntajes británicos hews y news.

La neumonía adquirida en la comunidad constituye una de las causas más frecuentes de ingresos hospitalarios, con elevada repercusión en la mortalidad. El objetivo del estudio ha sido evaluar la asociación de varios factores con el estado de gravedad al ingreso en pacientes hospitalizados por neumonía. Se realizó un estudio descriptivo con 1,809 pacientes hospitalizados por neumonía entre los años 2012 y 2020. Fueron evaluados factores relacionados con el paciente, con la enfermedad y con el manejo prehospitalario, como variables independientes; como variable dependiente fue considerado el estado al ingreso. Mediante análisis bivariado y multivariado (regresión logística), la asociación fue medida a través del odds ratio y su intervalo de confiaza de 95 %. Se demostró asociación significativa entre varias condiciones evaluadas y el estado de gravedad al ingreso; los factores que en el análisis multivariado mostraron mayor fuerza de asociación fueron: la condición de encamamiento (OR 3,6[2,7;4,7]), la presencia de derrame pleural de mediana o gran cuantía (OR 3[2;4,5]), el antecedente de demencia avanzada (OR 2,4[1,7;3,5]), la extensión radiológica no circunscrita a un lóbulo (OR 2[1,6;2,6]) y el antecedente de diabetes mellitus (OR 1,3[1,04;1,7]). Como conclusiones, se ha corroborado la relación existente entre la ocurrencia del estado de gravedad de los pacientes con neumonía adquirida en la comunidad al momento de su admisión hospitalaria y varias condiciones adversas, algunas inherentes a las características de los pacientes (encamamiento previo, demencia avanzada y diabetes mellitus) y otras al comportamiento radiológico de la enfermedad (extensión más allá de un lóbulo y la presencia de derrame pleural de mediana o gran cuantía al momento de la admisión).

Introduction: the improvement of health professionals is a necessity due to the continuous scientific and technical development. Objective: to identify the regularities of the professional training process on Community Acquired Pneumonia for Internal Medicine teachers at León Cuervo Rubio Hospital in Pinar del Río. Method: educational research was developed based on the dialectical-materialistic method, integrating qualitative and quantitative aspects, using theoretical and empirical methods such as the historical-logical, systemic-structural, documentary review, surveys, interview and observation, respectively. In addition, descriptive and inferential statistical methods, the sample used was 25 intentionally selected specialists in Internal Medicine teachers. The variable studied was the professional improvement process on Community Acquired Pneumonia. Results: Insufficient training actions on CAP directed to teachers. Deficient integration of CAP contents in on-the-job education through the use of the clinical method. Training actions with a sequential approach to the objectives and contents of NAC have not yet been organized. Weaknesses in the pedagogical preparation of teachers to have an impact on the improvement of performance on management of Community Acquired Pneumonia. Conclusions: There are limited actions for the improvement of the management of CAP, the planned professional development process does not make possible the updating and deepening of the contents of CAP, necessary to improve the performance of teachers in order to transform the health status of patients admitted and improve their quality of life.

Lung ultrasound is an accessible, low-cost technique that has demonstrated its usefulness in the prognostic stratification of COVID-19 patients. In addition, according to previous studies, it can guide us towards the potential aetiology, especially in epidemic situations such as the current one. 40 patients were prospectively recruited, 30 with confirmed SARS-CoV-2 pneumonia and 10 with community-acquired pneumonia. The patients included underwent both a chest X-ray and ultrasound. There were no differences in the 2 groups in terms of clinical and laboratory characteristics. The main ultrasound findings in the SARS-CoV-2 group were the presence of confluent B lines and subpleural consolidations and hepatinization in the community-acquired pneumonia group. Pleural effusion was more frequent in the community-acquired pneumonia group. There were no normal lung ultrasound exams. Analysis of the area under the curve curves showed an area under the curve for lung ultrasound of 89.2% (95% CI: 75.0-100%, p <.001) in the identification of SARS-CoV-2 pneumonia. The cut-off value for the lung score of 10 had a sensitivity of 93.3% and a specificity of 80.0% (p <.001). The combination of the findings of the lung ultrasound, with a lung score greater than 10, added to the rest of the additional tests, can be an excellent tool to predict the aetiology of the pneumonia. [ABSTRACT FROM AUTHOR]

Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Community-acquired pneumonia (CAP) is a disease that occurs frequently and is considered a very serious infection in childhood, the objective of this study was to evaluate the epidemiological behavior of CAP in younger children. 3 years in the Pediatrics Area of the Hospital Ambato IESS. Methodology: A retrospective and descriptive study was carried out in 113 children identified with CAP who attended the aforementioned hospital, in the period from August 2019 to March 2020. The selection of the sample was carried out through a consecutive purposive sampling. For the evaluation of the cases, the clinical data of the records records department of the health center were used. Results: According to the results obtained, it was evidenced that 54% corresponded to the female gender, 64% were between 2 and 3 years of age, 26% (n=29) of the CAPs had a bacterial origin, 25% (n=28) had a viral origin, the rest were not specified. In addition, 26% (n=29) had a common cold. 53% (n=60) had rural origin. The basic or primary educational level was the most common among parents (49%; n=55). Conclusions: the results show that CAP has a higher incidence in rural areas, with parents with a basic educational level and the bacterial etiology was slightly higher than the viral one, commonly associated with a common cold. [ABSTRACT FROM AUTHOR]

Background: Community-acquired pneumonia produces inflammatory products that produce preventable cardiovascular events. Objective: To establish if Community-Acquired Pneumonia (CAP) is a risk factor associated with cardiovascular disease. Materials and Methods: A cohort design was carried out with: patients hospitalized for a diagnosis of CAP and a control group without pneumonia (1:2), who met the selection criteria. Chi square, Relative Risk and confidence intervals were calculated for the crude and adjusted bivariate analysis and robust multivariate analysis. Results: Of the total study population, 693 patients were analyzed. The mean age was 64.1 ± 13.7 (SD) years. The most were male (61.5%). Among the classic cardiovascular factors, 96.8% used tobacco; 73.9% were hypertensive; 82.5% were diabetic and 96.5% were hypercholesterolemic. It was found that men had a higher frequency of acute coronary syndrome than women (22.3% vs. 4.5%; p<0.01), as well as in heart failure (33.1% vs. 25.8%; p<0.01) and in greater arrhythmia in women (23.2% vs 13.4%; p<0.01). In the multiple regression analysis, the observed association was preserved; adjusting with the confounding covariates of tobacco consumption, arterial hypertension, diabetes mellitus and hypercholesterolemia, for acute coronary syndrome: (RR= 3.98; 95% CI: 2.98-5.33), heart failure: (RR= 9, 65; 95% CI: 8.45-11.0) and arrhythmias: (RR= 10.7; 95% CI: 8.64-13.2). Conclusion: CAP is a risk factor associated with cardiovascular disease. [ABSTRACT FROM AUTHOR]

Copyright of Salud Uninorte is the property of Fundacion Universidad del Norte and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Española de Quimioterapia is the property of Sociedad Espanola de Quimioterapia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Española de Quimioterapia is the property of Sociedad Espanola de Quimioterapia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction and objectives: Mycoplasma pneumoniae (MP) is one of the most common etiological agents of community-acquired pneumonia (CAP) in children. We aimed to describe the clinical and epidemiological characteristics, treatment and outcome of children diagnosed with community-acquired MP pneumonia (CAMP) in a tertiary hospital in Valencia, Spain. Material and methods: Medical records of children

Introduction: severe community-acquired pneumonia has not been characterized at the Pediatric Teaching Hospital ¨Pedro Agustín Pérez¨ in Guantanamo. Objective: to profile this affection at the Intensive Care Unit of the already cited institution in the period 2016-2019. Method: a descriptive, longitudinal and retrospective study was carried out. The study population was made out of all the patients in the intensive care unit in that period of time (N=153). The variables analyzed were: gender, age, microbiological diagnosis, antimicrobial therapy, mechanical ventilation application, medical procedures applied, complications, in-hospital stay, state at the time of discharge and cause of death. Results were presented in tables and were summed up in absolute and cumulative frequencies. Results: most patients were male, ranging from 1 to 4 years of age (30.7 %). Streptococcus pneumoniae was the most common infection (36.0 %). 16.3 % if the cases required mechanical ventilation and the 22.9 % presented some complication, the most common being the parapneumonic pleural effusion (22.5 %). 96.4 % of the patients were discharged alive, and the main cause of death was septic shock (57.2 %). Conclusions: pneumonia remains a frequent pathology in patients in pediatric age; and prevails in male patients as well. After vaccination campaigns started, the Streptococcus pneumoniae emerged as the main bacterial pathogen to cause infections at any age, especially in patients below the 5 years of age.

Introducción: la neumonía adquirida en la comunidad (NAC) es una de las infecciones más frecuentes en el ámbito mundial, su incidencia es variable y está relacionada con la edad, presencia de enfermedades concomitantes y algunos factores de riesgo específicos como tabaquismo y abuso de alcohol.Objetivo:identificar los microorganismos causantes de neumonía adquirida en la comunidad a partir de la muestra de esputo expectorado. Método: se realizó un estudio descriptivo y trasversal de enero a junio de 2016. El universo de estudio estuvo formado por 88 pacientes, lo que también constituyó la muestra, con diagnóstico clínico y radiológico de neumonía adquirida en la comunidad realizado por el médico de familia. Se aplican procedimientos de laboratorio descritos en literatura de reconocido prestigio internacional. Resultados: se identifican 72 (81,8%) muestras de esputo productivo, de las cuales son positivas al cultivo bacteriológico 56 (77,7%) muestras.Predominaron lasPseudomonasaeruginosa, Staphylococcusaureusy Streptococcuspneumoniae. Moraxellacatarrhalis,Haemophilusinfluenzae, Achromobacter y Aspergillusspp. se encontraron en menor medida. Conclusiones: se identifican Klebsiellapneumoniae, Pseudomonasaeruginosa, Staphylococcusaureus, Streptococcuspneumoniae, Moraxellacatarrhalis,Haemophilusinfluezae y Achromobactersp. como microorganismos productores de neumonía en la comunidad, mostrando marcada resistencia a diversos antimicrobianos.

El objetivo de esta investigación es establecer los factores pronósticos que conllevan a mortalidad y prolongar la estancia intrahospitalaria en pacientes ancianos hospitalizados por Neumonía Adquirida en la Comunidad (NAC) del Servicio de Neumología del Hospital General del Sur en Maracaibo, Venezuela. La muestra estuvo conformada por 51 ancianos (³ 65 años), de ambos géneros, con diagnóstico clínico de NAC, hospitalizados. Los datos se obtuvieron a través del formato de la Escala de Fine modificada, la cual contemplaba edad, género, procedencia, comorbilidades asociadas, hallazgos en examen físico, laboratorio y radiografía de tórax. Para el análisis estadístico se aplicó el coeficiente de correlación de Pearson, el nivel alfa fijado fue de 0,05. Del total el 66 % fueron menores de 80 años, sin diferencias significativas entre los géneros, las comorbilidades más relacionadas al riesgo de neumonía fueron enfermedad renal (49,02 %) e hipertensión arterial (52,94 %); como parámetros paraclínicos la urea (> 65 mg/dL) y creatinina (1,5 mg/dL) constituyeron las variables de mayor riesgo. La temperatura y presión de O2 mostraron riesgo significativo para hospitalización; siendo 1,5 veces mayor de ser hospitalizado, si la temperatura es > 40 °C [OR 95 % = 1,5 (IC = 1,0-2,2)], y de 2,1 mayor probabilidad si la presión de O2 es < 60 mmHg [OR 95 % = 2,1 (IC = 1,5-3,0)]. Con una mortalidad del 24 %. Se concluye que la escala pronóstico de mortalidad de Fine es una herramienta útil para determinar el manejo terapéutico e individualizado por NAC en pacientes ancianos.

Copyright of Archivos de Bronconeumología (English Edition) is the property of Sociedad Espanola de Neumologia y Cirugia Toracica (SEPAR) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Community-acquired pneumonia (CAP) is an acute infectious disease. Inflammation of the lower respiratory system, interstitium, and microvasculature, mainly of bacterial etiology, is a typical pathological sign of this disease. It is one of the leading causes of death from infectious diseases. The survey was conducted within the KNOCAP multicenter research project (the full name of the project "The assessment of students' and physicians' knowledge of community-acquired pneumonia basics"). We have assessed the knowledge and preferences of doctors and 85 senior medical students from Belgorod National Research University majoring in Medicine by surveying them two times -- before and after the conduction of educational activities. The first stage of the project was carried out in 2017-2018, the second one -- in 2018-2019. Educational activities were held during the educational process (in particular, during Clinical Pharmacology). The greatest difficulties appeared when answering the questions: the choice of the main criterion for the terminating antimicrobial therapy (AMT); the choice of the main diagnostic sign when examining a CAP patient; the choice of the criterion for CAP diagnosis confirmation. This study makes a significant contribution to the development of a practical health care system because it allows both identifying "weak spots" and improving the quality of CAP patients' management tactics. There is a necessity to conduct more studies about this matter since the current health care system is experiencing changes, and new clinical guidelines are published. [ABSTRACT FROM AUTHOR]

Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To determine the incidence and clinical characteristics of children with community acquired pneumonia (CAP) admitted to the Hospital Pediátrico "Baca Ortiz", Ecuador. Materials and methods: This was an observational descriptive and retrospective study in infants admitted to the aforementioned hospital during the period from January to December 2016, the clinical data from medical records department were used, and the cumulative incidence during 2016 was calculated. Results: Out of the 645 infants, 283 were admitted with CAP diagnosis, the cumulative incidence was 43.8% for 2016. A higher frequency of those affected were male (56.5%; n=160) and 1-4 months old (49.8%; n=141), the presence of comorbidity was observed in 30.3% (n=86), the period of the year with the highest number of affected ones was January-March (44.5%; n=126), the majority of the patients were hospitalized >10 days (54.4%; n=154), the most frequent antibiotic therapy scheme was Ampicillin I Sulbactam plus Oxacillin (48.7%; n=138), with a period between 6-10 days of treatment as the most common one (63.6%; n=180). Conclusion: The incidence of CAP in children of the Hospital Pediátrico "Baca Ortiz" was 43.8% in 2016, higher than that shown on various population studies worldwide, including in Ecuador; revealing a high frequency of comorbidities and a hospital stay of more than 7 days in most cases. [ABSTRACT FROM AUTHOR]

La neumonía es la causa de muerte de aproximadamente 4 millones de niños al año en todo el mundo, la gran mayoría en países en desarrollo. En el primer año de vida, la incidencia es de 15-20 casos/1.000 niños/año. De 1 a 5 años asciende a 30-40 casos y, de nuevo, desciende en los mayores de 5 años a 10-20 casos/1.000 niños/año. Es una infección aguda del tracto respiratorio inferior adquirida en la comunidad con una duración inferior o igual a 14 días, que produce tos y/o dificultad respiratoria y con evidencia radiológica de infiltrado pulmonar agudo. El Streptococcus pneumoniae es el principal agente bacteriano. Se presenta el caso de un preescolar masculino de 2 años de edad. Inicia su enfermedad actual con rinorrea hialina anterior, hipertermia no cuantificada, tos seca. Es evaluado por facultativo y realizan paraclínicos que reportan leucocitosis, neutrofília y trombocitosis reactiva, diagnostican infección respiratoria baja e indican tratamiento antimicrobiano vía oral, el cual cumple sin evidenciar mejoría. Posteriormente se asocia dificultad respiratoria, consulta a centro de salud donde ingresan e indican tratamiento médico durante 48 horas sin mejoría clínica, refieren al Hospital Universitario de Caracas en regulares condiciones generales. En TAC de tórax se evidencian imágenes sugestivas de neumonía necrotizante bilateral, se indica doble antibioticoterapia durante 11 días para dar cobertura a Streptococcus pneumoniae resistente y/o Staphylococcus Aureus meticilino resistente adquirido en la comunidad, productor de leucocidina Panton - Valentine. Con evolución clínica satisfactoria egresa, con antibioticoterapia vía oral por 21 días y control por Neumopediatría.

RESUMEN Introducción: La neumonía comunitaria complicada es una entidad con gran impacto sobre la morbimortalidad pediátrica. Objetivo: Desarrollar un instrumento que permita pronosticar a los niños con alto riesgo de desarrollar neumonía comunitaria complicada. Métodos: Se realizó un estudio cuali-cuantitativo en el Hospital General "Comandante Pinares" de San Cristóbal, en el período 2013-2016 en dos etapas: una etapa diagnóstica inicial, en la que se efectuó un estudio de cohorte prospectivo observacional que permitió estimar la incidencia de neumonía complicada, describir sus características relevantes e identificar factores de riesgo. En una segunda etapa, se elaboró y validó un instrumento pronóstico de esta entidad. Resultados: La incidencia de neumonía complicada fue del 39,5 %, identificándose seis factores de riesgo: hacinamiento [OR 1,9], fumador pasivo [OR 1,76], no lactancia materna exclusiva hasta el sexto mes [OR 1,85], anemia [OR 4,5], morbilidad infecciosa recurrente [OR 1,69] y uso reciente de antimicrobianos [OR 2,38]. Al aplicar el instrumento pronóstico se obtuvo una sensibilidad del 85,47 y una especificidad del 92,74. Conclusiones: La neumonía complicada es una entidad de presentación frecuente, identificándose seis factores de riesgo. El instrumento desarrollado pronostica la posibilidad de desarrollar neumonía complicada en niños con sensibilidad aceptable y alta especificidad.

Copyright of Archivos de Bronconeumología (English Edition) is the property of Sociedad Espanola de Neumologia y Cirugia Toracica (SEPAR) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introducción: La neumonía adquirida en la comunidad (NAC) es una de las causas infecciosas más frecuentes de morbi-mortalidad a escala mundial en niños menores de 5 años. El objetivo del estudio fue precisar el diagnóstico bacteriano etiológico en lactantes con NAC. Métodos: Se condujo un estudio prospectivo, transversal y descriptivo en 17 pacientes de 6 meses a 2 años 11 meses de edad con NAC de mala evolución, que ingresaron al servicio de Neumología pediátrica. A los pacientes se les realizó broncoscopia con lavado broncoalveolar (LBA) con las medidas pertinentes durante el procedimiento para limitar el riesgo de contaminación. Resultados: Las bacterias aerobias aisladas fueron Moraxella sp. (23%), Streptococcus mitis (23%), Streptococcus pneumoniae (18%), Haemophilus influenzae (12%), Streptococcus oralis (12%), y Streptococcus salivarius (12%). Conclusiones: En contraste con otros informes se observó que Moraxella sp. es un importante patógeno potencial bacteriano, posiblemente debido a la mejora en la detección con broncoscopia más LBA.

Background: Psittacosis is a relatively uncommon cause of community-acquired pneumonia, often leading to diagnostic difficulty., Methods: A retrospective study was conducted on the clinical features of psittacosis patients in China. Forty-six cases of Chlamydophila psittaci infection with atypical pneumonia of varying severity in the last two years were described retrospectively., Results: Fever, relative bradycardia, and other systemic upsets were the main clinical presentation. The most common radiographic abnormality was segmental or lobar shadowing or consolidation. The total white cell counts were usually normal or slightly increased. The concentration of creatine kinase, C reactive protein, and lactic dehydrogenase increased, while albumin decreased remarkably. These cases exhibited good recovery after being treated with tetracycline or quinolone antibiotics., Conclusion: These features may help differentiate psittacosis from other traditional bacterial pneumonia. However, they do not provide a definitive diagnosis. Psittacosis diagnosis must perform the whole-genome sequencing for Chlamydophila psittaci in respiratory, blood, or sputum specimens. Increased awareness of psittacosis can shorten diagnostic delays and improve patient outcomes., (Copyright © 2023. Published by Elsevier España, S.L.U.)

Introducción: las infecciones respiratorias agudas se mantienen como un grupo importante de afecciones con alta morbilidad y mortalidad infantil y dentro de ellas las neumonías, la pandemia olvidada. Objetivo: verificar el diagnóstico de los niños ingresados por neumonías en el servicio de enfermedades respiratorias del Hospital General Docente “Aleida Fernández Chardiet”, del municipio de Güines. Métodos: se realizó un estudio descriptivo prospectivo de corte transversal de los pacientes ingresados con diagnóstico de neumonías en el servicio de enfermedades respiratorias del Hospital General Docente “Aleida Fernández Chardiet”, en el primer trimestre del 2013, tomando el universo de los pacientes ingresados con este diagnóstico (256). Resultados: el 72,8 % de los niños fueron del sexo masculino y el 48,1 % menor de 1 año, el 61,7 %, con radiografía de tórax normal al ingreso, el 45,6 % sin signos clínicos, el 45,6 % tratado con penicilina y en el 60,6 % de los pacientes se retiro antibiótico y el 93,5 % de ellos evolucionaron satisfactoriamente. Conclusiones: la neumonía predominó en el menor de un año, del sexo masculino, más de la mitad con radiografía de tórax (Rx T) normal al ingreso, el tratamiento de elección fue la penicilina, con evolución satisfactoria.

Community-acquired pneumonia is a common disease in Pediatrics and is still caused by Streptococcus pneumoniae after the neonatal period; however, Staphylococcus aureus is an important cause when it progresses with severe clinical and radiological deterioration associated with pulmonary complications. We present the case of a 6-month-old male infant who was admitted with a diagnosis of abscessed adenitis in the right laterocervical region; in 48 hours, respiratory deterioration appears and the chest radiograph shows right basal pneumonia complicated with pleural effusion. The microbiological study isolates staphylococcus aureus methicillin resistant (MRSA). A minimal thoracotomy was performed concluding pachypleuritis. A pulmonary abscess was evidenced on a chest ct scan. In conclusion, MRSA-CA infections should be considered in cases of complicated pneumonias with necrosis, empyema and lung abscess. Epidemiological surveillance and studies to determine the prevalence of colonization and infections caused by this microorganism are suggested. [ABSTRACT FROM AUTHOR]

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La incidencia de neumonía aumenta con la edad y afecta la morbilidad y mortalidad en adultos mayores. Este artículo revisa conceptos actuali-zados sobre el manejo de la neumonía en adultos mayores, estratificación de riesgo, antibioticote-rapia y tratamiento adyuvante. Se enfatizan as-pectos de prevención y consideraciones en cuan-to al abordaje geriátrico.

La neumonía adquirida en la comunidad (NAC) ocasiona importante morbilidad y mortalidad en la población adulta, especialmente en el anciano con enfermedades preexistentes. En esta revisión examinaremos aspectos relacionados con la epidemiología, diagnóstico clínico y microbiológico, evaluación de la gravedad, tratamiento empírico y prevención de la neumonía comunitaria. El principal patógeno aislado en la neumonía comunitaria sigue siendo Streptococcus pneumoniae, seguido por otros microorganismos como Haemophilus infuenzae, Mycoplasma pneumoniae, Chlamydophila pneumoniae y los virus respiratorios; en los casos más graves: S. aureus, bacilos gram negativos y Legionella spp. La evaluación de la gravedad permite predecir la evolución de la enfermedad, decidir el lugar de manejo, la extensión del estudio microbiológico y de laboratorio complementario y el tratamiento antimicrobiano empírico, para lo cual se han diseñado índices pronósticos validados en la literatura, como el Índice de Gravedad de la Neumonía y CURB-65. El paciente de bajo riesgo de manejo ambulatorio se recomienda tratar con amoxicilina, con o sin inhibidor de ß-lactamasas, o macrólidos durante 7–10 días. En los pacientes hospitalizados, se recomienda tratar con agentes β-lactámicos asociado a macrólidos o monoterapia con fuoroquinolonas. Las principales medidas de prevención de la neumonía comunitaria incluyen el tratamiento del tabaquismo y los programas de inmunización antiinfluenza y antineumocócica en las poblaciones de riesgo elevado.

Se llevó a cabo un estudio observacional, descriptivo y transversal de 18 niños menores de 5 años de edad, fallecidos por neumonía adquirida en la comunidad (como causa básica de muerte) en el Hospital Docente Pediátrico Sur durante el período de enero de 1997 a diciembre de 2011, con vistas a caracterizarles y determinar las tasas de mortalidad por dicha causa. Las variables clínicas, epidemiológicas y paraclínicas se obtuvieron de los registros de defunciones y morbilidad del Departamento de Estadística de la institución, así como de las historias clínicas de los pacientes. En la investigación se observó que el mayor número de fallecidos correspondiera al sexo masculino (67,7 %) y al grupo etario de 1-4 años (58,8 %); además primaron el cuadro clínico muy grave al momento del ingreso (44,4 %), la anemia (82,3 %), los ingresos previos (100,0 %), el hacinamiento (77,7 %), el asma bronquial como enfermedad crónica (61,1%), la linfocitosis (61,1 %), el recuento de leucocitos normal (50,0 %) y las imágenes de condensación inflamatoria bilateral en las radiografías (61,1 %). Las tasas de mortalidad específica y mortalidad proporcional por neumonía mostraron tendencias evolutivas descendentes, en tanto la de mortalidad bruta reveló menor cuantía

Copyright of Revista Española de Quimioterapia is the property of Sociedad Espanola de Quimioterapia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Se realizó un estudio observacional, descriptivo y prospectivo en 80 ancianos con neumonía adquirida en la comunidad, ingresados en el Servicio de Geriatría del Hospital Provincial Docente Clinicoquirúrgico "Saturnino Lora Torres" de Santiago de Cuba, desde enero hasta diciembre del 2008, a fin de caracterizarlos. En la serie predominaron el sexo masculino (53,7 %), el grupo etario de 80-89 años (38,7 %), los procedentes de domicilios en la ciudad (90,0 %) y los que residían en los distritos 1 y 3 (39,0 y 29,0 %, respectivamente). Asimismo, la hipertensión arterial, la cardiopatía isquémica y la insuficiencia cardíaca fueron las enfermedades asociadas prevalentes y en la totalidad de los afectados se siguió una terapia empírica.An observational descriptive and prospective study was conducted in 80 elderly people with community-acquired pneumonia, admitted to the Geriatrics Department of "Saturnino Lora" Provincial Teaching Clinical Surgical Hospital of Santiago de Cuba, from January to December 2008 to characterize them. Males (53.7%), the age group of 80-89 years (38.7%), those from homes in the city (90.0%), and those living in the districts 1 and 3 (39.0% and 29.0% respectively) predominated in the series. Also, arterial hypertension, ischemic heart disease and heart failure were the prevalent associated diseases, and in all the patients an empiric therapy was continued.

Introducción: la neumonía adquirida en la comunidad constituye en el siglo XXI la causa más frecuente de muerte de etiología infecciosa en los países desarrollados, aportando elevada incidencia y morbimortalidad, situación empeorada por la emergencia de gérmenes multirresistentes desde la comunidad. Las escalas pronóstico de severidad son herramientas útiles en el enfrentamiento diagnóstico terapéutico de esta enfermedad. Basado en ello, los autores se propusieron como objetivo caracterizar el comportamiento clínico-epidemiológico de la neumonía adquirida en la comunidad vinculándolo con la aplicación de escala CRB-65. Métodos: estudio descriptivo, observacional y prospectivo sobre universo de pacientes admitidos para ingreso por neumonía adquirida en la comunidad en el Hospital Universitario Clínico Quirúrgico Comandante Faustino Pérez, de Matanzas, en el 2007, empleando métodos filosóficos dialéctico-materialista, empíricos, teóricos y estadísticos con selección y operacionalización de variables aplicando medidas de resumen. Resultados: aproximadamente el 50 % de los pacientes que acudieron con neumonía adquirida en la comunidad fueron admitidos para ingreso, un 74,7 % mayores de 65 años, la terapia antimicrobiana combinada fue de 44 %, al aplicar escala CRB-65 más de un 60 % resultaron de escasa severidad pronosticada; entre los que tuvieron puntuaciones predictoras de gravedad un 60 % fueron transferidos tardíamente a unidades de atención a graves. La mortalidad total fue de 4,2 %, y en las unidades de atención a graves, de 40 %. Conclusiones: La neumonía adquirida en la comunidad aportó elevada incidencia y motivó hospitalización frecuente, fundamentalmente en población geriátrica, con comorbilidades asociadas. En una elevada proporción fue decidida la hospitalización en grupos de escasa severidad, tributarios de tratamiento ambulatorio según escala pronósticos CRB-65; por otra parte resultaron transferidos casos con criterios de gravedad tardíamente a unidades de atención a graves.Introduction: the community-acquired pneumonia is the most frequent cause of death of infectious etiology in the developed countries in the XXI century. It has a high incidence and morbimortality, situation that is worsened by the emergency of communitarian multi resistant germs. The severity prognostic scales are useful tools in the therapeutic- diagnostic confrontation of this disease. Based on that, the authors proposed themselves the objective of characterizing the clinic-epidemiologic behavior of the community-acquired pneumonia, linking it with the CRB-65 scale application. Methods: descriptive, observational and prospective research on the universe of patients who entered the Teaching Surgical Clinical Hospital Comandante Faustino Perez, of Matanzas, in 2007, for community-acquired pneumonia. We used dialectic-materialist philosophic, empiric, theoretic and statistic methods with variables selection and operationalization, applying summarizing measures. Results: near 50 % of the patient who assisted the hospital with community-acquired pneumonia were admitted as in-patients, 74,7 % of them were elder than 65 years old; the combined antimicrobial therapy reached 44 %. When the CRB-5 scale was applied more than 60 % had scarce predicted severity; among those who had values predicting severity, 60 % were transferred late to health care units for seriously ill persons. The total mortality was 4,2 %, and 40 % in the health care units for seriously ill persons. Conclusions: community-acquired pneumonia had a high incidence and was the cause of a frequent hospitalization, mainly in the geriatric population, with associated co-morbidities. In a high proportion the hospitalization was decided in groups of scarce severity, needed of an ambulatory treatment according to the prognostic scale CRB-65; from the other hand there were cases with seriousness criteria transferred late to the health care units for seriously ill persons.

BACKGROUND: Pneumonia is a generic term used to describe an inflammation of lung parenchyma that usually occurs in response to the uncontrolled proliferation of pathogenic organisms. OBJECTIVE: To evaluate the association between the inflammatory process (endothelial dysfunction) using the ankle-brachial index, with the presence of severity of community-acquired pneumonia, using the PSI scale in a hospital in Mexico City. MATERIAL AND METHOD: An observational, descriptive, crosssectional and prolective study was done, which took place at the Xoco General Hospital, Mexico City. The sample size was calculated for an alpha <0.05 significance, comparing the association between the presence of inflammation (endothelial dysfunction) in patients with community-acquired pneumonia, Group 1 (n=33), with non-severe pneumonia, and Group 2 (n=33), with severe pneumonia. Mean procalcitonin levels among patients who had severe pneumonia versus non-severe pneumonia were also compared. RESULTS: The statistical analysis in this study reported statistical significance with p<0.0001 when observing the association between endothelial dysfunction and severity of pneumonia. Significant difference found in this study between the two groups. Smoking and alcoholism were found as factor risks. CONCLUSIONS: There is association between endothelial dysfunction measured by the ankle brachial index and the severity of communityacquired pneumonia. [ABSTRACT FROM AUTHOR]

BACKGROUND: Bacterial pneumonia is an infection caused by microorganisms acquired in the outpatient setting. It represents a healthcare problem in Mexico and all over the world. It may be caused mainly by Streptococcus pneumoniae (21-39%), Haemophilus influenzae (1.5- 14%) and Staphylococcus aureus (0.8-9%) in ambulatory patients, and in hospitalized patients by S. pneumoniae, Mycoplasma pneumoniae and Chlamydophila pneumoniae. OBJECTIVE: To establish if there is a difference among pathogens that cause community-acquired pneumonia in the Hospital Central Norte, PEMEX, that were treated according to the IDSA guidelines (Infectious Diseases Society of America), as well as its antibiotic resistance. MATERIAL AND METHOD: An observational, descriptive, transversal and retrospective study was made with 249 patients (probabilistic sample) from January 2013 to May 2015. RESULTS: We obtained 112 sputum cultures with the isolation of: Pseudomonas aeruginosa 25%, Escherichia coli 23% and Klebsiella pneumoniae 12.5%. When we compared our results with the international statistics (IDSA), it only matched on 0.8%. The empiric treatment based on those guidelines (ceftriaxone + clarithromycin-azithromycin or levofloxacin) reported a microbial resistance of 92% and 67% of Pseudomonas aeruginosa, 73% of Escherichia coli and 67% and 83% of Klebsiella pneumoniae, respectively. CONCLUSION: Community-acquired pneumonia is among the fifth main causes of morbidity and mortality in the PEMEX Hospital with predominance of gram-negative bacteria. Microorganisms have better sensitivity to aminoglycosides, cefepime, piperacillin, tazobactam and carbapenemics. We remark the importance of obtaining reliable cultures and creating local guidelines in every healthcare unit in order to diminish bacterial resistance, healthcare related complications, hospital stay length, readmissions and improve treatment outcomes. [ABSTRACT FROM AUTHOR]

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The community acquired pneumonia is one of the most important health problems attended in our institution. In this article a critic analysis is made of an instrument for the stratification of the patients suffering of this disease in the urgency department, introduced as part of the guide of good correspondent clinic practices. Important deficiencies are identified that interfere in the application of this instrument and in its usage for the behaviour decisions taking by the assistance physician, of what comes the necessity of its improvement.

Resumen Introducción La neumonía adquirida en la comunidad (NAC) es una de las causas infecciosas más frecuentes de morbi-mortalidad a escala mundial en niños menores de 5 años. El objetivo del estudio fue precisar el diagnóstico bacteriano etiológico en lactantes con NAC. Métodos Se condujo un estudio prospectivo, transversal y descriptivo en 17 pacientes de 6 meses a 2 años 11 meses de edad con NAC de mala evolución, que ingresaron al servicio de Neumología pediátrica. A los pacientes se les realizó broncoscopia con lavado broncoalveolar (LBA) con las medidas pertinentes durante el procedimiento para limitar el riesgo de contaminación. Resultados Las bacterias aerobias aisladas fueron Moraxella sp . (23%), Streptococcus mitis (23%), Streptococcus pneumoniae (18%), Haemophilus influenzae (12%), Streptococcus oralis (12%), y Streptococcus salivarius (12%). Conclusiones En contraste con otros informes se observó que Moraxella sp. es un importante patógeno potencial bacteriano, posiblemente debido a la mejora en la detección con broncoscopia más LBA. Background Community-acquired pneumonia (CAP) is one of the most common infectious causes of morbidity and mortality in children <5 years of age. The aim of the study was to clarify the bacterial etiologic diagnosis in infants with CAP. Methods A prospective, cross-sectional and descriptive study in patients 6 months to 2 years 11 months of age with CAP with poor outcome was conducted. Patients were admitted to the Pediatric Pneumology Service and underwent bronchoscopy with bronchoalveolar lavage (BAL), taking appropriate measures during the procedure to limit the risk of contamination. Results Aerobic bacteria isolated were Moraxella sp . 23%, Streptococcus mitis 23%, Streptococcus pneumoniae 18%, Haemophilus influenzae 12%, Streptococcus oralis 12%, and Streptococcus salivarius 12%. Conclusions In contrast to other reports, we found Moraxella sp. to be a major bacterial pathogen, possibly because of improved detection with bronchoscopy plus BAL. [ABSTRACT FROM AUTHOR]

Copyright of Medicina (Buenos Aires) is the property of Medicina (Buenos Aires) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To develop an instrument for evaluating the quality of antibiotic management of patients with community-acquired pneumonia ( CAP) applicable in a middle-income developing country. Method A previous study and Indonesian guidelines were reviewed to derive potential quality of care indicators ( QIs). An expert panel performed a two-round Delphi consensus procedure on the QI's relevance to patient recovery, reduction of antimicrobial resistance and cost containment. Applicability in practice, including reliability, feasibility and opportunity for improvement, was determined in a data set of 128 patients hospitalised with CAP in Semarang, Indonesia. Results Fifteen QIs were selected by the consensus procedure. Five QIs did not pass feasibility criteria, because of inappropriate documentation, inefficient laboratory services or patient factors. Three QIs provided minor opportunity for improvement. Two QIs contradicted each other; one of these was considered not valid and excluded. A final set of six QIs was defined for use in the Indonesian setting. Conclusion Using the Delphi method, we defined a list of QIs for assessing the quality of care, in particular antibiotic treatment, for CAP in Indonesia. For further improvement, a modified Delphi method that includes discussion, a sound medical documentation system, improvement of microbiology laboratory services, and multi-center applicability tests are needed to develop a valid and applicable QI list for the Indonesian setting. [ABSTRACT FROM AUTHOR]