The Differences in Clinical Presentations Between Severe Health-care-Associated Pneumonia and Severe Community-Acquired Pneumonia: A Single-Center Experience

CHEST Journal ◽  
2010 ◽  
Vol 138 (4) ◽  
pp. 597A
Author(s):  
Eun Ju Jeon
Keyword(s):  
Health Care ◽  
Community Acquired Pneumonia ◽  
Single Center ◽  
Single Center Experience ◽  
Clinical Presentations ◽  
Severe Community Acquired Pneumonia ◽  
Health Care Associated Pneumonia

scholarly journals Management of Health-Care Associated Pneumonia (HCAP)

2013 ◽  
pp. 87-90
Author(s):  
Alessia Rosato ◽  
Claudio Santini
Keyword(s):  
Health Care ◽  
Treatment Approach ◽  
Multidrug Resistant ◽  
Outpatient Setting ◽  
Community Acquired Pneumonia ◽  
Traditional Classification ◽  
Hospital Acquired Pneumonia ◽  
Health Care Associated Pneumonia ◽  
Hospital Acquired

Introduction The traditional classification of Pneumonia as either community acquired (CAP) or hospital acquired (HAP) reflects deep differences in the etiology, pathogenesis, approach and prognosis between the two entities. Health-Care Associated Pneumonia (HCAP) develops in a heterogeneous group of patients receiving invasive medical care or surgical procedures in an outpatient setting. For epidemiology and outcomes, HCAP closely resembles HAP and possibly requires an analogous therapeutic regimen effective against multidrug-resistant pathogens. Materials and methods We reviewed the pertinent literature and the guidelines for the diagnosis and management of HCAP to analyze the evidence for the recommended approach. Results Growing evidence seems to confirm the differences in epidemiology and outcome between HCAP and CAP but fails to confirm any real advantage in pursuing an aggressive treatment for all HCAP and CAP patients. Discussion Further investigations are needed to establish the optimal treatment approach according to the different categories of patients and the different illness severities. Keywords Health Care Associated Pneumonia (HCAP); Community Acquired Pneumonia (CAP); Hospital Acquired Pneumonia (HAP); Multidrug-resistant (MDR) Pathogens

scholarly journals Health Care-Associated Pneumonia and Community-Acquired Pneumonia: a Single-Center Experience

2007 ◽  
Vol 51 (10) ◽  
pp. 3568-3573 ◽  
Author(s):  
Scott T. Micek ◽  
Katherine E. Kollef ◽  
Richard M. Reichley ◽  
Nareg Roubinian ◽  
Marin H. Kollef
Keyword(s):  
Health Care ◽  
Staphylococcus Aureus ◽  
Hospital Mortality ◽  
Hospital Admission ◽  
Health Care Providers ◽  
Community Acquired Pneumonia ◽  
Antimicrobial Treatment ◽  
Care Providers ◽  
Health Care Associated Pneumonia ◽  
Culture Positive

ABSTRACT Pneumonia occurring outside of the hospital setting has traditionally been categorized as community-acquired pneumonia (CAP). However, when pneumonia is associated with health care risk factors (prior hospitalization, dialysis, residing in a nursing home, immunocompromised state), it is now more appropriately classified as a health care-associated pneumonia (HCAP). The relative incidences of CAP and HCAP among patients requiring hospital admission is not well described. The objective of this retrospective cohort study, involving 639 patients with culture-positive CAP and HCAP admitted between 1 January 2003 and 31 December 2005, was to characterize the incidences, microbiology, and treatment patterns for CAP and HCAP among patients requiring hospital admission. HCAP was more common than CAP (67.4% versus 32.6%). The most common pathogens identified overall included methicillin-resistant Staphylococcus aureus (24.6%), Streptococcus pneumoniae (20.3%), Pseudomonas aeruginosa (18.8%), methicillin-sensitive Staphylococcus aureus (13.8%), and Haemophilus influenzae (8.5%). The hospital mortality rate was statistically greater among patients with HCAP than among those with CAP (24.6% versus 9.1%; P < 0.001). Administration of inappropriate initial antimicrobial treatment was statistically more common among HCAP patients (28.3% versus 13.0%; P < 0.001) and was identified as an independent risk factor for hospital mortality. Our study found that the incidence of HCAP was greater than that of CAP among patients with culture-positive pneumonia requiring hospitalization at Barnes-Jewish Hospital. Patients with HCAP were more likely to initially receive inappropriate antimicrobial treatment and had a greater risk of hospital mortality. Health care providers should differentiate patients with HCAP from those with CAP in order to provide more appropriate initial antimicrobial therapy.

scholarly journals Capsular dissection technique for reducing recurrent laryngeal neuropraxia and temporary hypoparathyroidism after thyroidectomy: a single center experience

2021 ◽  
Vol 7 (7) ◽  
pp. 1111
Author(s):  
Dimple Sahni ◽  
Rajwant Kaur ◽  
Gagandeep Kaur ◽  
Sangeeta Aggarwal ◽  
Sanjeev Bhagat
Keyword(s):  
Foreign Body ◽  
Foreign Bodies ◽  
Single Center ◽  
Single Center Experience ◽  
Clinical Presentations ◽  
Life Threatening ◽  
High Index Of Suspicion ◽  
A Prospective Study ◽  
Dissection Technique ◽  
Nose And Throat

<p class="abstract"><strong>Background:</strong> Foreign bodies in aerodigestive tract is common, frequent, and sometime life threatening emergency for otorhinolaryngologists mainly in the paediatric group. The aims of the present study was to find the incidence of foreign bodies, in relation to demographic factors, type and sites of foreign bodies its clinical presentations and its management.</p><p class="abstract"><strong>Methods:</strong> A prospective study was conducted on 100 cases coming to the ear, nose and throat (ENT) emergency and outpatient department (OPD). After thorough history, clinical examination, routine blood and urine investigations and urine done. Radiological examination was done to visualize the radio-opaque foreign body, and if the foreign body was not radio-opaque then computed tomography (CT) scan was done.  </p><p class="abstract"><strong>Results:</strong> Incidence of foreign was 67% in male than 33% in female. Mostly foreign bodies were in nose (49%), followed by oesophageal (31%), abdominal (14%), and bronchus (6%) respectively. 33% were totally asymptomatic, 25% with mucupurulent discharge from nose, dysphagia (16%), nasal obstruction (15%), and odynophagia (11%) respectively. Most of the foreign bodies were inorganic in nature, coin (42%), pearls (8.16%), and battery (6.45%). Among organic foreign bodies peanut was most common (33.33%), grains (10%). All foreign bodies were removed successfully with minimal morbidity and zero mortality.</p><p class="abstract"><strong>Conclusions:</strong> Present study suggested incidence was very common among male children, in rural background, with common asymptomatic presentation. With high index of suspicion, and proper and timely intervention all 100 cases were managed successfully. But still educating the parents about keeping such things away from kids prevent these incident.</p>

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