scholarly journals SERUM CORTISOL AS A BIOMARKER IN PATIENTS WITH COMMUNITY-ACQUIRED PNEUMONIA AT ASSIUT UNIVERSITY UNIVERSITY HOSPITAL

CHEST Journal ◽  
2020 ◽  
Vol 157 (6) ◽  
pp. A51
Author(s):  
S. Farghaly ◽  
Y. Ahmad ◽  
R. El Morshedy ◽  
R. El Zohni ◽  
D. Abd El_Kareem
Keyword(s):  
Serum Cortisol ◽  
Community Acquired Pneumonia ◽  
University Hospital

scholarly journals Radiographic aspects of acute community-acquired bacterial pneumonia and pulmonary tuberculosis in children

2021 ◽  
Author(s):  
Rivo Lova Herilanto Rakotomalala ◽  
Harimino Mireille Rakotondravelo ◽  
Andrianina Harivelo Ranivoson ◽  
Annick Lalaina Robinson
Keyword(s):  
Community Acquired Pneumonia ◽  
University Hospital ◽  
Radiographic Images ◽  
X Ray ◽  
Male Predominance ◽  
Mother And Child ◽  
Chest X Ray ◽  
The Right ◽  
The University ◽  
Tuberculosis In Children

Background: The etiological diagnosis of pneumonia is often difficult because of the impossibility of microbiological confirmation most of the time. Therefore, chest X-ray is still essential for a positive diagnosis and etiological orientation. The main objective of our study was to describe the radiographic aspects of acute community-acquired pneumonia and tubercular pneumonia in children.Methods: This was a descriptive retrospective study conducted at the university hospital mother and child of Tsaralalana from January 1st to July 31st, 2017.Results: Sixty-nine cases of pneumonia were included, including 13 cases of TB pneumonia and 46 cases of acute community-acquired pneumonia. The average age was 36.68 months with a male predominance. Clinically, respiratory functional signs predominated in both cases. Alteration in general condition was mainly observed in tubercular pneumonia (26.08%). Alveolar syndromes were present in 43.47% of TB pneumonias and 36.94% of acute community-acquired pneumonia. With regard to the radiographic images, alveolar involvement was common to both types of pneumonia; the nodular image was present in 8.69% of the tubercular pneumonias and 2.17% of the acute community-acquired pneumonia; the cavity image was present only in the tubercular pneumonia (p=0.04); the right-sided location predominated in both cases.Conclusions: X-ray images were common to both TB pneumonia and acute community-acquired pneumonia; some images were specific to TB pneumonia. However, the etiologic orientation of pneumonia is based on a combination of epidemiologic, clinical, and radiographic evidence.

Different methods to estimate serum free cortisol: a comparison during cortisol tetracosactide testing

2015 ◽  
Vol 53 (9) ◽  
Author(s):  
Julie Brossaud ◽  
Blandine Gatta ◽  
Antoine Tabarin ◽  
Jean-Benoît Corcuff
Keyword(s):  
Intensive Care ◽  
Roc Curves ◽  
Serum Cortisol ◽  
Cortisol Concentration ◽  
University Hospital ◽  
Serum Free ◽  
Concentration Determination ◽  
Total Cortisol ◽  
Free Cortisol ◽  
Before And After

AbstractSerum cortisol is routinely quantified by immunoassays. In intensive care units serum free cortisol (FC) determination has been described as a better indicator of survival than total cortisol (TC). To estimate FC different methods are available including saliva sampling. We compared five methods to estimate FC, before and after an ACTH stimulating test in patients suspected of adrenal insufficiency.Serum and saliva was collected from 130 patients from the Endocrine Department of a university hospital before and after tetracosactide injection for TC determination. FC was estimated: after serum ultrafiltration, quadratic (Coolens’) or cubic (Dorin’s) equations, using TC/cortisol-binding globulin concentrations ratio or using cortisol concentration determination in saliva.FC concentrations obtained by different techniques were significantly correlated and Passing-Bablok regressions showed no deviation from linearity between salFC and filtFC or quadFC. Using the routine assumption that the patients were correctly diagnosed using a post-tetracosactide TC threshold of 550 nmol/L the FC methods generating the best ROC curves wereFC concentrations obtained by different techniques are significantly but not similarly correlated with TC. As,

scholarly journals The Association between Nutritional Parameters and the Prognosis of Community Acquired Pneumonia

2021 ◽  
pp. 10-15
Author(s):  
Hiba Mayya ◽  
Malek Hejazie ◽  
Youssef Zreik
Keyword(s):  
Nutritional Status ◽  
Serum Albumin ◽  
Negative Correlation ◽  
Pneumonia Severity Index ◽  
Severity Index ◽  
Community Acquired Pneumonia ◽  
University Hospital ◽  
Pneumonia Severity ◽  
Cholesterol Levels ◽  
Observational Descriptive Study

Background: Community–acquired pneumonia (CAP) is the most common potentially fatal infectious disease in adults worldwide. Prognosis depends on many factors including nutritional status. (P.S this research began before COVID19 pandemic arrivals to our country).  Objective: The present study aims to assess the association between markers of nutritional status and severity of CAP. Materials and Methods: This is observational descriptive study conducted in the Department of Pulmonology in Tishreen University Hospital –Lattakia- Syria from November 2019 to November 2020. Adult patients with the diagnosis of CAP were enrolled in the study. Results: A total of 70 patients were included, Median age was 65 years, 40 (57.10%) were male. Serum albumin and cholesterol levels were lower in patients older than 65 years; (3.07±0.4 vs 3.5±0.5, p:0.001) and (135.2±33.2 vs 154.8±31.7, p: 0.01), respectively. Levels of albumin and cholesterol were significantly higher in survivors group; (3.6±0.4 vs. 2.7±0.3, p:0.001) and (158.3±23.9 vs. 120.3±35.08, p: 0.0001). Pearson's correlation analysis revealed negative correlation between pneumonia severity index (PSI) and: serum albumin (r = -0.61, p:0.0001), cholesterol(r = -0.45, p:0.0001) and BMI (r = -0.16, p: 0.1). The CRP showed negative correlation with serum albumin (r = -0.55, p:0.0001), cholesterol (r = -0.51 ,p:0.0001) and BMI (r = -0.09, p: 0.4). Conclusion: Serum albumin and cholesterol values were found to be related to the severity of CAP and initial levels may be a useful biomarkers to predict the outcome of patients.

scholarly journals Usefulness of Serum Cortisol in Assessment for the Severity of Community-Acquired Pneumonia

2010 ◽  
Vol 69 (6) ◽  
pp. 450
Author(s):  
Min-Su Kim ◽  
Hun-Pyo Park ◽  
Kyung-Hwa Yoon ◽  
Yeon-Jae Kim ◽  
Mi-Young Kim ◽  
...  
Keyword(s):  
Serum Cortisol ◽  
Community Acquired Pneumonia

scholarly journals 1027. Vancomycin Use in Community-Acquired Pneumonia: Assessing Inappropriate Therapy

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S361-S362
Author(s):  
Timothy Shan ◽  
Sara J Gore ◽  
Caitlin M McCracken ◽  
Gregory B Tallman ◽  
Haley K Holmer ◽  
...  
Keyword(s):  
Risk Factors ◽  
Positive Culture ◽  
Empiric Therapy ◽  
Community Acquired Pneumonia ◽  
University Hospital ◽  
Inappropriate Therapy ◽  
Definitive Therapy ◽  
Days Of Therapy ◽  
Risk Patients ◽  
The Impact

Abstract Background Current Infectious Disease Society of America guidelines recommend anti-methicillin-resistant Staphylococcus aureus(MRSA) agents for treatment of community-acquired pneumonia (CAP) only in specific high-risk patients. There are limited data on duration of vancomycin use that is appropriate in hospitalized patients with CAP. The objective of this study was to evaluate the use of vancomycin for CAP among inpatients. Methods We conducted a retrospective cohort study of inpatients at Oregon Health and Science University Hospital from August 1st, 2017 to July 31st, 2018 who received IV vancomycin and had a pneumonia encounter ICD-9 diagnosis code. Patients with hospital or ventilator-associated pneumonia were excluded. Appropriate therapy was defined as empiric therapy with known risk-factors, concordant therapy with no de-escalation option, or concurrent sepsis or febrile neutropenia. Vancomycin appropriateness was assessed based on medical history and microbiology for both empiric and definitive therapy. We characterized patients receiving inappropriate therapy and calculated the proportion of inappropriate days of therapy (DOT). Results We identified 52 patients with CAP who were treated with vancomycin for a median of 2 DOT (Interquartile Range (IQR): 1–3). Approximately 21% (11/52) of patients had risk factors warranting vancomycin empiric therapy and 42% (22/52) had concurrent sepsis. Nine CAP patients received inappropriate courses of vancomycin, median of 1 day (IQR: 1–2.25) of inappropriate therapy. The most common reason for classifying use as inappropriate was a positive culture for organisms other than MRSA. Patients receiving inappropriate therapy were more frequently transferred from another hospital (44% vs. 30%, P = 0.22). Overall, 16% (20/125) of vancomycin DOT were inappropriate. Conclusion In our study,CAP patients accounted for a small number of pneumonia patients who received vancomycin. The median inappropriate DOT was relatively short, possibly indicating that identification and de-escalation was performed quickly. Further work is required to determine the impact of these findings on patients. Disclosures All authors: No reported disclosures.

scholarly journals The Impact of Community-acquired Pneumonia on Acute Exacerbation of Chronic Obstructive Pulmonary Disease Patients as Regards In-hospital Complications and Early Readmission

2020 ◽  
Vol 14 (1) ◽  
pp. 10-15
Author(s):  
Dina Ruby
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Community Acquired Pneumonia ◽  
University Hospital ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Early Readmission ◽  
The Impact

Background and Objective: Pneumonia is a major reason for hospitalization for Acute Exacerbation of Chronic Obstructive Pulmonary Disease patients (AECOPD). There is limited data available on the outcomes of AECOPD patients with or without pneumonia. Therefore, the study investigates the prognosis of AECOPD patients with or without Community-acquired Pneumonia (CAP), concerning the Length of Hospital Stay (LOS), in-hospital complications and early readmission. Methods: This study was carried out on 100 male COPD patients without CAP, 90 patients with CAP who were admitted to the chest department of Ain Shams University hospital over a 1-year period. Data collection about LOS, in-hospital complications, was recorded and they were followed for 30 days to detect acute readmission. Results: The mean age was 64± 8 years old in COPD patients without CAP to 62± 12year old in patients with CAP, LOS in COPD patients with CAP was 11.30 ± 3.23 days to 7.57 ± 2.24 in patients without CAP, COPD patients with CAP had a higher rate of complications in comparison to those without CAP as 45.6%, 13% were admitted to Intensive Care Unit (ICU) respectively, 15.6%, 3% were mechanically ventilated respectively. LOS and C- Reactive Protein (CRP) were significant causes for readmission in COPD patients with and without CAP. Conclusion: COPD patients with CAP had longer LOS and more short term complications as ICU admission, mechanical ventilation and higher readmission rate in comparison to COPD patients without CAP.

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