Risk factors for development of community-acquired pneumonia in workers of main occupations in production of chrysotile asbestos

2019 ◽  
pp. 113-116 ◽  
Author(s):  
T. V. Bushueva ◽  
N. A. Roslaya
Keyword(s):  
Risk Factors ◽  
Comparative Analysis ◽  
Respiratory Infections ◽  
Reference Group ◽  
Community Acquired Pneumonia ◽  
Upper Respiratory Tract ◽  
Chrysotile Asbestos ◽  
Response Factors ◽  
Chi Square ◽  
The Past

Inpatient examination covered 46 workers of main occupations in chrysotile asbestos production, with diagnosed occupational disease “asbestosis”, and reference group comprising 20 healthy workers of the same enterprise. Th e results present comparative analysis of clinical and anamnesis data in dependence on the past pneumonia, studies of immune state in the asbestosis patients and the healthy workers, data on high occurrence of pneumonia in the workers, comparative analysis of respiratory infections occurrence and concomitant diseases according to the outpatients records and medical examinations. Findings are reliable diff erences and earlier respiratory manifestations in the past-pneumonia workers exposed to chrysotile asbestos, higher occurrence (1.3-fold) of chronic bronchitis and severe disorders of bronchial patency. Immune response factors were characterized as pathogenetic links of pneumococcus infectious invasion. Additional risk factors of pneumonia appeared to be frequent respiratory infections, chronic diseases of upper respiratory tract and middle ear, lower functional state of neutrophils, increased auto-reactivity. To evaluate signifi cance of risk factors infl uence, the authors used fi tt ing criterion X2 (chi-square). Intensity of relationships between the risk factor and outcome was evaluated by contingency coeffi  cient of Pearson. Signifi cance level (p) for all the calculation was accepted less than 0.05.

Complex evaluation of health state of population residing under combined exposure to noise and chemical risk factors caused by activities of major airport hub

2019 ◽  
pp. 12-16 ◽  
Author(s):  
Konstantin P. Luzhetsky ◽  
Ol’ga Yu. Ustinova ◽  
Svetlana S. Kleyn ◽  
Dmitrii N. Koshurnikov ◽  
Svetlana S. Vekovshinina ◽  
...  
Keyword(s):  
Risk Factors ◽  
Nervous System ◽  
Serum Level ◽  
Reference Group ◽  
Risk Index ◽  
Case Based Reasoning ◽  
Health State ◽  
Upper Respiratory Tract ◽  
Combined Exposure ◽  
Complex Evaluation

Complex evaluation covered health state of population residing under combined exposure to physical (noise) and chemical (manganese, formaldehyde, phenol, benzene) risk factors caused by airport activities. Findings are unacceptable chronic risks expressed through risk index for development of nervous system diseases (HI=9.45–51.75), respiratory disorders (HQ=2,62–6,95) and immune system ailments (HQ=1,75–4,23). In children, functional disorders of nervous system (parasympathetic type vegetative dystonia) and respiratory organs (chronic disorders of upper respiratory tract) are diagnosed 1,5–1,8 times higher than those in the reference group; over 5% of children aged 4–7 years demonstrate bilateral conductive deafness. Reliable cause-effect relationships were revealed between functional nervous system disorders (parasympathetic type vegetative dystonia, astheno-neurotic syndrome, vascular cephalgia, sleep disorders) and increased serum level of manganese and benzene (proportion of explained dispersion, R2=0,55–0,87, 26,44≤F≥389,54), between respiratory diseases (chronic rhinitis, chronic pharyngitis) and increased serum level of formaldehyde (R2=0,73–0,91; 350,8≤F≥778,3), with high statistic significance (p < 0,0001). For sanitary epidemiologic examination purposes, case-based reasoning for relationships of children health disorders, management decisions, the authors suggested and justified a list of parameters for negative combined impact of risk factors caused by airport hub.

Childbirth Yesterday and Today: A Comparative Analysis of Women’s Experiences and Feelings through the Ages to the Present

2020 ◽  
Vol 8 (8) ◽  
pp. 100-109
Author(s):  
Grażyna Bączek ◽  
Joanna Jasińska
Keyword(s):  
Comparative Analysis ◽  
Perinatal Care ◽  
Time Frame ◽  
Chi Square ◽  
The Past ◽  
Chi Square Test ◽  
Main Determinants ◽  
Changes Over Time ◽  
Delivery Rooms ◽  
Over Time

Introduction: Perinatal care has undergone many changes over time. Therefore, women’s feelings and experiences will differ depending on the perinatal care provided at the time of childbirth. Time of childbirth and the perinatal care received are the main determinants in this process. However, one thing remains unchanged over time. Childbirth is considered one of the most notable events in the life of every woman.  The aim of the study was a comparative analysis of experiences and feelings shared by females giving birth in the past and the present in Poland. Material and methods: A questionnaire was designed specifically for this research project. It was a set of multiple choice (single answer) questions concerning childbirth conditions and perinatal care. Results were analyzed with a chi square test. Data was collected in 2016 in Poland. The questionnaire was distributed both in paper and electronic form. Results: The study group comprised of 671 females divided into three groups: childbirth before 2000, between 2001–2012, and after 2013. This time frame was associated with significant changes in perinatal care in Poland over the years. Changes in the delivery rooms have raised the comfort of childbirth, but progression of obstetrics resulted in greater medicalization of childbirth.

scholarly journals 1324. Identification of Local Risk Factors for P. aeruginosa in Community-acquired Pneumonia in a Veteran Population

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S750-S750
Author(s):  
Emily A Gibbons ◽  
Teri L Hopkins ◽  
Linda Yang ◽  
Christopher R Frei ◽  
Marcos I Restrepo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Long Term Care ◽  
Care Facility ◽  
Community Acquired Pneumonia ◽  
Term Care ◽  
Long Term Care Facility ◽  
The Past ◽  
Local Risk ◽  
Severe Copd

Abstract Background The 2019 ATS/IDSA community-acquired pneumonia (CAP) guidelines recommend empiric P. aeruginosa (PSA) coverage if locally validated risk factors are present. They further recommend obtaining local data on CAP pathogens to quantify risk factors and help guide clinical decision-making. To comply with the current guideline recommendations and to determine which patients may benefit from empiric anti-pseudomonal therapy, we aimed to characterize our institution’s local risk factors for CAP caused by PSA. Methods This is a retrospective single-center matched cohort study of patients admitted to our institution with a CAP diagnosis and a positive respiratory culture who received antibiotic treatment in the past 19 years. Multivariate logistic regression was performed to assess the relationship between PSA and the following risk factors: severe or very severe COPD (FEV1 &lt; 50% predicted), requiring invasive mechanical ventilation or vasopressor support in the first 24 hours of admission, history of PSA infection/colonization in the previous year, tracheostomy, bronchiectasis, long-term care facility residence and admission with receipt of IV antibiotics in the previous 90 days. Results A total of 343 patients were screened and 213 were included. Patients were mostly male (99%) with a median (IQR) age of 70 (63-76) years. Long-term care facility residence was removed from the model to prevent it from being over fit as it was related tracheostomy. In the multivariate analysis the only independently associated risk factor for PSA CAP was evidence during the prior year of PSA infection or colonization (OR 3.66; 95% CI 1.26 – 10.56; p = 0.018). Other risk factors that did not reach statistical significance but may be clinically significant included severe or very severe COPD (OR 2.52; 95% CI 2.52 – 6.38; p = 0.055) and tracheostomy (OR 5.28; 95% CI 0.74 – 38.85; p = 0.098). Conclusion The results of this study provide valuable data to help guide empiric CAP treatment at our institution. Based on these results, patients with PSA infection or colonization in the past year are appropriate to provide empiric anti-pseudomonal therapy for CAP. Further evaluation of severe or very severe COPD and tracheostomy would be beneficial to better characterize their role in PSA CAP. Disclosures All Authors: No reported disclosures

scholarly journals The Experience of a Comparative Analysis of the Incidence of Pneumonia and Acute Respiratory Infections of the Upper Respiratory Tract after the Introduction of a System of Epidemiological Monitoring of Pneumonia

2019 ◽  
Vol 18 (1) ◽  
pp. 96-104 ◽  
Author(s):  
N. A. Kravchenko ◽  
T. A. Gavrilova ◽  
M. I. Khakimova ◽  
V. B. Kazanova ◽  
E. I. Vasilyeva ◽  
...  
Keyword(s):  
Comparative Analysis ◽  
Influenza A ◽  
Viral Infections ◽  
Respiratory Infections ◽  
Age Groups ◽  
Epidemiological Surveillance ◽  
Annual Growth Rate ◽  
Acute Respiratory Infections ◽  
Upper Respiratory Tract ◽  
Epidemiological Monitoring

 The system of epidemiological surveillance of community-acquired pneumonia (VP) in the Russian Federation (RF) has changed since 2011. As a result, additional opportunities have emerged for a comparative analysis of the incidence of EP and ARVI. The goal is to give a comparative description of the incidence of CAP and ARVI by age groups, territories and seasonality, taking into account the results of a selective laboratory examination of patients.Materials and methods.A retrospective descriptive epidemiological study on the results of epidemiological surveillance at the regional level (Irkutsk Region, 2012–2016) was conducted. For 2016, the dynamics of the patient’s number with influenza and acute respiratory viral infections (n = 706460) and VP (n = 15279) reported by weeks, as well as the results of selective PCR examination of 1788 patients for 13 viral and bacterial pathogens were analyzed.Results.Over 5 years, the incidence of the VP increased from 377.6 (370.0–385.2) per 100 thousand to 588.3 (578.7–597.9), the average annual growth rate was + 35.8%. At the same time, the incidence of ARVI decreased at an average annual rate of –2.9%. When comparing the incidence of CAP and ARVI in municipalities, it was found weakly correlation only (ρ = 0.172, p> 0.05). In contrast, in the analysis of seasonality, a direct strong correlation was found between SARS and EP by weeks of the year (ρ = 0.887, p <0.05). For an average of 5 years, there were 52 cases of ARVI per 1 case of EP. For children, there were no significant differences in this indicator by the seasons of the year, whereas in adults, EP were recorded relatively more often in summer and spring than in winter and autumn (p <0.05). Significant differences in the frequency of positive findings for the seasons of the year were found for pneumococcus, rhinoviruses, influenza A and RS viruses. The recorded incidence of CAP and ARVI was characterized by a weak correlation link by territory and a strong link by weeks.Conclusion.The introduction of the epidemiological monitoring system for pneumonia allowed to identify differences in the intra-annual dynamics of EF and ARVI among adults and children. This is the basis for correcting the tactics laboratory monitoring and prophylaxis of acute respiratory infections.

Identification of Risk Factors for Multidrug-Resistant Organisms in Community-Acquired Bacterial Pneumonia at a Community Hospital

2021 ◽  
pp. 089719002110397
Author(s):  
Elizabeth W. Covington ◽  
Alanna Rufe
Keyword(s):  
Risk Factors ◽  
Multivariate Regression ◽  
Bacterial Pneumonia ◽  
Community Hospital ◽  
Multidrug Resistant ◽  
Community Acquired Pneumonia ◽  
The Past ◽  
Multidrug Resistant Organisms ◽  
Potential Risk Factors ◽  
Culture Positive

Background: The 2019 Infectious Disease Society of America (IDSA) guidelines for the management of community-acquired bacterial pneumonia encourage the identification of locally validated risk factors for methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa to guide empiric therapy decisions for patients with community-acquired pneumonia (CAP). The guidelines urge clinicians to perform local validation to determine prevalence and risk factors pertinent to their institution. Objective: To determine the percentage of community-acquired pneumonia caused by multidrug-resistant organisms (MDROs) and assess risk factors potentially associated with multidrug-resistant organisms CAP at our hospital. Methods: This was a retrospective case control study analyzing patients admitted to the 344-bed community hospital with bacterial community-acquired pneumonia between January 1, 2019 and December 31, 2019. Univariate analysis and multivariate regression were performed to assess potential risk factors for MDRO pathogens. Results: MDROs were isolated in 41.3% of patients with culture-positive CAP (n=19/46), and 3.6% of patients with microbiological culture data within 48 hours of admission (19/527). Among patients with culture-positive CAP, hospitalization in the previous 90 days and receipt of antibiotics in the previous 90 days occurred more frequently in MDRO patients than non-MDRO patients (37% vs 11%, P=.032). No risk factors reached statistical significance in the multivariate regression. There were no differences in clinical outcomes between MDRO and non-MDRO patients. Conclusions: This study demonstrated a low overall prevalence of MDRO pathogens in patients with CAP. Potential risk factors for MDRO included hospitalization within the past 90 days and antibiotic use within the past 90 days.

scholarly journals 2791. Burden of Respiratory Infections in Trainees Higher Than Healthcare Records Indicate: Results from an Anonymous Survey

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S986-S986
Author(s):  
Stephanie Richard ◽  
Patrick Danaher ◽  
Brian White ◽  
Katrin Mende ◽  
Timothy Burgess ◽  
...  
Keyword(s):  
Risk Factors ◽  
Potential Risk ◽  
Respiratory Infections ◽  
Smoking Status ◽  
Activity Level ◽  
Mitigation Strategies ◽  
Military Population ◽  
Chi Square ◽  
Potential Risk Factors ◽  
The Impact

Abstract Background Influenza-like illnesses (ILIs) are common in military populations, particularly among trainees, and can impair mission-readiness. To develop effective preventive measures against ILIs, it is vital to understand the ILI burden in the military population and identify potential risk factors for infection. Methods Anonymous ILI surveys were administered from January 2017 to March 2019 to military medical trainees living in a congregated setting on Fort Sam Houston (JBSA-FSH), TX. The surveys included questions about sociodemographic characteristics, weight, height, smoking status, activity level, as well as some basic questions about ILI and potential risk factors. Factors associated with ILI were identified using chi-square, t-tests, and multivariate models. Results 2,381 surveys were returned that included age, sex, and ILI information. Respondents were 16–54 years old, 1,301 (55%) were male, 782 (33%) were Air Force, 817 (34%) were Army, and 763 (32%) were Navy/Marines. 39% of those surveyed (929) reported having experienced an ILI during their training with 40% (370) seeking healthcare for those symptoms. The primary reasons for seeking healthcare included the severity of the illness (59%), concern about spreading the illness (50%), and the accessibility of healthcare (41%). 53% of the respondents reported that ILI had an impact on their performance, among whom 77% stated reduced study time, 66% missing physical training, and 53% missed class. The final multivariate model indicates that men and participants 30+ years old were less likely to report ILI (OR 0.69 (0.58, 0.82); OR 0.65, (0.45, 0.94)) (Figure 1). In addition, participants who reported washing their hands after they coughed or sneezed were less likely to report having had an ILI (OR 0.73 (0.61, 0.89)). Conclusion Although 39% of respondents reported having an ILI during their training, only 40% sought healthcare, indicating that ILIs are more common during training than healthcare records indicate. More information is needed regarding how training outcomes vary among those with ILI who seek care, those with ILI who do not seek care and those without ILI during training, to allow a better estimate of the impact of ILI and development of ILI mitigation strategies. Disclosures All authors: No reported disclosures.

scholarly journals 1494. Validation of Methicillin-Resistant Staphylococcus aureus (MRSA) Risk Factors in Predicting MRSA Community-Acquired Pneumonia at an Academic Medical Center

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S749-S749
Author(s):  
Joelle Arieno ◽  
Robert Seabury ◽  
Jeffrey Steele ◽  
William Darko ◽  
Christopher Miller ◽  
...  
Keyword(s):  
Risk Factors ◽  
Panel Member ◽  
Community Acquired Pneumonia ◽  
Review Panel ◽  
The Past ◽  
Post Test ◽  
History Of ◽  
Post Test Probability ◽  
Test Probability ◽  
Research Grant

Abstract Background The 2019 Infectious Diseases Society of America community-acquired pneumonia (CAP) guidelines recommend anti-methicillin-resistant Staphylococcus aureus (MRSA) therapy in patients with CAP based on previously identified risk factors for MRSA with an emphasis on local epidemiology and institutional validation of risk. Thus, we sought to assess the ability of guideline-recognized risk factors to predict MRSA CAP at our institution. Methods This was a single-center, retrospective cohort study from January 2016 to March 2020. Patients were included if they were &gt;18 years old, diagnosed with CAP, and had a MRSA nasal screen and a respiratory culture obtained on admission. Patients were excluded if CAP diagnosis was not met, respiratory cultures were not obtained within 48 hours of antibiotic initiation, or they had cystic fibrosis. Sensitivity, specificity, negative predictive value, positive predictive value, and likelihood ratios (LR) were calculated using Vassar Stats 2019. Pre/post-test odds and pre/post-test probabilities were calculated using Microsoft Excel 2019. Results Of 705 screened patients, 221 were included. MRSA prevalence in CAP patients at our institution was 3.6%. History of MRSA isolated from a respiratory specimen had high specificity (98%), high positive LR of 20 (95% CI 5.3 – 74.8), and high post-test probability of 42.8%. Receipt of IV antibiotics during hospitalization within the past 90 days had a positive LR of 1.9 (95% CI 0.74 – 4.84). A positive MRSA nasal screen on admission had a positive LR of 6.9 (95% CI 4.0 – 12.1), negative LR 0.28 (95% CI 0.08 – 0.93), positive post-test probability of 20.7%, and negative post-test probability of 1.04%. Conclusion Our study utilized institutional data to validate guideline-recognized risk factors for MRSA CAP specifically at our institution. Risk factors including history of MRSA isolated from a respiratory specimen, and positive post-admission MRSA nasal screen were validated as significant risk factors; receipt of IV antibiotics during hospitalization within the past 90 days was not shown to be a risk factor for MRSA CAP based on our institutional data. Validated risk factors may help providers discern which patients with CAP at our institution would benefit most from empiric MRSA treatment. Disclosures Jeffrey Steele, PharMD, Paratek Pharmaceuticals (Advisor or Review Panel member) Wesley D. Kufel, PharmD, Melinta (Research Grant or Support)Merck (Research Grant or Support)Theratechnologies, Inc. (Advisor or Review Panel member)

scholarly journals Influence of age-related and vascular factors on the state of external and internal liquoroconductive spaces of brain

2000 ◽  
Vol XXXII (3-4) ◽  
pp. 40-43
Author(s):  
M. V. Kovalyova ◽  
M. Yu. Martinov ◽  
T. P. Gorina
Keyword(s):  
Risk Factors ◽  
Comparative Analysis ◽  
Brain Aging ◽  
Reference Group ◽  
The State ◽  
Vascular Risk ◽  
Age Related ◽  
Vascular Insufficiency ◽  
Analysis Of Results ◽  
Subarachnoid Spaces

A comparative analysis of results of examination of patients with chronic brain vascular insufficiency and findings on reference group was carried out. The significance of age-related and vascular risk factors in development of changes in external and internal liquoroconductive spaces is stated. It is noted that insignificant and moderate dilatation of subarachnoid spaces and ventricular systems mainly indicate natural involutional processes. Heterogeneity of anterior and posterior regions involvement of subarachnoid spaces in brain aging are revealed. Influence of silent ischemic insults on the state of ventricular system is mentioned.

Mycoplasma Pneumoniae Infections

2020 ◽  
Author(s):  
T. Prescott Atkinson ◽  
William M. Geisler ◽  
Ken B. Waites
Keyword(s):  
Mycoplasma Pneumoniae ◽  
Respiratory Infections ◽  
Treatment Strategies ◽  
Community Acquired Pneumonia ◽  
The Past ◽  
Laboratory Techniques ◽  
Life Threatening ◽  
A Cell ◽  
Living Organisms

The class Mollicutes includes organisms in the genera Mycoplasma and Ureaplasma. They are prokaryotes that lack a cell wall, and are among the smallest known living organisms in both cellular dimensions and genome sizes. At least 17 different species inhabit the mucosae of the respiratory and urogenital tracts of humans, several of which are pathogenic in a variety of clinical illnesses. Their fastidious nature and often slow growth in vitro have hampered understanding of their roles as agents of human disease. Mycoplasma pneumoniae is an important cause of community acquired respiratory infections that occur endemically and epidemically worldwide in persons of all ages and ranges in severity from mild to life-threatening. Molecular-based laboratory techniques have resulted in increased understanding of the pathogenesis and epidemiology M. pneumoniae infections as well as improved means for laboratory detection. Resistance of M. pneumoniae to macrolide antimicrobials has emerged worldwide over the past several years, complicating treatment strategies. This review contains 2 figures, 1 table and 58 references Key Words: Antimicrobial Resistance, Ciliated respiratory epithelium, Community Acquired Pneumonia, Cytadherence, Mycoplasma pneumoniae, Reinfections

scholarly journals Use of medications in children hospitalized with community-acquired pneumonia

2018 ◽  
Vol 11 (3) ◽  
pp. 8-12 ◽  
Author(s):  
D. D. Siukaeva ◽  
I. A. Narkevich ◽  
V. N. Timchenko ◽  
O. D. Nemyatyh ◽  
N. A. Maslova
Keyword(s):  
Retrospective Study ◽  
Medical Records ◽  
Respiratory Infections ◽  
Community Acquired Pneumonia ◽  
Acute Respiratory Infections ◽  
Upper Respiratory Tract ◽  
Total Drug ◽  
Beta Lactam ◽  
Drug List ◽  
Upper Respiratory

The aim is to characterize the use of medications in pediatric inpatients with community-acquired pneumonia.Materials and methods. Medical records of 547 children treated for community-acquired pneumonia in 4 medical organizations in St. Petersburg over 2015-2017 were analyzed.The results of this retrospective study (N = 547) showed that children aged 1 to 3 years were most vulnerable (31.44%). Along with that, 45.70% of  patients had concomitant diseases; among those, acute respiratory infections of the upper respiratory tract prevailed (32.20%). As for the medications, the category J drugs “Antimicrobials of systemic action” were most commonly used (30.30%) and contributed the largest part in the total drug costs (80.22%). Specifically, the greatest contribution was made by the J01D group «Beta-lactam antibacterial drugs, other» (64.54%); their cost took 77.22% of the expenses and covered 48.97% of the drug list. 

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