scholarly journals TREATMENT OF COMMUNITY-ACQUIRED PNEUMONIA IN CHILDREN: OPTIMIZATION OF ANTIBIOTIC THERAPY

2021 ◽  
Author(s):  
Veronika Dudnyk ◽  
Nataliya Sinchuk ◽  
Kateryna Khromykh
Keyword(s):  
Antibiotic Therapy ◽  
Age Groups ◽  
Community Acquired Pneumonia ◽  
Age Group ◽  
Case Histories ◽  
First Line ◽  
X Ray ◽  
Comparison Groups ◽  
Chest X Ray ◽  
Common Infections

Community-acquired pneumonia is one of the most common infections in children with an annual incidence of 34 to 40 cases per 1000 children in Europe and North America. Pneumonia is a common cause of death in children under five years of age worldwide. Thus, about 1,8 million children die from pneumonia annually. According to the statistics of the Ministry of Health of Ukraine, about 80,000 children every year suffer from community-acquired pneumonia in Ukraine. Material and methods: Retrospective analysis of 100 case histories of children aged 3-9 years old with outpatient segmental/polisegmental pneumonia who were in inpatient treatment in the pulmonology department of regional hospital from January 2017 to December 2018. The representativeness of the comparison groups is represented by age and sex. Methods of examination: clinical-anamnestic, laboratory and instrumental (pulse oximetry, chest X-ray). Results: Most of the children (58%) were admitted to the hospital on the first day of the illness. In 33% of children, comorbidity was noted. All children had fever, an unproductive cough, while symptoms of intoxication (76 ± 4.27%) and dyspnea (52 ± 4.49%) were more pronounced in children 3-6 years old. In the general analysis of blood in children of the first age group, in most cases, leukocytosis was more than 12 G / L (56 ± 4.96%), neutrophilic shift of the leukocyte formula to the left of 88 ± 3.25% and elevated ESR (84 ± 3.66%). X-ray in children of the first age group was dominated by polysegmental pneumonia at 54 ± 4.44%, while in children of the second age group segmental pneumonia was more common (64 ± 4.66%). Half of the children of both age groups prescribed antibiotics of the first line - a group of penicillins and cephalosporins. When starting antibiotic therapy with penicillins, the symptoms of pneumonia decreased already in the 2nd day in 16% ± 3.67% in the group of children 3-6 years old and in 18% ± 3.84% of children 7-9 years. Conclusion. Pneumonia is one of the most common diseases in children, and one of those that can cause many complications and even death. Accordingly, the treatment of this disease should be maximally effective and short-lived. The best choice for treating pneumonia is a group of oral aminopenicillins, which were administered in the first days of the disease and showed significantly better results than patients treated with cephalosporins.

scholarly journals Age-specific risk factors of severe pneumonia among pediatric patients hospitalized with community-acquired pneumonia

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Lumin Chen ◽  
Chong Miao ◽  
Yanling Chen ◽  
Xian Han ◽  
Ziying Lin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Age Groups ◽  
Community Acquired Pneumonia ◽  
Laboratory Findings ◽  
X Ray ◽  
Icu Admission ◽  
Rsv Infection ◽  
History Of ◽  
Chest X Ray

Abstract Background Risk factors that predispose the development of severe community-acquired pneumonia (CAP) among pediatric CAP patients of different age ranges are yet to be identified. Methods We retrospectively analyzed pediatric in-patients (< 6 years old) diagnosed with CAP in our hospital. We subdivided patients into four age groups (< 6 months, 6 months-1 year, 1–2 years, and 2–6 years). Their medical records, including demographic information, clinical features, laboratory findings, and chest radiographic reports, were reviewed and collected for further analysis. Univariate logistic regression analysis and stepwise regression analysis were applied to identify risk factors associated with severe CAP and ICU admission for overall patients and age-stratified subgroups. Results A total of 20,174 cases were initially included. Among them, 3309 (16.40%) cases were identified as severe CAP, and 2824 (14.00%) cases required ICU admission. Potential risk factors for severe CAP and ICU admission identified by univariate analysis included younger age, rural residency, premature birth, low birth weight (LBW), formula feeding, congenital heart disease (CHD), history of pneumonia or neonatal jaundice, patients with other health issues, certain symptoms (manifesting wheezing, dyspnea, cyanosis, but have no cough or fever), abnormal laboratory findings (abnormal levels of white blood cells, albumin, and C-reactive protein and RSV infection), and chest X-ray (odds ratio [OR] > 1 for all). CHD, low albumin, proteinuria, abnormal chest x-ray were independent risks factors across different age groups, whereas birth or feeding history, history of pneumonia, cyanosis or dyspnea on admission, and RSV infection were independent risk factors for only younger kids (< 1 year), and wheezing was an independent risk factor only for older children (2–5 years old). Conclusions Risk factors predicting disease severity among children hospitalized with CAP vary with age. Risk factor stratification of pediatric CAP based on age-specific risk factors can better guide clinical practice. Trial registration This study has been registered in China, with the registration number being ChiCTR2000033019.

scholarly journals Estimation of dose and cancer risk to newborn from chest X-ray in South-South Nigeria: a call for protocol optimization

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Akintayo Daniel Omojola ◽  
Michael Onoriode Akpochafor ◽  
Samuel Olaolu Adeneye ◽  
Isiaka Olusola Akala ◽  
Azuka Anthonio Agboje
Keyword(s):  
Cancer Risk ◽  
Age Groups ◽  
Field Size ◽  
Radiological Protection ◽  
International Studies ◽  
X Ray ◽  
Thermoluminescent Dosimeters ◽  
Chest X Ray ◽  
Neonatal Patient ◽  
The Mean

Abstract Background The use of X-ray as a diagnostic tool for complication and anomaly in the neonatal patient has been helpful, but the effect of radiation on newborn stands to increase their cancer risk. This study aims to determine the mean, 50th percentile (quartile 2 (Q2)), and 75th percentile (quartile 3 (Q3)) entrance surface dose (ESD) from anteroposterior (AP) chest X-ray and to compare our findings with other relevant studies. The study used calibrated thermoluminescent dosimeters (TLDs), which was positioned on the central axis of the patient. The encapsulated TLD chips were held to the patients’ body using paper tape. The mean kilovoltage peak (kVp) and milliampere seconds (mAs) used was 56.63(52–60) and 5.7 (5–6.3). The mean background TLD counts were subtracted from the exposed TLD counts and a calibration factor was applied to determine ESD. Results The mean ESDs of the newborn between 1 and 7, 8 and 14, 15 and 21, and 22 and 28 days were 1.09 ± 0.43, 1.15 ± 0.50, 1.19 ± 0.45, and 1.32 ± 0.47 mGy respectively. A one-way ANOVA test shows that there were no differences in the mean doses for the 4 age groups (P = 0.597). The 50th percentile for the 4 age groups was 1.07, 1.26, 1.09, and 1.29 mGy respectively, and 75th percentile were 1.41, 1.55, 1.55, and 1.69 mGy respectively. The mean effective dose (ED) in this study was 0.74 mSv, and the estimated cancer risk was 20.7 × 10−6. Conclusion ESD was primarily affected by the film-focus distance (FFD) and the patient field size. The ESD at 75th percentile and ED in this study was higher compared to other national and international studies. The estimated cancer risk to a newborn was below the International Commission on Radiological Protection (ICRP) limit for fatal childhood cancer (2.8 × 10−2Sv−1).

scholarly journals 806. 2013–2015 Nationwide Tuberculosis Contact Investigation in Childcare Centers and Schools in Korea

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S289-S289
Author(s):  
Woosuck Suh ◽  
Jong-Hyun Kim ◽  
Ji Hyen Hwang ◽  
Sodam Lee ◽  
Kang-Hee Lee ◽  
...  
Keyword(s):  
School Setting ◽  
Age Groups ◽  
Disease Status ◽  
Childcare Centers ◽  
X Ray ◽  
Contact Investigation ◽  
Chest X Ray ◽  
Latent Tb ◽  
The Republic ◽  
Latent Tb Infection

Abstract Background The Republic of Korea has the highest incidence rate of tuberculosis (TB) among members of the OECD, reported as 78.8/100,000 population in 2016. In response, a state-run intensive contact investigation for TB is being conducted. More effective TB control requires an epidemiologic emphasis on the diagnosis and treatment of latent TB infections in children and adolescents, compared with other age groups. Here we present an analysis of data from the childcare center and school contact investigation by the Korea Centers for Disease Control and Prevention (CDC) in 2013–2015. Methods Data collected from index patients included age, sex, occupation, disease status, results of AFB smear/culture, and chest x-ray. Data collected from contacts included age, sex, results of serial tuberculin skin test (TST), and chest x-ray. Congregate settings included childcare centers, kindergartens, elementary and secondary schools, and age groups were stratified as follows: 0–4 years, 5–12 years, and 13–18 years. TSTs were considered positive if induration ≥10 mm on the first test (TST1) or demonstrated an increase ≥6 mm over the induration of TST1 on repeat testing after 8 weeks (TST2). Results Of the 197,801 subjects with data collected, 173,998 were eligible and included in our analysis. TST1 results were available for 159,346 (91.6%) and when results were positive, induration was 10–14 mm in 7.6% and ≥15 mm in 1.5%. TST2 results were available for 119,797 (82.7%) of the 144,904 with negative TST1, and conversion rate was 9.0%. Altogether considering TST1 and TST2, 17.3% contacts had latent TB infections. Positive rates of TST significantly decreased with age: 20.3% in 0–4 years, 18.8% in 5–12 years, 17.1% in 13–18 years. Conclusion In this 3-year school-setting contact investigation, 17.3% contacts were diagnosed with latent TB infection, as demonstrated by TST reactions. Positive rates of TST significantly but mildly decreased with age. Disclosures All authors: No reported disclosures.

Routine Chest X-ray Examination?

PEDIATRICS ◽  
1978 ◽  
Vol 62 (5) ◽  
pp. 859-860
Author(s):  
David H. Baker ◽  
Walter E. Berdon
Keyword(s):  
Age Group ◽  
X Ray ◽  
Chest X Ray ◽  
Routine Chest ◽  
Preoperative Chest

In reference to the article by Sane et al. entitled "Value of Preoperative Chest X-ray Examinations in Children" (Pediatrics 60:669, November 1977), we would like to know if the authors broke down the abnormalities by age group—for instance, five-year segments. If so, did a preponderance of abnormalities of any variety occur at any particular age? We believe that should be stated, as it would strengthen their thesis if there was no difference between 0 and 19 years of age.

scholarly journals GP management of community-acquired pneumonia in Italy: the ISOCAP study

2005 ◽  
Vol 63 (1) ◽  
Author(s):  
C.M. Sanguinetti ◽  
F. De Benedetto ◽  
C.F. Donner
Keyword(s):  
Outpatient Treatment ◽  
The Elderly ◽  
Community Acquired Pneumonia ◽  
Microbiological Analysis ◽  
X Ray ◽  
Systemic Arterial Hypertension ◽  
Chest X Ray ◽  
Socioeconomic Burden ◽  
Copd Diagnosis ◽  
Observation Period

Background. Community-Acquired Pneumonia (CAP) is still a significant problem in terms of incidence, mortality rate, particularly in infants and the elderly, and socioeconomic burden. General Practitioners (GPs) are the first reference for patients with this disease, but there are few published studies regarding the outpatient treatment of CAP. Methods. The ISOCAP study aimed to identify the type and outcome of the diagnostic-therapeutic management of CAP by GPs in Italy, within the framework of developing a closer interrelationship between GPs and pulmonary specialists. Thirty-six Pulmonary Divisions throughout Italy each contacted 5 local GPs who agreed to recruit the first 5 consecutive patients who consulted them for suspected CAP within the study’s 1-year observation period. Results. A total of 183 GPs took part in the study and enrolled, by the end of the observation period, 763 CAP patients; of these, complete data was available for 737 patients [males=373, females=364, mean age (±SD) 58.8±19.6 years]. 64.4% of patients had concomitant diseases, mainly systemic arterial hypertension and COPD. Diagnosis of CAP was based by GPs on physical examination only in 41.6% of cases; in the remaining chest X-ray was also performed. In only 4.6% of patients were samples sent for microbiological analysis. All patients were treated with antibiotics: 76.7% in mono-therapy, 23.3% with a combination of antibiotics. The antibiotic class most prevalently used in mono-therapy was cephalosporin, primarily ceftriaxone; the most frequently used combinations were cephalosporin+macrolide and cephalosporin+quinolone. Mono-therapy was effective in 70% of cases, the combination of two or more antibiotics in 91.2% of patients. Overall treatment efficacy was 94.7%; hospitalisation was required in 8.5% of cases. Conclusions. Outpatient management of CAP by GPs in Italy is effective, hospitalisation being necessary only in the most severe cases due to age, co-morbidities or extent of pneumonia. This signifies a very significant savings in national health costs.

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.

scholarly journals INDICATORS OF CARIES OF PERMANENT TEETH TAKING INTO ACCOUNT THE DEGREE OF ITS ACTIVITY IN ADOLESCENTS STUDYING IN DIFFERENT EDUCATIONAL INSTITUTIONS

2021 ◽  
pp. 83-87
Author(s):  
L.F. Kaskova ◽  
V.M. Batig ◽  
I.I. Drozda ◽  
Y.Kh. Kilmukhametova
Keyword(s):  
College Students ◽  
University Students ◽  
Dental Health ◽  
Age Groups ◽  
Permanent Teeth ◽  
Educational Institutions ◽  
Age Group ◽  
Caries Activity ◽  
Comparison Groups ◽  
Dental Diseases

In recent years, there has been noted a tendency to deterioration of dental health in children and teenagers. Therefore, it is important to study the dental status of children who attend different educational establishments to identify risk factors for dental diseases and develop means of their elimination. The survey of adolescents studying in various educational institutions (school, college, university) in Chernivtsi was conducted according to the generally accepted method. The study of the prevalence (%) and intensity of caries (CPV of teeth) was taking into account the degree of caries activity in each age period: compensated (1st), subcompensated (2nd), decompensated (3rd). A total of 107 schoolchildren, 317 college students, and 116 university students were surveyed. Adolescents are 15 to 18 years old. To conduct the study, the average rates of caries in each age group were calculated to determine the degree of caries activity in each age period, taking into account the area where adolescents live. The following indicators were obtained for the Chernivtsi region: – 15 years: compensated form – up to 4 caries-affected teeth, subcompensated – 5-7, decompensated – 8 or over; – 16 years: compensated – up to 5, subcompensated – 6-8, decompensated – 9 or over; – 17 years: compensated – up to 7, subcompensated – 8-10, decompensated – 11 or over; – 18 years: compensated – up to 8, subcompensated – 9-11, decompensated 12, or over. Our research showed that college students in all studied age periods (15, 16, 17, and 18 years) had worse results than teenagers in the comparison groups (schoolchildren of 15-16 years, university students of 17-18 years). About 62% of all examined teenagers had the first degree of caries activity, 19.5% had the 2nd, and 18.5% had the 3rd degree of caries. Teenagers enrolled in college were divided according to the degree of caries activity: in the 1st degree – 36.3%, 2nd – 32.2%, 3rd – 31.5%, at school: 1st degree – 100%, at university: 1st degree – 97.4%, 2nd – 2.6%. At the age of 18, the number of college students who have a decompensated degree of caries activity increases to 36.6% due to a decrease in the number in the group with a subcompensated degree. University students in 100% of cases had a compensated degree of caries activity. Caries intensity rates in each age group are lower in schoolchildren than in college students and are the lowest in university students. In teenagers with the first degree of caries activity, the highest rate of caries intensity was observed in college (15-18 year adolescents), and the lowest – at school (15-16 years). University students, despite being 17-18 years old, had lower rates than college teens. All students had the first degree of caries activity. When comparing the rate of caries intensity in the studied 15 year-olds with the compensated degree of caries activity, it was found that in schoolchildren it is 1.7 times lower than in college students, in 16 year-olds – 1.5 times. At the age of 17 and 18 – 1.7 times, compared to university students. Thus, our research showed that college students of all studied age groups had worse indices than teenagers in the comparison groups. They have a more severe course of caries. The results suggest that further studies into the causes of caries in college students need to be conducted.

Chest X-ray requests in primary care for suspected community acquired pneumonia

2017 ◽  
Vol 72 ◽  
pp. S15
Author(s):  
Mazen Elfaki ◽  
Martina Paetzel ◽  
John Nugent
Keyword(s):  
Primary Care ◽  
Community Acquired Pneumonia ◽  
X Ray ◽  
Chest X Ray

scholarly journals Reading and interpretation of chest X-ray in adults with community-acquired pneumonia

2011 ◽  
Vol 15 (6) ◽  
pp. 540-546
Author(s):  
Diana Carolina Moncada ◽  
Zulma Vanessa Rueda ◽  
Antonio Macías ◽  
Tatiana Suárez ◽  
Héctor Ortega ◽  
...  
Keyword(s):  
Community Acquired Pneumonia ◽  
X Ray ◽  
Chest X Ray

scholarly journals Effectiveness of Lung Ultrasound in Comparison with Chest X-Ray in Diagnosis of Lung Consolidation

2019 ◽  
Vol 7 (15) ◽  
pp. 2457-2461
Author(s):  
Youssef Ibrahim Haggag ◽  
Karim Mashhour ◽  
Kamal Ahmed ◽  
Nael Samir ◽  
Waheed Radwan
Keyword(s):  
Lung Ultrasound ◽  
Community Acquired Pneumonia ◽  
P Value ◽  
Initial Examination ◽  
X Ray ◽  
Chest Ultrasound ◽  
Lung Consolidation ◽  
Plain Chest ◽  
Chest X Ray

BACKGROUND: Lung ultrasound (US) is an available and inexpensive tool for the diagnosis of community-acquired pneumonia (CAP); it which has no hazards of radiation and can be easily used. AIM: To evaluate the efficacy of lung ultrasound in the diagnosis and follow-up of CAP. PATIENTS AND METHODS: 100 patients aged from 40 to 63 years with a mean age of 52.3 ± 10 years admitted to the Critical Care Department, Cairo University with pictures of CAP. Lung US was performed for all patients initially, then a plain chest X-ray (CXR) was performed. Another lung ultrasound was performed on the 10th day after admission. RESULTS: Initial chest X-ray was correlated with the initial chest ultrasound examination in CAP diagnosis (R-value = 0.629, P < 0.001). Cohen's κ was run to determine if there is an agreement between the findings of the initial chest X-ray findings and those of the initial chest ultrasound in CAP diagnosis. A moderate agreement was found where κ = .567 (95% CI, 0.422 to 0.712) and P < 0.001. Upon initial examination, the CXR diagnosed CAP in 48.0% of patients, while lung US diagnosed the disease in 70% of patients. Moreover, lung US was more sensitive than CXR (P-value < 0.001). Compared to the accuracy of computed tomography (CT) chest (100%) which is the gold standard for CAP diagnosis, the accuracy of lung US was 95.0%, while the accuracy of CXR was 81.0%. CONCLUSION: This study proved the effectiveness of lung ultrasound in CAP diagnosis.

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