Seminars in respiratory and critical care medicine最新文献_第5页

Viral Pneumonia: From Influenza to COVID-19. 病毒性肺炎：从流感到 COVID-19。

IF 3.2 3区医学

Seminars in respiratory and critical care medicine Pub Date : 2024-04-01 Epub Date: 2024-01-16 DOI: 10.1055/s-0043-1777796

Catia Cilloniz, Guinevere Dy-Agra, Rodolfo S Pagcatipunan, Antoni Torres

引用次数: 0

New Guidelines for Severe Community-acquired Pneumonia. 社区获得性重症肺炎新指南。

IF 3.2 3区医学

Seminars in respiratory and critical care medicine Pub Date : 2024-04-01 Epub Date: 2024-03-01 DOI: 10.1055/s-0043-1777797

Davide Calabretta, Ignacio Martìn-Loeches, Antoni Torres

引用次数: 0

Severe Community-Acquired Pneumonia. 严重社区获得性肺炎。

IF 3.2 3区医学

Seminars in respiratory and critical care medicine Pub Date : 2024-04-01 DOI: 10.1055/s-0044-1780515

Ignacio Martìn-Loeches, A. Torres

引用次数: 0

Long-Term Outcomes in Severe Community-Acquired Pneumonia. 严重社区获得性肺炎的长期疗效。

IF 3.2 3区医学

Seminars in respiratory and critical care medicine Pub Date : 2024-04-01 Epub Date: 2024-02-23 DOI: 10.1055/s-0044-1781426

Francesco Carella, Stefano Aliberti, Anna Stainer, Antonio Voza, Francesco Blasi

引用次数: 0

Biomarkers: Are They Useful in Severe Community-Acquired Pneumonia? 生物标志物：它们对重症社区获得性肺炎有用吗？

IF 3.2 3区医学

Seminars in respiratory and critical care medicine Pub Date : 2024-04-01 Epub Date: 2024-01-09 DOI: 10.1055/s-0043-1777771

Pedro Póvoa, Melissa Pitrowsky, Gonçalo Guerreiro, Mariana B Pacheco, Jorge I F Salluh

{"title":"Biomarkers: Are They Useful in Severe Community-Acquired Pneumonia?","authors":"Pedro Póvoa, Melissa Pitrowsky, Gonçalo Guerreiro, Mariana B Pacheco, Jorge I F Salluh","doi":"10.1055/s-0043-1777771","DOIUrl":"10.1055/s-0043-1777771","url":null,"abstract":"Community acquired pneumonia (CAP) is a prevalent infectious disease often requiring hospitalization, although its diagnosis remains challenging as there is no gold standard test. In severe CAP, clinical and radiologic criteria have poor sensitivity and specificity, and microbiologic documentation is usually delayed and obtained in less than half of sCAP patients. Biomarkers could be an alternative for diagnosis, treatment monitoring and establish resolution. Beyond the existing evidence about biomarkers as an adjunct diagnostic tool, most evidence comes from studies including CAP patients in primary care or emergency departments, and not only sCAP patients. Ideally, biomarkers used in combination with signs, symptoms, and radiological findings can improve clinical judgment to confirm or rule out CAP diagnosis, and may be valuable adjunctive tools for risk stratification, differentiate viral pneumonia and monitoring the course of CAP. While no single biomarker has emerged as an ideal one, CRP and PCT have gathered the most evidence. Overall, biomarkers offer valuable information and can enhance clinical decision-making in the management of CAP, but further research and validation are needed to establish their optimal use and clinical utility.","PeriodicalId":21727,"journal":{"name":"Seminars in respiratory and critical care medicine","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139404277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Severe Community-Acquired Pneumonia in Immunocompromised Patients. 免疫力低下患者的严重社区获得性肺炎。

IF 3.2 3区医学

Seminars in respiratory and critical care medicine Pub Date : 2024-04-01 Epub Date: 2024-01-24 DOI: 10.1055/s-0043-1778137

Dara Chean, Camille Windsor, Antoine Lafarge, Thibault Dupont, Sabrine Nakaa, Livia Whiting, Adrien Joseph, Virginie Lemiale, Elie Azoulay

{"title":"Severe Community-Acquired Pneumonia in Immunocompromised Patients.","authors":"Dara Chean, Camille Windsor, Antoine Lafarge, Thibault Dupont, Sabrine Nakaa, Livia Whiting, Adrien Joseph, Virginie Lemiale, Elie Azoulay","doi":"10.1055/s-0043-1778137","DOIUrl":"10.1055/s-0043-1778137","url":null,"abstract":"Due to higher survival rates with good quality of life, related to new treatments in the fields of oncology, hematology, and transplantation, the number of immunocompromised patients is increasing. But these patients are at high risk of intensive care unit admission because of numerous complications. Acute respiratory failure due to severe community-acquired pneumonia is one of the leading causes of admission. In this setting, the need for invasive mechanical ventilation is up to 60%, associated with a high hospital mortality rate of around 40 to 50%. A wide range of pathogens according to the reason of immunosuppression is associated with severe pneumonia in those patients: documented bacterial pneumonia represents a third of cases, viral and fungal pneumonia both account for up to 15% of cases. For patients with an undetermined etiology despite comprehensive diagnostic workup, the hospital mortality rate is very high. Thus, a standardized diagnosis strategy should be defined to increase the diagnosis rate and prescribe the appropriate treatment. This review focuses on the benefit-to-risk ratio of invasive or noninvasive strategies, in the era of omics, for the management of critically ill immunocompromised patients with severe pneumonia in terms of diagnosis and oxygenation.","PeriodicalId":21727,"journal":{"name":"Seminars in respiratory and critical care medicine","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139547019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Definition, Epidemiology, and Pathogenesis of Severe Community-Acquired Pneumonia. 严重社区获得性肺炎的定义、流行病学和发病机制。

IF 3.2 3区医学

Seminars in respiratory and critical care medicine Pub Date : 2024-04-01 Epub Date: 2024-02-08 DOI: 10.1055/s-0044-1779016

Rodrigo Cavallazzi, Julio A Ramirez

{"title":"Definition, Epidemiology, and Pathogenesis of Severe Community-Acquired Pneumonia.","authors":"Rodrigo Cavallazzi, Julio A Ramirez","doi":"10.1055/s-0044-1779016","DOIUrl":"10.1055/s-0044-1779016","url":null,"abstract":"The clinical presentation of community-acquired pneumonia (CAP) can vary widely among patients. While many individuals with mild symptoms can be managed as outpatients with excellent outcomes, there is a distinct subgroup of patients who present with severe CAP. In these cases, the mortality rate can reach approximately 25% within 30 days and even up to 50% within a year. It is crucial to focus attention on these patients who are at higher risk. Among the various definitions of severe CAP found in the literature, one commonly used criterion is the requirement for admission to intensive care unit. Notable epidemiological characteristics of these patients include the impact of acute cardiovascular diseases on clinical outcomes and the enduring, independent effect of pneumonia on long-term outcomes. Factors such as pathogen virulence, the presence of comorbidities, and the host response are important contributors to the pathogenesis of severe CAP. In these patients, the host response may be dysregulated and compartmentalized. Gaining a better understanding of the epidemiology and pathogenesis of severe CAP will provide a foundation for the development of new therapies for this condition. This manuscript aims to review the definition, epidemiology, and pathogenesis of severe CAP, shedding light on important aspects that can aid in the improvement of patient care and outcomes.","PeriodicalId":21727,"journal":{"name":"Seminars in respiratory and critical care medicine","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139707788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pathological Diagnosis of Pulmonary Aspergillosis. 肺曲霉菌病的病理诊断。

IF 3.2 3区医学

Seminars in respiratory and critical care medicine Pub Date : 2024-02-01 Epub Date: 2024-01-24 DOI: 10.1055/s-0043-1776757

Henrik E Jensen, Cecilie B Becker

引用次数: 0

Risk of Multidrug-Resistant Pathogens in Severe Community-Acquired Pneumonia 严重社区获得性肺炎患者感染耐多药病原体的风险

IF 3.2 3区医学

Seminars in respiratory and critical care medicine Pub Date : 2024-02-01 DOI: 10.1055/s-0043-1778138

{"title":"Risk of Multidrug-Resistant Pathogens in Severe Community-Acquired Pneumonia","authors":"","doi":"10.1055/s-0043-1778138","DOIUrl":"https://doi.org/10.1055/s-0043-1778138","url":null,"abstract":"Severe community-acquired pneumonia (SCAP) is difficult to treat when caused by difficult-to-treat (DTR) pathogens because of limited treatment options and poorer clinical outcomes. Over time, several predictive scoring systems based on risk factors for infection with multidrug resistant pathogens have been developed. We reviewed the available tools for identifying DTR pathogens as the cause of SCAP, both predictive scoring systems and rapid diagnostic methods, to develop management strategies aimed at early identification of DTR pathogens, reducing broad-spectrum antibiotic use and improving clinical outcomes. The scoring systems reviewed show considerable heterogeneity among them at the level of the region studied, the definition of risk factors, as well as which DTR pathogens are the target pathogens. The models described have shown limited effectiveness in reducing inappropriate antibiotic treatment or improving patient outcomes by themselves. However, predictive models could serve as a first step in identifying DTR pathogen infections as part of a larger detection algorithm. Rapid diagnostic tools, such as multiplex polymerase chain reaction, would be useful for the rapid identification of pneumonia-causing pathogens and their resistance mechanisms. In resource-limited settings, rapid tests should be limited to patients at high risk of developing SCAP due to DTR pathogens. We propose an integrative algorithm based on the different scores, taking into account local epidemiological data, where ideally each center should have an antimicrobial stewardship program.","PeriodicalId":21727,"journal":{"name":"Seminars in respiratory and critical care medicine","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139667023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical Manifestation and Treatment of Allergic Bronchopulmonary Aspergillosis. 过敏性支气管肺曲霉菌病的临床表现和治疗。

IF 3.2 3区医学

Seminars in respiratory and critical care medicine Pub Date : 2024-02-01 Epub Date: 2023-12-28 DOI: 10.1055/s-0043-1776912

Ritesh Agarwal, Valliappan Muthu, Inderpaul S Sehgal

{"title":"Clinical Manifestation and Treatment of Allergic Bronchopulmonary Aspergillosis.","authors":"Ritesh Agarwal, Valliappan Muthu, Inderpaul S Sehgal","doi":"10.1055/s-0043-1776912","DOIUrl":"10.1055/s-0043-1776912","url":null,"abstract":"Allergic bronchopulmonary aspergillosis (ABPA) is a complex hypersensitivity reaction to airway colonization by Aspergillus fumigatus in patients with asthma and cystic fibrosis. The pathophysiology of ABPA involves a complex interplay between the fungus and the host immune response, which causes persistent inflammation and tissue damage. Patients present with chronic cough, wheezing, and dyspnea due to uncontrolled asthma. Characteristic symptoms include the expectoration of brownish mucus plugs. Radiographic findings often reveal fleeting pulmonary infiltrates, bronchiectasis, and mucus impaction. However, the definitive diagnosis of ABPA requires a combination of clinical, radiological, and immunological findings. The management of ABPA aims to reduce symptoms, prevent disease progression, and minimize the future risk of exacerbations. The treatment approach involves systemic glucocorticoids or antifungal agents to suppress the inflammatory response or fungal growth and prevent exacerbations. Biological agents may be used in patients with severe disease or glucocorticoid dependence. This review provides an overview of the clinical manifestations and current treatment options for ABPA.","PeriodicalId":21727,"journal":{"name":"Seminars in respiratory and critical care medicine","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139058684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0