Interventions in African and Asian countries could vastly improve outcomes for young kids
Autores: Matheus Cordeiro Marchiotti; Guilherme de Almeida Costa; Ricardo Beneti; Alexandre Martins Portelinha Filho
Trabalho dos nossos residentes de infectologia do HR de Presidente Prudente, com orientação de preceptores da infectologia e pneumologia, apresentado como e-poster no 11º Congresso Paulista de Infectologia. P
Um estudo realizado por cientistas do Centro de Pesquisa em Doenças Inflamatórias, da USP, e da Faculdade de Medicina Tropical de Liverpool, no Reino Unido, descobriu um mecanismo celular chave que controla a proliferação e o consequente transporte do pneumococo –a bactéria causadora da pneumonia– do nariz para o pulmão.
Original Article from The New England Journal of Medicine — Procalcitonin-Guided Use of Antibiotics for Lower Respiratory Tract Infection
The aim was to aid diagnosis of pneumonia in those presenting with lower respiratory tract symptoms in routine primary care. A cohort of 28 883 adult patients with acute cough attributed to lower respiratory tract infections (LRTIs) was recruited from 5222 UK practices in 2009–13. Symptoms, signs and treatment were recorded at presentation and subsequent events followed-up for 30 days by chart review. The predictive value of patient characteristics, presenting symptoms and clinical findings for the diagnosis of pneumonia in the first 7 days was established. Of the 720 out of 28 883 (2.5.%) radiographed within 1 week of the index consultation, 115 (16.0%; 0.40% of 28 883) were assigned a definite or probable pneumonia diagnosis. The significant independent predictors of radiograph-confirmed pneumonia were temperature >37.8°C (RR 2.6; 95% CI 1.5–4.8), crackles on auscultation (RR 1.8; 1.1–3.0), oxygen saturation 100·min–1 (RR 1.9; 1.1–3.2). Most patients with pneumonia (99/115, 86.1%) exhibited at least one of these four clinical signs; the positive predictive value of having at least one of these signs was 20.2% (95% CI 17.3–23.1). In routine practice, radiograph-confirmed pneumonia as a short-term complication of LRTI is very uncommon (one in 270). Pulse oximetry may aid the diagnosis of pneumonia in this setting. Pulse oximetry probably has a role in the diagnosis of pneumonia in the community
Faz tempo que não vejo um broncograma tão evidente. Paciente PVHA e tabagista, em abandono terapêutico.