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Heparin-binding protein as a predictor of mortality in patients with diabetes mellitus and community-acquired pneumonia in intensive care unit:a propensity score matched study

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World Journal of Emergency Medicine 2024年第4期15卷 263-272页

作者： Yuhan Sun Baoqing Sun Zhigang Ren Mingshan Xue Changju Zhu Qi Liu Translational Medicine Center Department of Emergency Medicinethe First Affiliated Hospital of Zhengzhou UniversityZhengzhou 450052China State Key Laboratory of Respiratory Disease National Clinical Research Center for Respiratory DiseaseGuangzhou Institute of Respiratory Healththe First Affiliated Hospital of Guangzhou Medical UniversityGuangzhou 510230China Department of Infectious Disease the First Affiliated Hospital of Zhengzhou UniversityZhengzhou 450052China Henan Medical Key Laboratory of Emergency and Trauma Research Department of Emergency Medicinethe First Affiliated Hospital of Zhengzhou UniversityZhengzhou 450052China

BACKGROUND:Patients with diabetes mellitus(DM)are vulnerable to community-acquired pneumonia(CAP),which have a high mortality *** aimed to investigate the value of heparin-binding protein(HBP)as a prognostic marker of mortality in patients with DM and ***:This retrospective study included CAP patients who were tested for HBP at intensive care unit(ICU)admission from January 2019 to April *** were allocated to the DM or non-DM group and paired with propensity score *** characteristics and clinical outcomes up to 90 days were *** primary outcome was the 10-day *** operating characteristic(ROC)curves,Kaplan-Meier analysis,and Cox regression were used for statistical ***:Among 152 enrolled patients,60 pairs were successfully *** was no significant difference in 10-day mortality,while more patients in the DM group died within 28 d(P=0.024)and 90 d(P=0.008).In the DM group,HBP levels at ICU admission were higher in 10-day non-survivors than in 10-day survivors(median 182.21[IQR:55.43-300]ng/ml *** 66.40[IQR:34.13-107.85]ng/mL,P=0.019),and HBP levels could predict the 10-day mortality with an area under the ROC curve of *** cut-off value,sensitivity,and specificity were 160.6 ng/mL,66.7%,and 90.2%,*** Cox regression analysis indicated that HBP was an independent prognostic factor for 10-day(HR 7.196,95%CI:1.596-32.455,P=0.01),28-day(HR 4.381,95%CI:1.449-13.245,P=0.009),and 90-day mortality(HR 4.581,95%CI:1.637-12.819,P=0.004)in patients with ***:Plasma HBP at ICU admission was associated with the 10-day,28-day,and 90-day mortality,and might be a prognostic factor in patients with DM and CAP.

关键词： community-acquired pneumonia Diabetes mellitus Heparin-binding protein Propensity score match

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Role of biomarkers in community-acquired pneumonia management

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Journal of Acute Disease 2024年第3期13卷 87-92页

作者： Bahaeddin Onur Hakan BarışDemirbas Arif Gulmez Department of Emergency Medicine Istanbul Health and Technology UniversityIstanbulTurkey Department of Emergency PHCCAl Karaana Health CenterDohaQatar Department of Emergency PHCCUmm Slala Health CenterDohaQatar Department of Family Medicine PHCCAl Thumama Health CenterDohaQatar

community-acquired pneumonia(CAP)poses a significant global health threat,particularly affecting vulnerable *** and scoring systems play a crucial role in diagnosing,assessing severity,and guiding treatment decisions for CAP *** like C reactive protein,procalcitonin,and the neutrophil-to-lymphocyte ratio aid in diagnosis and severity assessment,while scoring systems such as CURB-65 and pneumonia Severity Index classify patients into risk *** biomarkers(uremia,elevated respiratory rate,hypotension,and age≥65)like serum amyloid A and S100 proteins show promise in predicting disease severity and ***,further research is needed to determine their precise roles and clinical utility in CAP management.

关键词： CURB-65 community-acquired pneumonia Procalcitonin Alpha-1 antitrypsin Serum amyloid A

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Serum activin A as a prognostic biomarker for community acquired pneumonia

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World Journal of Clinical Cases 2024年第22期12卷 5016-5023页

作者： Yu-Ting Wang Yan Liu Guang-Hui Zhou Kan Liu Yan Fen Hui Ding Pulmonary and Critical Care Medicine Yixing People’s Hospital of Jiangsu UniversityYixing 214200Jiangsu ProvinceChina

BACKGROUND It is essential to develop new biomarker with effective prognostic roles because of the unclear clinical use of the current community-acquired pneumonia(CAP)*** To evaluate the association between serum activin A levels and prognosis in CAP *** A total of 168 CAP individuals grouped according to the severity and prognosis of illness condition,and 48 healthy individuals as the control group were enrolled in this *** concentrations of activin A were measured using enzymelinked *** interaction between activin A levels and etiologies of CAP was *** on the severity of CAP,110 patients(65.48%)were categorized into group-I,42(25%)cases were grouped into group-II,and 16(9.52%)cases were categorized into *** Serum activin A levels were higher in patients with CAP than controls,but independent of ***,the scores of pneumonia Severity Index(PSI)and CURB-65 positively correlated with the increasing levels of serum activin A,and were at their highest peak in individuals in group-III(P<0.001).Combining activin A with CURB-65 or PSI was more effective in improving predictive property(P<0.01).According to Cox proportional regression analysis,after adjusting clinical parameters,we confirmed that activin A showed a powerful predictive property for hospital mortality in CAP patients(P<0.001).CONCLUSION Higher level of serum activin A was associated with poor prognosis of *** A can be used as a more valuable biomarker of prognosis in CAP patients.

关键词： community-acquired pneumonia Activin A Etiology Prognosis Etiology

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Pathogenic changes of community-acquired pneumonia in a children’s hospital in Beijing,China before and after COVID-19 onset:a retrospective study

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World Journal of Pediatrics 2022年第11期18卷 746-752页

作者： Li-Na Zhang Ling Cao Ling-Hui Meng Department of Pulmonology Children’s HospitalCapital Institute of PediatricsBeijingChina Center for Evidence-Based Medicine Office of Science and TechnologyCapital Institute of PediatricsBeijingChina

Background This study aimed to analyze the pathogenic characteristics of community-acquired pneumonia(CAP)in a children’s hospital before and after the coronavirus disease 2019(COVID-19)pandemic and to provide testimony for preventing CAP in the *** A retrospective analysis was *** information was collected from the electronic medical record system of the hospital.A total of 2739 children were included from February 1,2019,to January 31,*** Among these 2739 patients were 1507(55.02%)males and 1232(44.98%)females;the median age was 3.84 *** were 2364 cases during the pre-COVID-19 period and 375 cases during the post-COVID-19 *** number of hospitalized children after the pandemic was 84.14%*** median age after the onset was 1.5 years younger than that before the onset(4.08 years old)(Z=−7.885,Ppneumoniae pneumonia(MPP)and influenza virus pneumonia(IVP)decreased *** the pre-COVID-19 period,the proportions of detected pathogens were as follows:MP(59.56%)>bacteria(50.42%)>viruses(29.57%)>fungi(3.43%).During the post-COVID-19 period,the pathogen proportions were bacteria(56.53%)>viruses(53.60%)>MP(23.47%)>fungi(3.73%).Conclusions There was a significant decrease in the number of children with CAP hospitalized after the pandemic,especially among school-age children,and the pathogen proportions of CAP with MP and IV were significantly *** inferred that CAP was effectively prevented in school-age children because of the strong mitigation measures.

关键词： community-acquired pneumonia Comparison Coronavirus disease 2019 Pathogen

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Influence of overweight and obesity on the mortality of hospitalized patients with community-acquired pneumonia

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World Journal of Clinical Cases 2022年第1期10卷 104-116页

作者： Ning Wang Bo-Wei Liu Chun-Ming Ma Ying Yan Quan-Wei Su Fu-Zai Yin Department of Endocrinology Hebei Medical UniversityShijiazhuang 050017Hebei ProvinceChina Department of Endocrinology First Hospital of QinhuangdaoQinhuangdao 066001Hebei ProvinceChina Department of Endocrinology Chengde Medical UniversityChengde 067000Hebei ProvinceChina

BACKGROUND Obesity is associated with a better prognosis in patients with community-acquired pneumonia(the so-called obesity survival paradox),but conflicting results have been *** To investigate the relationship between all-cause mortality and body mass index in patients with community-acquired *** This retrospective study included patients with community-acquired pneumonia hospitalized in the First Hospital of Qinhuangdao from June 2013 to November *** patients were grouped as underweight(community-acquired pneumonia.

关键词： Body mass index Overweight community-acquired pneumonia Mortality Prognosis Obesity

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community-acquired pneumonia complicated by rhabdomyolysis: A clinical analysis of 11 cases

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World Journal of Clinical Cases 2019年第24期7卷 4218-4225页

作者： Bo Zhao Rui Zheng Department of Respiratory Medicine Shengjing Hospital of China Medical University

BACKGROUND In clinical practice, community-acquired pneumonia(CAP) can be complicated by rhabdomyolysis(RM), and RM symptoms are mild and easily missed during diagnosis. Moreover, available data on RM induced by CAP are mainly from case reports. Due to the relatively low incidence of CAP-induced RM, more systematic studies are required to understand the characteristics of CAP-induced RM to improve its diagnosis and *** To investigate the clinical characteristics of patients with CAP-induced *** This was a retrospective study of 11 patients with CAP-induced RM. Baseline characteristics, diagnostic work-up, and laboratory test results were summarized and compared with those of 48 patients with exercise-induced RM admitted during the same *** CAP-induced RM was more common in men, and affected older patients compared to those with exercise-induced RM. However, the average age of the patients in this study was lower than the age of peak incidence of CAP in adults in China. The major clinical manifestations were high fever and respiratory symptoms. RM symptoms were mild and often overlooked. Patients with CAP-induced RM had elevated inflammatory parameters, respiratory alkalosis,relatively low serum potassium levels and often had abnormalities in hepatic and renal function and cardiac enzymes. Compared with the exercise group, the pneumonia group had lower levels of creatine kinase and myoglobin, a higher incidence of acute kidney injury, and worse renal function and *** events were mainly related to the severity of *** CAP-induced RM has different clinical characteristics from those of exerciseinduced RM. Early detection and treatment could reduce complications and consequently shorten the treatment course.

关键词： community-acquired pneumonia Rhabdomyolysis Exercise Acute kidney injury

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Clinical characteristics of community-acquired pneumonia in children caused by mycoplasma pneumoniae with or without myocardial damage:A single-center retrospective study

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World Journal of Clinical Pediatrics 2023年第3期12卷 115-124页

作者： Shukri Omar Yusuf Peng Chen Department of Pediatrics The Second Hospital of Jilin UniversityChangchun 130041Jilin ProvinceChina

BACKGROUND Mycoplasma pneumoniae(MP)is a prevalent pathogen that causes respiratory infections in children and *** To assess the differences in the clinical features of MP-associated communityacquired pneumonia(CAP)in children who presented with mild or severe mycoplasma pneumoniae pneumonia(MPP);to identify the incidence of myocardial damage between the two *** This work is a retrospective *** identified children between 2 mo and 16 years of age with clinical and radiological findings consistent with *** admitted patients to the inpatient department of the Second Hospital of Jilin University,Changchun,China,from January 2019 to December *** A total of 409 hospitalized patients were diagnosed with *** them were 214(52.3%)males and 195(47.7%)*** duration of fever and cough was the longest in severe MPP ***,plasma levels of highly sensitive Creactive protein(t=-2.834,Ppneumoniae is the main cause of *** incidence of myocardial damage was higher and statistically significant in severe MPP cases than in mild MPP cases.

关键词： community-acquired pneumonia Mycoplasma pneumoniae Mild mycoplasma pneumoniae pneumonia Severe mycoplasma pneumoniae pneumonia Myocardial damage

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Outcome prediction value of National Early Warning Score in septic patients with community-acquired pneumonia in emergency department: A single-center retrospective cohort study

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World Journal of Emergency Medicine 2020年第4期11卷 206-215页

作者： Hai-jiang Zhou Tian-fei Lan Shu-bin Guo Emergency Medicine Clinical Research Center Beijing Chao-yang HospitalCapital Medical University&Beijing Key Laboratory of Cardiopulmonary Cerebral ResuscitationBeijingChina Department of Allergy Beijing Shijitan HospitalCapital Medical UniversityBeijingChina

BACKGROUND:To evaluate the accuracy of National Early Warning Score(NEWS)in predicting clinical outcomes(28-day mortality,intensive care unit[ICU]admission,and mechanical ventilation use)for septic patients with community-acquired pneumonia(CAP)compared with other commonly used severity scores(CURB65,pneumonia Severity Index[PSI],Sequential Organ Failure Assessment[SOFA],quick SOFA[qSOFA],and Mortality in Emergency Department Sepsis[MEDS])and admission lactate ***:Adult patients diagnosed with CAP admitted between January 2017 and May 2019 with admission SOFA≥2 from baseline were *** characteristics were *** primary outcome was the 28-day mortality after admission,and the secondary outcome included ICU admission and mechanical ventilation *** prediction value of parameters above was compared using receiver operating characteristics(ROC)*** regression analyses were carried out to determine the risk factors for the 28-day ***-Meier survival curves were plotted and compared using optimal cut-off values of qSOFA and ***:Among the 340 enrolled patients,90 patients were dead after a 28-day follow-up,62 patients were admitted to ICU,and 84 patients underwent mechanical *** single predictors,NEWS achieved the largest area under the receiver operating characteristic(AUROC)curve in predicting the 28-day mortality(0.861),ICU admission(0.895),and use of mechanical ventilation(0.873).NEWS+lactate,similar to MEDS+lactate,outperformed other combinations of severity score and admission lactate in predicting the 28-day mortality(AUROC 0.866)and ICU admission(AUROC 0.905),while NEWS+lactate did not outperform other combinations in predicting mechanical ventilation(AUROC 0.886).Admission lactate only improved the predicting performance of CURB65 and qSOFA in predicting the 28-day mortality and ICU ***:NEWS could be a valuable predictor in septic patients with CAP in emergency depa

关键词： community-acquired pneumonia Sepsis National Early Warning Score(NEWS) Intensive care unit Emergency departments

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Efficacy and significance of various scores for pneumonia severity in the management of patients with community-acquired pneumonia in China

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Chinese Medical Journal 2012年第4期125卷 639-645页

作者： Yang Yan Xu Feng Shi Li-yun Diao Ran Cheng Yu-sheng Chen Xi-yuan Jing Ji-yong Wang Xuan-ding Shen Hua-hao Zhejiang Univ Affiliated Hosp 2 Dept Resp Med Sch Med Hangzhou 310009 Zhejiang Peoples R China Zhejiang Univ Affiliated Hosp 2 Dept Intens Care Unit Sch Med Hangzhou 310009 Zhejiang Peoples R China Zhejiang Univ Affiliated Hosp 2 Dept Infect Prevent & Control Sch Med Hangzhou 310009 Zhejiang Peoples R China Hangzhou Normal Univ Div Immunol Hangzhou 310036 Zhejiang Peoples R China Zhejiang Univ Affiliated Hosp 2 Dept Internal Med Binjiang BranchSch Med Hangzhou 310009 Zhejiang Peoples R China Hangzhou Binjiang Hosp Hangzhou 310009 Zhejiang Peoples R China

Background community-acquired pneumonia （CAP） remains one of the leading causes ot death from infectious diseases around the *** severe CAP patients are admitted to the intensive care unit （ICU）,and receive intense *** present study aimed to evaluate the role of the pneumonia severity index （PSI）,CURB-65,and sepsis score in the management of hospitalized CAP patients and explore the effect of ICU treatment on prognosis of severe *** A total of 675 CAP patients hospitalized in the Second Affiliated Hospital of Zhejiang University School of Medicine were retrospectively *** ability of different pneumonia severity scores to predict mortality was compared for effectiveness,while the risk factors associated with 30-day mortality rates and hospital length of stay （LOS） were *** effect of ICU treatment on the outcomes of severe CAP patients was also *** All three scoring systems revealed that the mortality associated with the low-risk or intermediate-risk group was significantly lower than with the high-risk *** the risk level increased,the frequency of ICU admission rose in tandem and LOS in the hospital was *** areas under the receiver operating characteristic curve in the prediction of mortality were 0.94,0.91 and 0.89 for the PSI,CURB-65 and sepsis score,*** with the corresponding control groups,the mortality was markedly increased in patients with a history of smoking,prior admission to ICU,respiratory failure,or co-morbidity of heart *** differences were also identified in LOS between control groups and patients with ICU treatment,heart,or cerebrovascular *** regression analysis showed that age over 65 years,a history of smoking,and respiratory failure were closely related to mortality in the overall CAP cohort,whereas age,ICU admission,respiratory failure,and LOS at home between disease attack and hospital admission were identified as independent

关键词： community-acquired pneumonia pneumonia severity pneumonia severity index CURB-65 score sepsis score intensive care unit treatment

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Improving antibiotic prescribing in the emergency department for uncomplicated community-acquired pneumonia

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World Journal of Emergency Medicine 2020年第4期11卷 199-205页

作者： Rebekah Shaw Erica Popovsky Alyssa Abo Marni Jacobs Nicole Herrera James Chamberlain AndreaHahn Division of Pediatrics Children’s National Health SystemWashingtonDCUSA Division of Emergency Medicine Children’s National Health SystemWashingtonDCUSA Department of Pediatrics George Washington University School of Medicine and Health SciencesWashingtonDCUSA Division of Biostatistics and Epidemiology Children’s National Health SystemWashingtonDCUSA Division of Infectious Diseases Children’s National Health SystemWashingtonDCUSA

BACKGROUND:The Pediatric Infectious Disease Society(PIDS)and Infectious Disease Society of America(IDSA)published an evidence-based guideline for the treatment of uncomplicated communityacquired pneumonia(CAP)in children,recommending aminopenicillins as the first-line *** guideline compliance with 10%–50%of patients admitted to the hospital receiving narrow-spectrum antibiotics has been reported.A new clinical practice guideline(CPG)was implemented in our emergency department(ED)for uncomplicated *** aim of this study was to examine baseline knowledge and ED provider prescribing patterns pre-and post-CPG ***:Prior to CPG-implementation,an anonymous case-based survey was distributed to evaluate knowledge of the current PIDS/IDSA guideline.A retrospective chart review of patients treated in the ED for CAP from January 2015 to February 2017 was performed to assess prescribing patterns for intravenous(IV)antibiotics in the ED at Children’s National Health System pre-and post-CPG ***:ED providers were aware of the PIDS/IDSA guideline recommendations,with 86.4%of survey responders selecting ampicillin as the initial antibiotic of ***,only 41.2%of patients admitted to the hospital with uncomplicated CAP pre-CPG received ampicillin(P<0.01).There was no statistically signifi cant increase in ampicillin prescribing post-CPG(P=0.40).CONCLUSIONS:Providers in the ED are aware of the PIDS/IDSA guideline regarding the first-line therapy for uncomplicated CAP;however,this knowledge does not translate into clinical *** of a CPG in isolation did not significantly change prescribing patterns for uncomplicated CAP.

关键词： Antibiotics community-acquired pneumonia Emergency department Pediatrics

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