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Annual and seasonal patterns in etiologies of pediatric community-acquired pneumonia due to respiratory viruses and Mycoplasma pneumoniae requiring hospitalization in South Korea.

韩国需要住院治疗的呼吸道病毒和支原体肺炎e引起的儿童社区获得性肺炎病原学的年度和季节性模式。

  • 影响因子:2.79
  • DOI:10.1186/s12879-020-4810-9
  • 作者列表:"Lee E","Kim CH","Lee YJ","Kim HB","Kim BS","Kim HY","Kim Y","Kim S","Park C","Seo JH","Sol IS","Sung M","Song MS","Song DJ","Ahn YM","Oh HL","Yu J","Jung S","Lee KS","Lee JS","Jang GC","Jang YY","Chung EH","Chung HL","Choi SM","Choi YJ","Han MY","Shim JY","Kim JT","Kim CK","Yang HJ","Pneumonia and Respiratory Disease Study Group of Korean Academy of Pediatric Allergy and Respiratory Disease.
  • 发表时间:2020-02-12
Abstract

BACKGROUND:Community-acquired pneumonia (CAP) is one of the leading worldwide causes of childhood morbidity and mortality. Its disease burden varies by age and etiology and is time dependent. We aimed to investigate the annual and seasonal patterns in etiologies of pediatric CAP requiring hospitalization. METHODS:We conducted a retrospective study in 30,994 children (aged 0-18 years) with CAP between 2010 and 2015 at 23 nationwide hospitals in South Korea. Mycoplasma pneumoniae (MP) pneumonia was clinically classified as macrolide-sensitive MP, macrolide-less effective MP (MLEP), and macrolide-refractory MP (MRMP) based on fever duration after initiation of macrolide treatment, regardless of the results of in vitro macrolide sensitivity tests. RESULTS:MP and respiratory syncytial virus (RSV) were the two most commonly identified pathogens of CAP. With the two epidemics of MP pneumonia (2011 and 2015), the rates of clinical MLEP and MRMP pneumonia showed increasing trends of 36.4% of the total MP pneumonia. In children < 2 years of age, RSV (34.0%) was the most common cause of CAP, followed by MP (9.4%); however, MP was the most common cause of CAP in children aged 2-18 years of age (45.3%). Systemic corticosteroid was most commonly administered for MP pneumonia. The rate of hospitalization in intensive care units was the highest for RSV pneumonia, and ventilator care was most commonly needed in cases of adenovirus pneumonia. CONCLUSIONS:The present study provides fundamental data to establish public health policies to decrease the disease burden due to CAP and improve pediatric health.

摘要

背景: 社区获得性肺炎 (CAP) 是全球儿童发病率和死亡率的主要原因之一。其疾病负担因年龄和病因而异,且具有时间依赖性。我们旨在调查需要住院治疗的儿科CAP病因的年度和季节模式。 方法: 我们在 2010 年至 30,994 年期间在韩国 23 家全国医院对 2015 名患有CAP的儿童 (年龄 0-18 岁) 进行了一项回顾性研究。支原体肺炎e (MP) 肺炎在临床上分为大环内酯类敏感MP、大环内酯类低效MP (MLEP) 、大环内酯类难治性MP (MRMP) 基于大环内酯治疗开始后的发热持续时间,无论体外大环内酯敏感性试验的结果如何。 结果: MP和呼吸道合胞病毒 (RSV) 是CAP最常见的两种病原体。随着MP肺炎的两次流行 (2011 和 2015),临床MLEP和MRMP肺炎的发生率呈上升趋势,占MP肺炎总数的 36.4%。在 <2 岁的儿童中,RSV (34.0%) 是CAP最常见的原因,其次是MP (9.4%); 然而,MP是 2-18 岁儿童CAP的最常见原因 (45.3%)。全身性皮质类固醇最常用于MP肺炎。RSV肺炎在重症监护病房的住院率最高,腺病毒肺炎病例最常需要呼吸机护理。 结论: 本研究为制定公共卫生政策以降低CAP导致的疾病负担和改善儿科健康提供了基础数据。

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影响因子:14.71
发表时间:2020-02-01
来源期刊:Nature immunology
DOI:10.1038/s41590-019-0571-2
作者列表:["Adrover JM","Aroca-Crevillén A","Crainiciuc G","Ostos F","Rojas-Vega Y","Rubio-Ponce A","Cilloniz C","Bonzón-Kulichenko E","Calvo E","Rico D","Moro MA","Weber C","Lizasoaín I","Torres A","Ruiz-Cabello J","Vázquez J","Hidalgo A"]

METHODS::The antimicrobial functions of neutrophils are facilitated by a defensive armamentarium of proteins stored in granules, and by the formation of neutrophil extracellular traps (NETs). However, the toxic nature of these structures poses a threat to highly vascularized tissues, such as the lungs. Here, we identified a cell-intrinsic program that modified the neutrophil proteome in the circulation and caused the progressive loss of granule content and reduction of the NET-forming capacity. This program was driven by the receptor CXCR2 and by regulators of circadian cycles. As a consequence, lungs were protected from inflammatory injury at times of day or in mouse mutants in which granule content was low. Changes in the proteome, granule content and NET formation also occurred in human neutrophils, and correlated with the incidence and severity of respiratory distress in pneumonia patients. Our findings unveil a 'disarming' strategy of neutrophils that depletes protein stores to reduce the magnitude of inflammation.

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影响因子:2.81
发表时间:2020-01-05
DOI:10.3390/ijerph17010356
作者列表:["Yang LC","Suen YJ","Wang YH","Lin TC","Yu HC","Chang YC"]

METHODS::Pneumonia is a common respiratory infectious disease that involves the inflammation of the pulmonary parenchyma. Periodontal disease is widespread and correlated with pneumonia. However, the relationship between periodontal treatment and clinical infectious outcomes in patients with pneumonia has remained undetermined. The aim of this study was to investigate the association between periodontal treatment and the risk of pneumonia events in the Taiwanese population. A nationwide population-based cohort study was conducted using data from the Taiwanese National Health Insurance Research Database (NHIRD). A total of 49,400 chronic periodontitis patients who received periodontal treatment from 2001 to 2012 were selected. In addition, 49,400 healthy individuals without periodontal diseases were picked randomly from the general population after propensity score matching according to age, gender, monthly income, urbanization, and comorbidities. The Cox proportional hazard regression analysis was adopted to assess the hazard ratio (HR) of pneumonia between the periodontal treatment cohort and the comparison cohort. The average ages of the periodontal treatment and comparison groups were 44.25 ± 14.82 years and 44.15 ± 14.5 years, respectively. The follow up durations were 7.66 and 7.41 years for the periodontal treatment and comparison groups, respectively. We found 2504 and 1922 patients with newly diagnosed pneumonia in the comparison cohort and the periodontal treatment cohort, respectively. The Kaplan-Meier plot revealed that the cumulative incidence of pneumonia was significantly lower over the 12 year follow-up period in the periodontal treatment group (using the log-rank test, p < 0.001). In conclusion, this nationwide population-based study indicated that the patients with periodontal treatment exhibited a significantly lower risk of pneumonia than the general population.

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影响因子:2.89
发表时间:2020-04-01
DOI:10.1016/j.ijid.2020.01.038
作者列表:["Ngocho JS","Horumpende PG","de Jonge MI","Mmbaga BT"]

METHODS:OBJECTIVE:To describe the treatment of community-acquired pneumonia (CAP) in children under five years in Tanzania. METHODS:Between January and December 2017, children aged 2-59 months with chest radiography-confirmed CAP were enrolled. The parents were interviewed to collect information on the patients and home-based medication. Clinical information was derived from the patient files. Nasopharyngeal swab and blood samples were collected for isolation of the causative pathogens. Swab samples were analysed by quantitative PCR whereas blood samples were tested using BacT/Alert 3D. RESULTS:Overall, 109 children with CAP were included in this analysis. Provision of care to most children was delayed (median = 4.6 days). A quarter (26.6%) were given unprescribed/leftover antibiotics at home. Only one child had positive bacterial culture. Referrals were associated with nasopharyngeal carriage of Streptococcus pneumoniae (p = 0.003) and Haemophilus influenzae (p = 0.004). Of all admitted children, more than a quarter (n = 29) did not need to be hospitalised and inappropriately received injectable instead of oral antibiotics. CONCLUSION:We found high rates of home treatment, particularly with antibiotics. Appropriate health care was delayed for most children because of home treatment. Efforts are needed at the community level to improve awareness of antimicrobial resistance.

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肺炎方向

肺炎是指终末气道、肺泡和肺间质的炎症。可由细菌、病毒、真菌、寄生虫等致病微生物,以及放射线、吸入性异物等理化因素引起。临床主要症状为发热、咳嗽、咳痰、痰中带血,可伴胸痛或呼吸困难等。

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