Article
Immunology
Moe Uddin, Turab Mohammed, Mark Metersky, Antonio Anzueto, Carlos A. Alvarez, Eric M. Mortensen
Summary: This study aimed to examine the association between beta-lactam plus doxycycline and mortality for patients hospitalized with community-acquired pneumonia. The study found that the use of doxycycline as part of guideline-concordant antibiotic therapy was associated with lower 30- and 90-day mortality than regimens without doxycycline.
CLINICAL INFECTIOUS DISEASES
(2022)
Article
Respiratory System
Yu Song, Wenxue Sun, Deyu Dai, Yue Liu, Zhongyi Li, Zhennan Tian, Xiaomin Liu
Summary: Severity assessment and accurate prognosis prediction are critical for CAP patients, with PCT identified as an independent predictor for prognosis. The combination of CURB-65 and PCT outperformed other predictive methods in predicting 90-day mortality.
EXPERT REVIEW OF RESPIRATORY MEDICINE
(2021)
Article
Infectious Diseases
Luis A. Ruiz, Leyre Serrano, Silvia Perez, Sonia Castro, Amaia Urrutia, Ane Uranga, Amaia Artaraz, Ainhoa Gomez, Pedro P. Espana, Rafael Zalacain
Summary: This study aimed to evaluate the impact of using a predefined cutoff value for lymphopenia as an early predictor of in-hospital mortality and other outcomes in patients with pneumococcal pneumonia. The study found that lymphopenia could be used as a reproducible predictor of complicated clinical course in these patients.
Article
Immunology
Leigh M. Howard, Kathryn M. Edwards, Yuwei Zhu, Derek J. Williams, Wesley H. Self, Seema Jain, Krow Ampofo, Andrew T. Pavia, Sandra R. Arnold, Jonathan A. McCullers, Evan J. Anderson, Richard G. Wunderink, Carlos G. Grijalva
Summary: The study found that PIV was more commonly detected in children, but often co-detected with other pathogens. Clinical features of PIV-1, PIV-2, and PIV-3 infections were similar in children and adult pneumonia patients. In children, PIV pneumonia was less severe than bacterial pneumonia.
CLINICAL INFECTIOUS DISEASES
(2021)
Article
Pediatrics
I-Fan Chang, Wei-Liang Shih, Yun-Chung Liu, Te-Wei Ho, Ting-Yu Yen, Hsiu-Hao Chang, Luan-Yin Chang, Chi-Tai Fang, Feipei Lai
Summary: Anemia is associated with poor outcomes in pediatric CAP, with iron-deficiency anemia and normocytic anemia being particularly concerning. Patients with these types of anemia should be carefully monitored and managed due to their higher disease severity risks.
PEDIATRIC PULMONOLOGY
(2022)
Article
Infectious Diseases
Felippe Lazar Neto, Lucas Oliveira Marino, Antoni Torres, Catia Cilloniz, Julio Flavio Meirelles Marchini, Julio Cesar Garcia de Alencar, Andrea Palomeque, Nuria Albacar, Rodrigo Antonio Brandao Neto, Heraldo Possolo Souza, Otavio T. Ranzani
Summary: The study externally validated pneumonia risk assessment tools on COVID-19 patients from two distinct countries, comparing their performance with recently developed COVID-19 mortality risk stratification tools. The results show that recent clinical COVID-19 assessment scores had comparable performance to standard pneumonia prognostic tools, providing important clinical reference value.
CLINICAL MICROBIOLOGY AND INFECTION
(2021)
Article
Critical Care Medicine
Abhishek Deshpande, Michael Klompas, Pei -Chun Yu, Peter B. Imrey, Andrea M. Pallotta, Thomas Higgins, Sarah Haessler, Marya D. Zilberberg, Peter K. Lindenauer, Michael B. Rothberg
Summary: This study investigates the frequency and timing of influenza testing and its associations with treatment and outcomes in adults hospitalized with community-acquired pneumonia (CAP). The results show that a significant proportion of CAP patients are not tested for influenza, even during flu season. However, for patients testing positive, they receive antiviral treatment more often and early treatment is associated with lower mortality and shorter hospital stays.
Article
Emergency Medicine
Dong Huang, Dingxiu He, Rong Yao, Wen Wang, Qiao He, Zhenru Wu, Yujun Shi, Zongan Liang
Summary: This study investigated the association between admission lactate and mortality in severe community-acquired pneumonia (SCAP) patients. The results of the study showed a significant correlation between elevated admission lactate levels and mortality in SCAP patients. The association was likely nonlinear, with the most notable impact on mortality within the range of 1.5 to 4 mmol/L.
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2023)
Letter
Medicine, General & Internal
Jan O. Friedrich, Elisa Gouvea Bogossian
Summary: In a trial evaluating the efficacy of hydrocortisone in treating community-acquired pneumonia, researchers found a nearly 50% lower 28-day mortality rate in the hydrocortisone group compared to the placebo group. They also observed a higher incidence of septic shock in the placebo group. The trial did not allow the use of open-label glucocorticoids, which may have contributed to the higher mortality rate in the placebo group.
NEW ENGLAND JOURNAL OF MEDICINE
(2023)
Article
Medicine, General & Internal
Javier de Miguel-Diez, Rodrigo Jimenez-Garcia, Valentin Hernandez-Barrera, Jose M. de Miguel-Yanes, David Carabantes-Alarcon, Jose J. Zamorano-Leon, Ana Lopez-de-Andres
Summary: Obese and morbidly obese patients with community-acquired pneumonia have a lower risk of in-hospital mortality than non-obese patients.
EUROPEAN JOURNAL OF INTERNAL MEDICINE
(2022)
Article
Critical Care Medicine
Judith Marin-Corral, Sergi Pascual-Guardia, Francesco Amati, Stefano Aliberti, Joan R. Masclans, Nilam Soni, Alejandro Rodriguez, Oriol Sibila, Francisco Sanz, Giovanni Sotgiu, Antonio Anzueto, Katerina Dimakou, Roberta Petrino, Ewoudt van de Garde, Marcos I. Restrepo
Summary: This study analyzed aspiration risk factors, microbiology patterns, and empiric anti-anaerobic use in patients hospitalized with CAP. Results showed that patients with ACAP or CAP/AspRF+ had similar anaerobic flora compared with those without aspiration risk factors, and Gram-negative bacteria were more prevalent in severe ACAP patients. Despite similar microbiological flora between groups, a large proportion of CAP patients received anti-anaerobic antibiotic coverage.
Article
Immunology
Abhishek Deshpande, Michael Klompas, Ning Guo, Peter B. Imrey, Andrea M. Pallotta, Thomas Higgins, Sarah Haessler, Marya D. Zilberberg, Peter K. Lindenauer, Michael B. Rothberg
Summary: Less than 6% of eligible inpatients with pneumonia were switched early, with no worse outcomes observed. Early switching was associated with fewer days on antibiotics. Hospitals should encourage evidence-based recommendations to switch therapy in stable patients.
CLINICAL INFECTIOUS DISEASES
(2023)
Article
Medicine, General & Internal
Meng Su, Qian Wang, Dan Li, Ling-Ling Wang, Chun-Yang Wang, Jiang-Li Wang, Qing Zhang, Luan-Ying Du, Jian-Ying Liu, Guang-Cheng Xie
Summary: Community-acquired pneumonia (CAP) caused by Mycoplasma pneumoniae is common among hospitalized children, with a high prevalence of bacterial coinfections complicating clinical diagnosis. Severe M pneumoniae pneumonia tends to occur in older children, exhibiting longer duration of cough, hospitalization, higher neutrophil ratio, and serum C-reactive protein levels.
Article
Microbiology
Nathaniel J. Rhodes, Caroline C. Jozefczyk, W. Justin Moore, Paul R. Yarnold, Karolina Harkabuz, Robert Maxwell, Sarah H. Sutton, Christina Silkaitis, Chao Qi, Richard G. Wunderink, Teresa R. Zembower
Summary: This study developed and tested clinical decision rules for identifying Clostridioides difficile infection (CDI) risk in hospitalized patients with community-acquired pneumonia (CAP). Findings showed that antibiotic use increased the risk of CDI in this patient population, highlighting the importance of antibiotic stewardship.
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY
(2021)
Article
Immunology
Yansha Song, Xiaocen Wang, Ke Lang, Tingting Wei, Jinlong Luo, Yuanlin Song, Dong Yang
Summary: This study constructed a nomogram to predict 28-day mortality in elderly patients with SCAP by analyzing clinical parameters. The nomogram includes age, Glasgow score, blood platelet, and blood urea nitrogen values. The AUC of the nomogram is 0.713, and the calibration curve for 28-day mortality shows high coherence between predicted and actual probability of mortality.
JOURNAL OF INFLAMMATION RESEARCH
(2022)
Article
Cardiac & Cardiovascular Systems
Christina Massoth, Mira Kuellmar, Dominic Enders, John A. Kellum, Lui G. Forni, Melanie Meersch, Alexander Zarbock
Summary: The severity and duration of acute kidney injury affect outcomes. Patients with persistent acute kidney injury after cardiac surgery have higher major adverse kidney events. This study evaluated biomarkers, specifically C-C motif chemokine ligand 14, to predict persistent acute kidney injury and major adverse kidney events. The results showed that C-C motif chemokine ligand 14 was the most predictive biomarker for these outcomes.
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
(2023)
Letter
Anesthesiology
Michael C. Reade
ANAESTHESIA AND INTENSIVE CARE
(2023)
Article
Pharmacology & Pharmacy
Victoria L. Williams, Pamela L. Smithburger, Allison N. Imhoff, Lara M. Groetzinger, Colleen M. Culley, Clayton X. Burke, Raghavan Murugan, Phillip E. Lamberty, Mujtaba Mahmud, Neal J. Benedict, John A. Kellum, Sandra L. Kane-Gill
Summary: This study evaluated the impact of using a clinical decision support system (CDSS) and stress biomarker testing in guiding therapeutic decisions for high-risk patients with drug-induced acute kidney injury (D-AKI) in the intensive care unit (ICU). The results showed that stress biomarkers, in conjunction with CDSS alerts, can influence treatment decisions for high-risk D-AKI patients.
ANNALS OF PHARMACOTHERAPY
(2023)
Review
Cell Biology
Lianjiu Su, Jiahao Zhang, Hernando Gomez, John A. Kellum, Zhiyong Peng
Summary: Mitophagy is a crucial mitochondrial quality control mechanism that removes damaged mitochondria and reactive oxygen species (ROS) production. The relationship between mitochondrial oxidative stress, ROS production, and mitophagy is closely intertwined and involved in various pathological conditions of acute kidney injury (AKI). The complex process of mitophagy in mammals involves multiple pathways and its interaction with different types of cell death, such as apoptosis, pyroptosis, and ferroptosis in kidney injury, remains unclear. This review discusses recent advances in understanding the relationship between ROS and mitophagy, the different pathways of mitophagy, the interplay between mitophagy and cell death, and their significance in the pathogenesis of AKI.
Article
Pharmacology & Pharmacy
Victoria L. Williams, Lara M. Groetzinger, Pamela L. Smithburger, Allison Imhoff, Colleen M. Culley, Raghavan Murugan, John A. Kellum, Sandra L. Kane-Gill
Summary: Traditional methods for evaluating changes in kidney function are limited in identifying acute kidney injury (AKI), while damage biomarkers can identify patients at risk for AKI before changes in kidney function occur. This case series demonstrates the successful use of kidney biomarkers in conjunction with a clinical decision support system (CDSS) to inform treatment strategies for AKI prevention.
AMERICAN JOURNAL OF HEALTH-SYSTEM PHARMACY
(2023)
Article
Urology & Nephrology
Raghavan Murugan, Monique Y. Boudreaux-Kelly, John A. Kellum, Paul M. Palevsky, Steven Weisbord
Summary: Recent studies have shown that most cases of contrast-associated acute kidney injury (CA-AKI) in patients with chronic kidney disease (CKD) are mild and not associated with elevated kidney injury biomarkers. This study used highly sensitive kidney cell cycle arrest and cardiac biomarkers to assess the risk of CA-AKI and major adverse kidney events in CKD patients undergoing angiography.
Editorial Material
Geriatrics & Gerontology
Andrew Teodorczuk, Michael C. Reade, Frederick A. Graham
Summary: This article reviews the 2021 Australian Delirium Clinical Care Standards, which provide important solutions to improve delirium care practices, addressing different audiences and incorporating the latest evidence.
Article
Critical Care Medicine
Jayesh Dhanani, Jason Pincus, Shane Townsend, George Pang, Elizabeth Vujcich, Morgan Windsor, Michael C. Reade
Summary: We report a case of a 30-yr-old male patient who developed a massive tracheoesophageal fistula after inhalation injury and burns. Surgical repair and VV ECMO were successfully used to treat refractory acute respiratory failure caused by this condition. This case highlights the importance of recognizing and managing acquired tracheoesophageal fistulae in burn patients.
JOURNAL OF BURN CARE & RESEARCH
(2023)
Review
Medicine, General & Internal
Michael Charles Reade, A. Auliff, B. McPherson, M. Edstein
Summary: Global Health Engagement is an important method used by the Australian Defence Force to shape Australia's strategic environment and protect its interests. Two recent examples of such engagements include malaria mitigation programs in partnership with the Vietnam People's Army and the Papua New Guinea Defence Force. These programs focused on collaboration, capacity building, and meeting the strategic policy requirements of all involved nations. Process and outcome measures were implemented to ensure effective use of funding, and personal trust and cultural understanding were fostered between individuals and military units. The inclusion of formal education in global health and global health engagement courses for future leaders in health-related professions, including military health planners and commanders, further strengthens the success of these programs.
BMJ MILITARY HEALTH
(2023)
Article
Medicine, General & Internal
Adam Mahoney, M. C. Reade, M. Moffat
Summary: This study explores the experiences and attitudes of Australian military medical practitioners towards live tissue training. The results indicate that live tissue training possesses unique characteristics that cannot be fully replicated by current alternative learning aids. Therefore, these positive experiences should be taken into account when deciding whether to transition to non-animal alternatives.
BMJ MILITARY HEALTH
(2023)
Meeting Abstract
Urology & Nephrology
Y. Diana Kwong, Kathleen Liu, Chi-Yuan Hsu, Bruce Cooper, Paul Palevsky, John Kellum, Kirsten Johansen, Christine Miaskowski
AMERICAN JOURNAL OF KIDNEY DISEASES
(2023)
Review
Critical Care Medicine
Claudio Ronco, Lakhmir Chawla, Faeq Husain-Syed, John A. Kellum
Summary: Sepsis and septic shock are still major causes of morbidity and mortality in critically ill patients. The clinical manifestation of these syndromes involves several steps, including microbial invasion, infection establishment, immune response, inflammation, tissue damage, organ dysfunction, and organ crosstalk. Different extracorporeal therapies can be used at different stages to target specific molecules or provide organ support. However, the success of these therapies may need to be evaluated using endpoints other than mortality.
Review
Biochemistry & Molecular Biology
Debra M. Foster, John A. Kellum
Summary: Endotoxin, also known as lipopolysaccharide (LPS), induces inflammatory response and can lead to sepsis and septic shock. Quantifying endotoxin and removing it using extracorporeal methods may be beneficial for patients with endotoxic septic shock.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2023)
Article
Critical Care Medicine
Marcus Young, Natasha E. Holmes, Kartik Kishore, Sobia Amjad, Michele Gaca, Ary Serpa Neto, Michael C. Reade, Rinaldo Bellomo
Summary: The use of natural language processing (NLP) can help identify behavioral disturbance phenotypes with different characteristics, prevalence, trajectory, treatment, and outcomes. In critically ill patients, those with an agitated phenotype are more likely to receive antipsychotic medications and have a higher risk of mortality compared to patients with a non-agitated or combined phenotype.
Review
Urology & Nephrology
John A. Kellum, Debra Foster, Paul M. Walker
Summary: There is significant heterogeneity among sepsis patients in terms of organ dysfunction distribution and severity, possibly due to multiple subtypes of sepsis. Endotoxin is an important molecular phenotype of sepsis, characterized by unique clinical features and high mortality.