Showing posts with label pneumonia. Show all posts
Showing posts with label pneumonia. Show all posts

Monday, March 2, 2015

Pneumonia Effects in Childhood on Adult Respiratory Status: The Lung and Winding Road



          We are certainly aware that young children predisposed to lower respiratory illnesses in infancy and toddlerhood are often the ones who go on in childhood to experience some problems with lung function and develop illnesses such as asthma.  But what happens when these same children become adults?  Do they continue to experience problems with lung function? 
      Chan et al. (doi: 10.1542/peds.2014-3060)  explore these questions by following a cohort of children diagnosed with and without lower respiratory illnesses in the first 3 years of life and then followed with spirometry at ages 11,16,22, and 26 years of age along with information on asthma and wheezing obtained at 8 different time intervals between ages 11 and 29.  If a child experienced early pneumonia, the risk of experiencing asthma into adult life and being predisposed to developing adult chronic obstructive pulmonary disease was greater than if pneumonia had not been present in infancy and toddlerhood. 
      Understanding how early infection might trigger this life-long challenge with impaired airway function makes for an interesting discussion.  So take a deep breath and learn more about this longitudinal cohort, and how the findings in this study might apply to your own young patients with lower respiratory illness as they get older.

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Tuesday, November 25, 2014

The Pneumococcal Vaccine: Rates of Pneumonia and Sinusitis Before, After Implementation

By: Lewis First, MD, MS; Editor-in-Chief 
Sneeze photo by Anna Gutermuth via Flickr

I don’t think many of us would argue with the benefits of the pneumococcal vaccine in reducing rates of pneumococcal bacteremia and sepsis—but what about other manifestations of this infection—i.e. pneumonia and sinusitis?

Lindstrand et al. (doi: 10.1542/peds.2013-4177) performed a population-based study in Sweden of all hospitalizations pre- and post-introduction of the pneumococcal vaccines (PCV 7 and PCV 13) to look at hospitalizations for these two disorders. Their results are dramatic (in a very positive sense)!

If you had any doubt as to the effectiveness of immunizing against pneumococcus, this study being early released this week will do a “doubt-ectomy”—and hopefully not just for health care professionals but for families who may be less convinced about the need to vaccinate their children.

The study makes some sharp points about the reduction in hospitalizations that can be attributed to the administration of this vaccine—but read it for yourself and see what I mean.

Thursday, October 30, 2014

For Treating Empyema, Which Is Better—Urokinase Drainage or Video-Assisted Thoracoscopy?

By: Lewis First, MD, MS; Editor-in-Chief 

Video-assisted thoracoscopy.
Image by Cancer Research UK  via Wikimedia Commons.
Every once in a while we have a patient who develops a parapneumonic effusion of pus (otherwise known as an empyema) as a complication of an acute bacterial pneumonia. When this happens, treatment might involve a chest tube and when that fails, the use of thoracoscopy.

Recently however, the addition of urokinase to enzymatically break apart the empyema has been suggested to make the chest-tube drainage method more effective—but is it as effective as video-assisted thoracoscopy (VATS)?

Marhuenda et al. (doi:10.1542/peds.2013-3935) approached this question by performing a prospective randomized multicenter clinical trial in children younger than 15 years old with empyema that required intervention.

The results indicate that urokinase plus drainage may be just as effective as VATS, but if you want to see for yourself, scope out this study and discuss it with your local pediatric surgeons to see if they agree the two treatments are similar. Be sure to share what you learn with us by leaving a comment here on the blog, sharing an eLetter on our journal’s website or visiting us on Facebook or Twitter.

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