Geriatric chest wall injury: is it time for a new sense of urgency?

Geriatric chest wall injury: is it time for a new sense of urgency? J Thorac Dis. 2019 May;11(Suppl 8):S1029-S1033 Authors: Christie DB, Nowack T, Drahos A, Ashley DW Abstract Geriatric trauma has become an increasingly recognized management concern for trauma centers, and hospitals alike, on a national scale. The population of the United States is aging, as life expectancy rates have demonstrated a steady climb to an average of 78.8 years of expected life. With pervasive efforts of medical screening, prevention and chronic medical condition management, more elderly people will lead more active lifestyles and will be more predisposed to injury. As best practice guidelines specific for the geriatric trauma population have yet to be developed, many researchers have identified management strategies that have offset complications and mortality rates inherent to this patient population after injury. The impact of rib fractures in the 65-year and older patient population has been well documented, as have the mortality and pneumonia rates yet, historically, little attention has been directed to curtailing these adverse outcomes with more advanced treatment options. With the advent of rib plating for rib fracture fixation and chest wall stabilization, the practice paradigm for rib fracture management is shifting, as a viable operative intervention now exists. In this review, we focus on the characteristics of the geriatric trauma patient, areas of management wher...
Source: Journal of Thoracic Disease - Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

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Publication date: Available online 15 July 2019Source: Respiratory Medicine Case ReportsAuthor(s): Yanqiu Wei, Peng Chen, Huihui Yue, Gaohong Sheng, Jiaojiao Chu, Hui-Lan ZhangAbstractGiant cell interstitial pneumonia (GIP) is an exceedingly rare lung disease, usually due to occupational exposure to hard-metal compounds (tungsten, carbide, cobalt). Diagnosis of GIP is mainly based on the presence of multinucleated giant cell (MNGC) in alveolar spaces by histologic examination. Here, we present a case of GIP with multi-organ involvement. A 63-year-old man was diagnosed with tuberculosis firstly, but conventional treatment d...
Source: Respiratory Medicine Case Reports - Category: Respiratory Medicine Source Type: research
We describe host inflammatory biomarkers and clinical outcomes among children hospitalized with RSV lower respiratory tract infection (LRTI) in Uganda and controls with rhinovirus and pneumococcal pneumonia. Methods: 58 children hospitalized with LRTI were included. We compared 37 patients with RSV, 10 control patients with rhinovirus and 11 control patients with suspected pneumococcal pneumonia. Results: Patients in the RSV group had significantly lower levels of C-reactive protein (CRP) and chitinase-3-like protein 1 (CHI3L1) than the pneumococcal pneumonia group (P
Source: The Pediatric Infectious Disease Journal - Category: Infectious Diseases Tags: Translational Medicine Reports Source Type: research
Conclusions Cystic fibrosis or CFTR-RD can present as ARP/CP. Complete diagnostic testing for CFTR-RD in patients with ARP/CP will broaden treatment options and help to identify comorbid illness.
Source: Pancreas - Category: Gastroenterology Tags: Original Articles Source Type: research
Background: Investigations of the relationship between vancomycin trough concentrations and area under the concentration time curve (AUC) are growing, but still limited. The authors sought to determine vancomycin exposure among hospitalized adults with presumed or confirmed invasive staphylococcal infections using 2-level pharmacokinetic monitoring to inform changes to an institutional vancomycin dosing protocol. Methods: This was a retrospective observational study performed in 2 acute care hospitals. Adults prescribed vancomycin (therapeutic trough 15–20 mg/L) for a presumed or documented invasive staphylococc...
Source: Therapeutic Drug Monitoring - Category: Drugs & Pharmacology Tags: Original Article Source Type: research
In conclusion, patients with CHH may develop adult-onset immunodeficiency or malignancy without preceding clinical symptoms of immune defect, warranting careful follow-up. Variable disease course and risk factors for mortality should be acknowledged.
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
ConclusionProteomic analysis pointed to impairment of lipid metabolism as a major change in septic patients secondary to HAP, which was further validated by the reduced levels of cholesterol moieties and apolipoproteins in plasma. Our results stress the involvement of lipids in the pathogenesis of sepsis, which is in accordance with previous reports supporting the role of lipid moieties in pathogen toxin clearance and in modulating inflammatory responses.
Source: Clinical Proteomics - Category: Biochemistry Source Type: research
We described a 9-month boy who was admitted to our hospital because of severe pneumonia and developed DRESS 3 weeks later. In addition, we performed a literature review of diabetes mellitus associated with DRESS by searching the PubMed. A total of 16 articles and 27 related case reports were obtained between 2001 and 2018. The mean age was 46yr. The duration from the onset of DRESS to the development of DM was 21d on average. 21 patients were diagnosed F1TD, 5 patients were confirmed T1DM, and 1 patient was defined T2DM. GAD were detected in 4 cases. Of 22 cases in which virus examination were carried out, evidence of viru...
Source: Frontiers in Endocrinology - Category: Endocrinology Source Type: research
Conclusion: Even when performed by operators with very distinct degrees of experience, LUS had a good interoperator reliability for detecting sonographic patterns on specific thoracic regions.What is Known:• Lung ultrasound is feasible, safe, and highly accurate for the diagnosis of pneumonia in children; however, it does not allow global visualization of the thorax in a single moment as in chest X-rays, and, similar to the stethoscope, partial thorax assessments must be performed sequentially.What is New:• This is the first study evaluating the agreement of LUS on specific thoracic regions between operators with...
Source: European Journal of Pediatrics - Category: Pediatrics Source Type: research
AbstractCigarettes are well-recognized risk factors responsible for the emergence of a variety of pathologic conditions affecting both the airways and the lungs. Smoking-related lung diseases can be classified as chronic obstructive pulmonary disease (COPD) and several types of interstitial diseases, such as pulmonary Langerhans cell histiocytosis, bronchiolitis, desquamative interstitial pneumonitis, acute eosinophilic pneumonia, and interstitial fibrosing lung diseases. The evidence of combined lower lung fibrosis and predominant upper lung emphysema is renowned as a distinct clinical entity, named combined pulmonary fib...
Source: Insights into Imaging - Category: Radiology Source Type: research
ConclusionsThe prevalence of providing antibiotics over-the-counter for pediatric illnesses in Addis Ababa is markedly high. Further studies into factors encouraging this malpractice are required. Enhancing education of personnel dispensing antibiotics and strict enforcement of national regulations are needed.
Source: Antimicrobial Resistance and Infection Control - Category: Infectious Diseases Source Type: research
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