The Journal of infection
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The Journal of infection · Nov 2011
Soluble urokinase plasminogen activator receptor (suPAR) for assessment of disease severity in ventilator-associated pneumonia and sepsis.
Urokinase plasminogen activator (uPAR) is a receptor mainly expressed on peripheral blood mononuclear cells and neutrophils. The role of its soluble form, namely suPAR, as a predictor of sepsis outcome in a homogenous cohort of 180 septic patients, was investigated. Blood from 180 patients with ventilator-associated pneumonia (VAP) and sepsis was collected for seven consecutive days. suPAR and PCT were measured in serum by an enzyme immunoassay and an immuno-time-resolved amplified cryptate assay respectively. ⋯ Concentrations of suPAR in supernatants of neutrophils of patients with sepsis were greater compared to controls. It is concluded that suPAR is a reliable marker of sepsis severity and a strong independent predictor of unfavorable outcome in VAP and sepsis. Neutrophils are involved in release.
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The Journal of infection · Oct 2011
Comparative StudyImpact of pandemic A/H1N1/2009 influenza on children and their families: comparison with seasonal A/H1N1 and A/H3N2 influenza viruses.
To make a direct comparison between the total burden of pandemic influenza and that of other seasonal influenza A viral subtypes in otherwise healthy children. ⋯ Perceived symptom severity and the risk of serious outcomes are similar in children with influenza due to pandemic A/H1N1/2009 or seasonal A/H3N2 influenza, but both of these viruses seem to have a greater clinical and socioeconomic impact than seasonal A/H1N1 virus, regardless of the patients' age or gender.
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The Journal of infection · Oct 2011
Pandemic (H1N1) 2009 virus infection: persistent viral shedding after Oseltamivir treatment.
To study pandemic (H1N1) 2009 virological outcomes after Oseltamivir treatment in confirmed cases of pandemic (H1N1) 2009 virus infections. A hospital-based cohort study was conducted in south Thailand, between June and September 2009. ⋯ Prolonged presence of pandemic (H1N1) 2009 detected by rRT-PCR was found. An extended course of antiviral treatment should be considered in patients with underlying diseases and severe clinical symptoms.
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The Journal of infection · Oct 2011
Very low pandemic influenza A (H1N1) 2009 mortality associated with early neuraminidase inhibitor treatment in Japan: analysis of 1000 hospitalized children.
There were many cases of pandemic influenza A (H1N1) 2009 (H1N1/09) in Japan during the 2009-2010 epidemic. They accounted for 16% of the total population (20.7 million/128 million), and 59% of the patients were children 15 years of age and under (12.2 million/20.7million). However, there were only 38 paediatric deaths. We analyzed the clinical manifestations and treatment of children hospitalized because of H1N1/09 infection in order to clarify the association between treatment with neuraminidase inhibitors and the low mortality rate. ⋯ Although a high proportion of the patients in this study had severe respiratory complications, the case fatality rate was only 0.1%. The low mortality rate of children due to the H1N1/09 epidemic in Japan was probably attributable to the universal implementation of early treatment with neuraminidase inhibitors.
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The Journal of infection · Sep 2011
ReviewImmunomodulatory agents in the treatment of community-acquired pneumonia: a systematic review.
Despite the availability of excellent antibiotics, the mortality from community-acquired pneumonia (CAP) remains substantial. Most deaths occur during the first week of hospitalization. Because antibiotics rapidly eradicate bacteria from pulmonary secretions, an ongoing inflammatory response may be responsible for the poor outcome, and treatment with immunomodulatory drugs might be beneficial in this setting. ⋯ Aspirin might also be of benefit in treating patients hospitalized for pneumonia because of its anti-inflammatory activity as well as its benefits in acute myocardial infarction. Treatment of CAP with corticosteroids has yielded mixed results and the value of this approach is not well established, although further research is currently underway. Ibuprofen is not of benefit in treating sepsis in humans and glitazones may increase the risk of severe pneumonia.