Archive for March 27, 2008

Crystalluria from Acyclovir Use

N. Engl J Medicine  Mar 27, 2008  V.358  N.13  e14

Images in Clinical Medicine

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http://content.nejm.org/cgi/content/full/358/13/e14?query=TOC

March 27, 2008 at 11:43 pm Leave a comment

C-Reactive Protein Is an Independent Predictor of Severity in Community-acquired Pneumonia

The American Journal of Medicine Mar 2008  V.121  N.3  p.219-225

Abstract
Background

C-reactive protein (CRP) is an acute phase protein synthesized by the liver primarily in response to interleukin-6. Initial studies have suggested that inflammatory markers may have a role in predicting severity. We investigated whether admission and day 4 CRP could predict severity in community-acquired pneumonia.

Methods
A prospective study was carried out over a 2-year period in a large teaching hospital. CRP was measured on admission and on day 4. The outcomes of interest were: 30-day mortality; need for mechanical ventilation and/or inotropic support; development of complicated pneumonia (lung abscess, empyema, or complicated parapneumonic effusion); the value of predictive tests were assessed using multivariate logistic regression.

Results
There were 570 patients included in the study; 30-day mortality was 9.6%. Low CRP levels showed a high negative predictive value for excluding 30-day mortality (CRP <10 mg/L=100%, CRP <50=99.1%, CRP <100=98.9%, CRP <200=94.9%). Low admission CRP levels <100 mg/L were independently associated with reduced 30-day mortality (odds ratio [OR] 0.18; 0.04-0.85), P=.03; need for mechanical ventilation and/or inotropic support (OR 0.21; 0.14-0.4), P=.002; and complicated pneumonia (OR 0.05; 0.01-0.35), P=.003.

A CRP that fails to fall by 50% or more within 4 days of admission is independently associated with increased 30 day mortality (OR 24.5; 6.4-93.4), P <.0001; need for mechanical ventilation and/or inotropic support (OR 7.1; 2.8-17.8), P <.0001 and complicated pneumonia (OR 15.4; 6.32-37.6), P <.0001.

Conclusions
Admission CRP <100 mg/L has reduced risk for 30-day mortality, need for mechanical ventilation and/or inotropic support, and complicated pneumonia. Failure of CRP to fall by 50% or more at day 4 leads to an increased risk for 30-day mortality, need for mechanical ventilation and/or inotropic support, and complicated pneumonia. C-reactive protein is an independent marker of severity in community-acquired pneumonia.

abstract
http://www.amjmed.com/article/S0002-9343(07)01180-1/fulltext

FREE Full Text (CLIC en  full text PDF) o directamente en el siguiente link:
http://download.journals.elsevierhealth.com/pdfs/journals/0002-9343/PIIS0002934307011801.pdf

March 27, 2008 at 6:45 pm Leave a comment

Infectious syphilis in high-income settings in the 21st century

The Lancet Infectious Diseases Mar 2008  V.8  p.244-253

Review

Kevin A Fenton MD  b ,   Romulus Breban PhD c,   Raffaele Vardavas PhD d,   Justin T Okano MS d,   Tara Martin e,   Sevgi Aral PhD a   and   Prof Sally Blower PhD d

abstract
http://www.thelancet.com/journals/laninf/article/PIIS1473309908700653/abstract

March 27, 2008 at 6:43 pm Leave a comment

Neuroinvasion by Mycoplasma pneumoniae in Acute Disseminated Encephalomyelitis

Emerging Infectious Diseases Journal  April 2008  V.14  N.4

Bernhard Stamm,*  Michael Moschopulos,* Hansjoerg Hungerbuehler,* Jeannette Guarner,† Gillian L. Genrich,† and Sherif R. Zaki†

*Kantonsspital Aarau, Aarau, Switzerland; and †Centers for Disease Control and Prevention, Atlanta, Georgia, USA

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http://www.cdc.gov:80/eid/content/14/4/641.htm?s_cid=eid641_e

March 27, 2008 at 5:33 pm Leave a comment

Chagas Disease, France

Emerging Infectious Diseases Journal  April 2008  V.14  N.4

François-Xavier Lescure,*  Ana Canestri,† Hugues Melliez,‡ Stéphane Jauréguiberry,* Michel Develoux,* Richard Dorent,* Jean-Baptiste Guiard-Schmid,* Philippe Bonnard,* Faïza Ajana,‡ Valeria Rolla,§ Yves Carlier,¶ Frederick Gay,†Marie-Hélène Elghouzzi,# Martin Danis,† and Gilles Pialoux*

*Hôpital Tenon AP-HP, Paris, France; †Hôpital La Pitié Salpétrière AP-HP, Paris, France; ‡Le Centre Hospitalier de Tourcoing, Tourcoing, France; §Instituto de Pesquisa Clinica Evandro Chagas – Fiocruz, Rio de Janeiro, Brazil; ¶Université libre de Bruxelles, Brussels, Belgium; and #Etablissement Français du Sang d’lle de France, Paris, France

FREE Full Text (CLIC en Download this article as PDF)
http://www.cdc.gov:80/eid/content/14/4/644.htm?s_cid=eid644_e

March 27, 2008 at 2:04 am Leave a comment

Dengue Virus Type 4, Manaus, Brazil

Emerging Infectious Diseases Journal  April 2008  V.14  N.4

Regina Maria Pinto de Figueiredo,*1  Felipe Gomes Naveca,†1 Michele de Souza Bastos,*1 Miriam do Nascimento Melo,* Suziane de Souza Viana,‡ Maria Paula Gomes Mourão,* Cristóvão Alves Costa,‡ and Izeni Pires Farias§

*Fundação de Medicina Tropical do Amazonas, Manaus, Brazil; †Fundação Alfredo da Matta, Manaus, Brazil; ‡Instituto Nacional de Pesquisas da Amazônia, Manaus, Brazil; and §Universidade Federal do Amazonas, Manaus, Brazil

FREE Full Text (CLIC en Download this article as PDF)
http://www.cdc.gov:80/eid/content/14/4/667.htm?s_cid=eid667_e

March 27, 2008 at 2:01 am Leave a comment

Antimicrobial-Resistant Pathogens in Intensive Care Units in Canada: Results of the Canadian National Intensive Care Unit (CAN-ICU) Study, 2005-2006

Antimicrobial Agents and Chemotherapy  1 Apr 2008  V.52  N.4  p.1430-1437
 
George G. Zhanel,1,2,3* Mel DeCorby,1,3 Nancy Laing,1,3 Barb Weshnoweski,3 Ravi Vashisht,1,3 Franil Tailor,3 Kim A. Nichol,3 Aleksandra Wierzbowski,1,3 Patricia J. Baudry,1,3 James A. Karlowsky,1,3 Philippe Lagacé-Wiens,1,3 Andrew Walkty,1,3 Melissa McCracken,4 Michael R. Mulvey,4 Jack Johnson,5

The Canadian Antimicrobial Resistance Alliance (CARA), and Daryl J. Hoban1,3 Department of Medical Microbiology, Faculty of Medicine, University of Manitoba,1 Departments of Medicine,2 Clinical Microbiology, Health Sciences Centre, Winnipeg, Manitoba, Canada,3 Nosocomial Infections Branch, National Microbiology Laboratory, Winnipeg, Manitoba, Canada,4 International Health Management Associates, Chicago, Illinois5

abstract
http://aac.asm.org/cgi/content/abstract/52/4/1430

March 27, 2008 at 2:00 am Leave a comment

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