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Sensors (Basel) 2021 May 13;21(10). Epub 2021 May 13.

Instituto Superior Técnico (IST), Av. Rovisco Pais n. 1, 1049-001 Lisboa, Portugal.

In 2019, a new virus, SARS-CoV-2, responsible for the COVID-19 disease, was discovered. Asymptomatic and mildly symptomatic patients were forced to quarantine and closely monitor their symptoms and vital signs, most of the time at home. This paper describes e-CoVig, a novel mHealth application, developed as an alternative to the current monitoring paradigm, where the patients are followed up by direct phone contact. Read More

Arch Gerontol Geriatr 2021 Jul-Aug;95:104394. Epub 2021 Mar 15.

Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ewha Womans University College of Medicine, Ewha Womans Seoul Hospital, Seoul, Republic of Korea. Electronic address:

Background: Due to population aging, the number of cases of pneumonia in nursing homes in South Korea has been increasing. This study investigated the characteristics and clinical outcomes in nursing home residents with pneumonia admitted to a tertiary hospital.

Methods: A retrospective cohort study was conducted of patients transferred to the tertiary hospital from nursing homes between August 2009 and October 2016. Read More

Pneumologe (Berl) 2021 Mar 16:1-6. Epub 2021 Mar 16.

Klinik für Pneumologie, Allergologie, Schlaf- und Intensivmedizin Petruskrankenhaus Wuppertal, Wuppertal, Deutschland.

Pneumonia is a common and severe disease in older people. In this group of patients pneumonia is among the four most frequent diseases leading to death. The diagnosis can often be difficult due to an atypical clinical presentation. Read More

Med J Malaysia 2021 03;76(2):258-260

International Islamic University of Malaysia, Department of Medicine, Pahang, Malaysia.

Acute ischaemic stroke is a debilitating disease and may lead to haemorrhagic transformation associated with few factors such as high National Institute of Health Stroke Scale (NIHSS), low Modified Rankin Score (MRS), cardio-embolic clot and others.1 We report herein a 61 years old man whom presented with left sided weakness and diagnosed with acute right middle cerebral artery (MCA) infarction. Thrombolytic therapy was not offered due to low Alberta Stroke Program Early CT (ASPECT) score and hence managed conservatively. Read More

J Am Geriatr Soc 2021 04 6;69(4):861-867. Epub 2021 Mar 6.

Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts, USA.

Objective: Describe a systematic approach to address advance care planning (ACP) during a COVID-19 outbreak and its impact on the incidence of new do-not-hospitalize (DNH) directives among long-term care (LTC) residents.

Design: Prospective quality improvement initiative.

Setting: Two long-term chronic care campuses within a large academic healthcare organization. Read More

Infect Dis Rep 2021 Jan 5;13(1):33-44. Epub 2021 Jan 5.

Internal Medicine Department, Coimbra Hospital and Universitary Centre, 3004-561 Coimbra, Portugal.

Purpose: Nursing home-acquired pneumonia (NHAP) patients are at higher risk of multi-drug resistant infection (MDR) than those with community-acquired pneumonia (CAP). Recent evidence suggests a single risk factor for MDR does not accurately predict the need for broad-spectrum antibiotics. The goal of this study was to compare the rate antibiotic failure between NHAP and CAP patients. Read More

Front Physiol 2020 3;11:594138. Epub 2020 Dec 3.

Department of Medicine, University of South Dakota Sanford School of Medicine, Sioux Falls, SD, United States.

Background: Alcoholic hepatitis (AH) is a unique syndrome characterized by high short-term mortality. The impact of the academic status of a hospital (urban and teaching) on outcomes in AH is unknown.

Methods: National Inpatient Sample dataset (2006-2014) on AH admissions stratified to academic center (AC) or non-academic center (NAC) and analyzed for in-hospital mortality (IHM), hospital resource use, length of stay in days (d), and total charges (TC) in United States dollars (USD). Read More

Int J Environ Res Public Health 2020 12 2;17(23). Epub 2020 Dec 2.

Department of Nursing, Faculty of Biomedical and Health Science, Universidad Europea de Madrid, 28670 Madrid, Spain.

On 11 March 2020 the SARS-CoV-2 virus was officially declared a pandemic and measures were set up in various countries to avoid its spread among the population. This paper aims to analyse the perception of risk of COVID-19 infection in the Spanish population. A cross-sectional, descriptive observational study was conducted with a total of 16,372 Spanish participants. Read More

Arch Phys Med Rehabil 2021 03 27;102(3):549-555. Epub 2020 Nov 27.

Progressive Rehabilitation Associates, Portland, Oregon.

Rehabilitation after significant acquired brain injury (ABI) to address complex independent activities of daily living and return to family and community life is offered primarily after initial hospitalization in outpatient day treatment, group home, skilled nursing, and residential settings and in the home and community of the person served. The coronavirus 2019 pandemic threatened access to care and the health and safety of staff, persons served, and families in these settings. This article describes steps taken to contain this threat by 7 leading posthospital ABI rehabilitation organizations. Read More

Can J Dent Hyg 2020 Oct 1;54(3):144-155. Epub 2020 Oct 1.

Professor emerita of clinical dentistry, University of Southern California, Los Angeles, CA, USA; Director, National Center for Dental Hygiene Research and Practice.

Previous position papers have confirmed to varying degrees associations between periodontal microbes and respiratory tract infections such as nosocomial or hospital-acquired pneumonia (HAP), ventilator-associated pneumonia (VAP), and chronic obstructive pulmonary diseases (COPD). Causal relationships have not been confirmed and have been the source of much confusion for the medical and oral health professions.

Aim: To investigate whether sufficient evidence exists for a causal relationship between periodontal microbes and respiratory diseases, with a focus on HAP and VAP. Read More

BMJ Open 2020 11 11;10(11):e040573. Epub 2020 Nov 11.

Medical Assessment, CHU Grenoble Alpes, Grenoble, Rhône-Alpes, France.

Introduction: 30-day readmission rate is considered an adverse outcome reflecting suboptimal quality of care during index hospitalisation for community-acquired pneumonia (CAP). However, potentially avoidable readmission would be a more relevant metric than all-cause readmission for tracking quality of hospital care for CAP. The objectives of this study are (1) to estimate potentially avoidable 30-day readmission rate and (2) to develop a risk prediction model intended to identify potentially avoidable readmissions for CAP. Read More

Women Birth 2021 Feb 23;34(1):e32-e37. Epub 2020 Sep 23.

Centre for Midwifery, Child and Family Health, School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, New South Wales, Australia. Electronic address: https://www.twitter.com/vscarf.

Problem: The COVID-19 pandemic response has required planning for the safe provision of care. In Australia, privately practising midwives are an important group to consider as they often struggle for acceptance by the health system.

Background: There are around 200 Endorsed Midwives eligible to practice privately in Australia (privately practising midwives) who provide provide the full continuum of midwifery care. Read More

Prog Rehabil Med 2020 8;5:20200020. Epub 2020 Sep 8.

Department of Rehabilitation, Japanese Red Cross Ashikaga Hospital, Ashikaga, Japan.

Objective: To clarify the effect of early dysphagia rehabilitation, early rehabilitation was started within 2 days of admission by speech-language-hearing therapists in patients with severe aspiration pneumonia.

Methods: The subjects were inpatients with severe aspiration pneumonia (A-DROP≥3) admitted to our hospital between April 2014 and March 2019. We retrospectively investigated patient age, sex, A-DROP score, community-acquired or nursing- and healthcare-associated pneumonia, invasive and noninvasive ventilation, comorbidities, nutritional risk, admission from nursing home, discharge to nursing home, walking ability before admission and at discharge, Food Intake LEVEL Scale (FILS) score at the start of rehabilitation and at discharge, the achievement of oral intake, alternative nutrition in use at discharge, number of days from admission to the start of rehabilitation, and number of days from admission to oral intake. Read More

Cureus 2020 Jul 1;12(7):e8947. Epub 2020 Jul 1.

1st Pulmonology Department, Sismanogleio Hospital, Athens, GRC.

Introduction Pneumonia severity index (PSI) is a prognostic index used for estimating the possibility of death due to community-acquired pneumonia. Vitamin D is a fat-soluble vitamin, essential for calcium and phosphate homeostasis. Vitamin D also has antimicrobial properties and according to recent studies, its deficiency may be correlated to an increased frequency of respiratory infections. Read More

J Infect 2020 Oct 29;81(4):621-624. Epub 2020 Jul 29.

Immunisation and Countermeasures Division, Public Health England, 61 Colindale Avenue, London NW9 5EQ, UK.

Background: Care homes have been disproportionately affected by the COVID-19 pandemic and continue to suffer large outbreaks even when community infection rates are declining, thus representing important pockets of transmission. We assessed occupational risk factors for SARS-CoV-2 infection among staff in six care homes experiencing a COVID-19 outbreak during the peak of the pandemic in London, England.

Methods: Care home staff were tested for SARS-COV-2 infection by RT-PCR and asked to report any symptoms, their contact with residents and if they worked in different care homes. Read More

BMC Pulm Med 2020 Jul 24;20(1):201. Epub 2020 Jul 24.

Institute for Clinical research University of Southern Denmark, Campusvej 55, DK-5230, Odense M, Denmark.

Background: To investigate the use of do-not-resuscitate (DNR) orders in patients hospitalized with community-acquired pneumonia (CAP) and the association with mortality.

Methods: We assembled a cohort of 1317 adults hospitalized with radiographically confirmed CAP in three Danish hospitals. Patients were grouped into no DNR order, early DNR order (≤48 h after admission), and late DNR order (> 48 h after admission). Read More

Chest 2021 01 17;159(1):58-72. Epub 2020 Jul 17.

Division of Pulmonary Diseases & Critical Care Medicine, University of Texas Health San Antonio, San Antonio, TX; Section of Pulmonary & Critical Care Medicine, South Texas Veterans Health Care System, San Antonio, TX. Electronic address:

Background: Aspiration community-acquired pneumonia (ACAP) and community-acquired pneumonia (CAP) in patients with aspiration risk factors (AspRFs) are infections associated with anaerobes, but limited evidence suggests their pathogenic role.

Research Question: What are the aspiration risk factors, microbiology patterns, and empiric anti-anaerobic use in patients hospitalized with CAP?

Study Design And Methods: This is a secondary analysis of GLIMP, an international, multicenter, point-prevalence study of adults hospitalized with CAP. Patients were stratified into three groups: (1) ACAP, (2) CAP/AspRF+ (CAP with AspRF), and (3) CAP/AspRF- (CAP without AspRF). Read More

Geriatrics (Basel) 2020 Jul 7;5(3). Epub 2020 Jul 7.

Division of General Medicine, Center of Community Medicine, Jichi Medical University, Shimotsuke-City, Tochigi 329-0498, Japan.

Aspiration pneumonia (AsP), a phenotype of community-acquired pneumonia (CAP), is a common and problematic disease with symptomless recurrence and fatality in old adults. Characteristic factors for distinguishing AsP from CAP need to be determined to manage AsP. No such factorial markers in oldest-old adults, who are often seen in the primary-care settings, have yet been established. Read More

Infect Dis (Lond) 2020 09 19;52(9):603-611. Epub 2020 Jun 19.

Unit of Pneumology Service, Hospital Universitario Cruces, Barakaldo, Spain.

Nowadays, most cases of pneumococcal community-acquired pneumonia (PCAP) are diagnosed by positive urinary antigen. Our aims were to analyse process of care in patients hospitalised with non-bacteremic PCAP (NB-PCAP) and identify factors associated with poor outcome (PO) in this population. We conducted a prospective study, including patients hospitalised for NB-PCAP (positive urinary antigen and negative blood culture) over a 15 year period. Read More

Farm Hosp 2020 06 12;44(7):43-48. Epub 2020 Jun 12.

Servicio de Farmacia, Residencia de personas mayores dependientes La Cañada, Valencia. España.

The COVID-19 pandemic is having a devastating effect on the nursing homes for dependent older people. The difficulty of management of this crisis is aggravated by the frailty of the people served and by the specific characteristics of the care  area, mainly the fact of not being integrated into the health system. The  objective of this work is to describe the pharmaceutical care developed by a  hospital pharmacy service established in a nursing home and, from a more  global perspective, analyze the strengths and weaknesses found from the  various experiences of hospital pharmacy in all spanish autonomous  communities to deal with this pandemic. Read More

Br Dent J 2020 04;228(8):615-622

Primary Endpoint Solutions, Watertown MA, USA; Brigham and Women's Hospital, Boston, MA, USA.

Background Healthcare-acquired pneumonias are a significant risk for nursing home and hospital patients. While oral care interventions (OCIs) have been found to be effective in reducing the risk of ventilator-associated pneumonia (VAP), their utility in mitigating non-ventilator-associated pneumonias (NVAP) remains unknown. We performed a structured meta-analysis of randomised and non-randomised clinical trials of enhanced oral hygiene procedures on NVAP. Read More

J Infect Chemother 2020 Aug 6;26(8):807-812. Epub 2020 Apr 6.

Internal Medicine Unit, Policlinico Casilino, Rome, Italy.

Background: nursing home-acquired pneumonia (NHAP), is among the main causes of hospitalization and mortality of frail elderly patients. Aim of this study was analysis of patients residing in long-term care facilities (LTCF) and developing pneumonia to reach a better knowledge of criteria for hospitalization and outcomes.

Materials/methods: this is a prospective, observational study in which patients residing in 3 LTCFs (metropolitan area of Rome, Italy) and developing pneumonia, hospitalized or treated in LTCF, were recruited and followed up from January 2017 to June 2019. Read More

Am J Nurs 2020 04;120(4):34-42

Mary C. Zonsius is an assistant professor in the Department of Adult Health and Gerontological Nursing and an assistant dean of evaluation at the Rush University College of Nursing, Chicago. Fawn A. Cothran is an assistant professor at the UC Davis Betty Irene Moore School of Nursing, Sacramento, CA. Joanne M. Miller is an associate professor emeritus at the Rush University College of Nursing. Contact author: Mary C. Zonsius, The authors and planners have disclosed no potential conflicts of interest, financial or otherwise. A podcast with the authors is available at www.ajnonline.com.

Among adults ages 65 and older, dementia doubles the risk of hospitalization. Roughly one in four hospitalized patients has dementia, and the prevalence of dementia in the United States is rising rapidly. Patients with dementia have significantly higher rates of hospital-acquired complications, including urinary tract infections, pressure injuries, pneumonia, and delirium, which when unrecognized and untreated can accelerate physical and cognitive decline, precipitating nursing home placement and death. Read More

J Am Med Dir Assoc 2020 03 13;21(3):315-321. Epub 2020 Feb 13.

Professor Emeritus, Department of Medicine, Division of Infectious Diseases, Jacobs School of Medicine and Biomedical Science, State University of New York at Buffalo, Buffalo, NY. Electronic address:

This is the second of 2 parts of a narrative review of nursing home-associated pneumonia (NHAP) that deals with etiology and treatment in the nursing home. In the 1980s and 1990s, the etiology of NHAP was considered to be similar to community-acquired pneumonia (CAP). This belief was reflected in CAP guidelines until 2005 when the designation healthcare-associated pneumonia or HCAP was introduced and nursing home residents were included in the HCAP category. Read More

Tuberc Respir Dis (Seoul) 2020 Jan;83(1):81-88

Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea.

Background: Use of appropriate antibiotics for the treatment of pneumonia is integral in patients admitted to intensive care units (ICUs). Although it is recommended that empirical treatment regimens should be based on the local distribution of pathogens in patients with suspected hospital-acquired pneumonia, few studies observe patients admitted to ICUs with nursing home-acquired pneumonia (NHAP). We found factors associated with the use of inappropriate antibiotics in patients with pneumonia admitted to the ICU via the emergency room (ER). Read More

Pneumologie 2019 Oct 17;73(10):605-616. Epub 2019 Oct 17.

Pneumonia belongs to the most frequent and most deadly infectious diseases worldwide. It represents an increasing problem for the aging population. The incidence and mortality rises with every decade. Read More

J Infect Chemother 2020 Feb 28;26(2):181-187. Epub 2019 Aug 28.

Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin-kawaharacho, Sakyo, Kyoto 606-8507, Japan.

Background: Treatment of aspiration pneumonia is an important problem due to aging of populations worldwide. However, the effectiveness of cefepime in aspiration pneumonia has not yet been evaluated.

Aim: To compare the clinical efficacy and safety of cefepime and meropenem in patients with moderate-to-severe aspiration pneumonia. Read More

Evid Based Dent 2019 03;20(1):14-15

Department of Public Health, NHS Fife, Fife, Scotland.

Data sources Cochrane Oral Health Trials Register, Cochrane Central Register of Controlled Trials, MEDLINE, Embase, CINAHL, Chinese Biomedical Literature Database, China National Infrastructure, US National Institutes of Health Ongoing Trials Registry, WHO Clinical Trials Registry, Sciencepaper Online, 19 Chinese dental and nursing journals. Reference lists of included studies were also screened.Study selection Studies were included if they explored oral care with the purpose of reducing pneumonia compared to no oral care, usual care or other oral care measures. Read More