Abstract:
BACKGROUND:Pneumonia is a leading infectious cause of morbidity and mortality in the United States. The Infectious Disease Society of America (IDSA) and American Thoracic Society (ATS) have published treatment guidelines for community-acquired pneumonia (CAP) based upon the site of acquisition and specific pathogen risk. The literature demonstrates improved outcomes with guideline-concordant empiric therapy. A subset of patients with CAP has risk factors for drug-resistant pathogens (DRPs). IDSA/ATS treatment guidelines do not provide clear recommendations for empiric treatment, and clinical studies have not provided descriptive data for this group. METHODS:A retrospective chart review of all admissions between January 1, 2008 and April 19, 2009 with an International Classification of Diseases-9 code and physician-documented diagnosis of pneumonia at two community hospitals were performed. IDSA pneumonia type and presence of risk factors for DRP were recorded for each patient, and the empiric antibiotic therapy received was evaluated. Admissions were excluded if immunosuppression or pregnancy was present. RESULTS:Of the 400 admissions reviewed, 343 patients were included. A total of 228 patients (71%) had CAP. Forty-three percent of patients with CAP had risk factors for DRP. Only 2% of this group received an antibiotic regimen with coverage of the specific DRP risk factor present. The most common DRPs not receiving coverage in this group were Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus. P. aeruginosa and methicillin-resistant S. aureus occurred more commonly in culture-positive patients with CAP with DRP risk factors but did not achieve statistical significance. A larger sample size would be needed to determine whether this difference is significant. CONCLUSIONS:Risk factors for DRP occurred commonly in our CAP population. Patients with CAP with risk for DRP may be a distinct group who are without clear guidance on treatment. Future studies are needed to define the risk of DRP and the impact upon empiric therapy for patients with CAP.
journal_name
South Med Jjournal_title
Southern medical journalauthors
Fleming V,Buck B,Nix N,Kumar P,Southwood Rdoi
10.1097/SMJ.0b013e318287fe71subject
Has Abstractpub_date
2013-03-01 00:00:00pages
209-16issue
3eissn
0038-4348issn
1541-8243pii
00007611-201303000-00006journal_volume
106pub_type
杂志文章abstract::Since April 1975, 292 patients have had gastric operations for morbid obesity: gastric bypass with Roux-en-Y gastrojejunostomy (RY), 105 patients; gastric bypass with loop gastrojejunostomy (loop), 69 patients; greater curvature gastroplasty, 40 patients; and gastric partition with gastrogastrostomy, 78 patients. Foll...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198211000-00005
更新日期:1982-11-01 00:00:00
abstract:BACKGROUND:In recent years, more and more discussions have arisen with regard to the role of (partially) hydrolyzed formulas as standard feedings for infants with a high risk to have allergy. METHODS:This review is based on an extensive overview of the literature dealing with the subjects of allergy prevention and hyd...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/00007611-199712000-00002
更新日期:1997-12-01 00:00:00
abstract::Safety restraints have proven effective in the prevention of serious automobile injuries and deaths, but safety education has been ineffective in getting consumers to use restraints. We surveyed the personal and counseling practices of a group of pediatricians over a one-year period to determine whether prenatal and p...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198110000-00003
更新日期:1981-10-01 00:00:00
abstract::We have described the clinical, hemodynamic, and echocardiographic features of torn aortic cusps with mitral valve fenestration in a patient with infective endocarditis. Hemodynamic studies showed left atrial pressure intermittently exceeding left ventricular end-diastolic pressure. This phenomenon corresponded with i...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198411000-00022
更新日期:1984-11-01 00:00:00
abstract::Anorexia nervosa and bulimia are two of the four eating disorders that appear to be increasingly prevalent. Each has its own diagnostic criteria and medical hazards, though certain features are shared. It is important for internists to be aware of these disorders, since their management is best accomplished by a team ...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:
更新日期:1986-07-01 00:00:00
abstract::The frequency of gastritis in relation to its various predisposing conditions is unclear, as is the respective distribution of damage caused by its predisposing conditions. We studied 100 patients with the endoscopic diagnosis of gastritis. The incidence of gastritis in our university gastroenterology endoscopy servic...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198708090-00005
更新日期:1987-09-01 00:00:00
abstract::We have reviewed 60 consecutive cases, occurring in 57 patients, of intramedullary fixation of fractures of the midshaft of the tibia done over a ten-year period with the Lottes nail. Of 50 acute fractures, 38 were open fractures, nailed after adequate irrigation and debridement; the other 12 were closed fractures. Th...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198104000-00015
更新日期:1981-04-01 00:00:00
abstract::A 16-year-old white boy had nephrotic syndrome due to focal segmental glomerulosclerosis six months before the diagnosis of Hodgkin's disease was established. Peritoneal dialysis was necessary for volume control after one month of unsuccessful therapy with high doses of corticosteroids. Nephrosis remitted after two co...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198909000-00034
更新日期:1989-09-01 00:00:00
abstract:OBJECTIVE:To determine the association of utilization of health maintenance tables (HMTs) as a provider reminder tool within the electronic medical record with the completion of women's preventive health services. METHODS:Guidelines from the US Preventive Services Task Force and the Advisory Committee on Immunization ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000001160
更新日期:2020-10-01 00:00:00
abstract::[This corrects the article on p. 232 in vol. 113.]. ...
journal_title:Southern medical journal
pub_type: 杂志文章,已发布勘误
doi:10.14423/SMJ.0000000000001121
更新日期:2020-07-01 00:00:00
abstract::We found magnetic resonance imaging helpful in the localization of both an adrenal and an extra-adrenal pheochromocytoma, since these tumors produced a high-intensity "light bulb" image. MRI is an excellent method for localizing pheochromocytomas because it detects adrenal and extra-adrenal pheochromocytomas missed by...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198911000-00017
更新日期:1989-11-01 00:00:00
abstract::Slipped capital femoral epiphysis has been described in several syndromes associated with short stature and endocrine disturbances. I have presented a case of slipped capital femoral epiphysis in conjunction with Russell-Silver syndrome. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198907000-00026
更新日期:1989-07-01 00:00:00
abstract::Gabapentin, an antiepileptic agent, is a safe and versatile medication also used in the adjunctive treatment of painful disorders. These include neuropathic pain, such as postherpetic neuralgia, diabetic neuropathy, and the pain of reflex sympathetic dystrophy. Interstitial cystitis, a painful disease entity, shares m...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:
更新日期:2000-02-01 00:00:00
abstract::The National Cholesterol Education Program and physician/patient awareness of the risks of hypercholesterolemia have resulted in aggressive screening and treatment of elevated cholesterol levels. The "one size fits all" concept has been used as the criterion for intervention. However, this has been promulgated without...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/00007611-199310001-00003
更新日期:1993-10-01 00:00:00
abstract:OBJECTIVES:Manifestations of gastroparesis are heterogeneous and clinical complications are poorly defined. Misconceptions of gastroparesis may be common. The objective was to determine physicians' perception of gastroparesis and identify areas that need further research and education. METHODS:A physician survey was p...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e318215fa5a
更新日期:2011-06-01 00:00:00
abstract::Endorphins and narcotics have been implicated in the exacerbation of neurologic deficits after stroke. To test the theory that narcotic antagonists might offer an improvement in neurologic sequelae following stroke, we administered various doses of naloxone intraperitoneally to 50 adult gerbils 45 minutes after caroti...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198905000-00005
更新日期:1989-05-01 00:00:00
abstract:OBJECTIVES:Pancreatic steatosis in adults has been proposed to be associated with obesity; however, data on pancreatic steatosis in children are lacking. Our study aimed to measure the prevalence of pancreatic steatosis in children and to examine its association with obesity and nonalcoholic fatty liver disease. METHO...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000000432
更新日期:2016-03-01 00:00:00
abstract:OBJECTIVES:Inclusion of select orthopedic problems in the orthopedics observation unit (OOU) may reduce hospital admissions. Our system allows OOU status for 24 hours, but the effect on admissions is unknown. Our primary hypothesis was that we could predict which OOU patients required admission based on the presence of...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000000181
更新日期:2014-10-01 00:00:00
abstract::Primary carcinoma of the trachea is not common. Of 23 cases diagnosed as "carcinoma of the trachea" at our institution since 1949, 21 actually represented secondary involvement from carcinoma of the larynx, lung, or esophagus. The two cases of primary carcinoma of the trachea are presented. Discussed are the relation ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197704000-00020
更新日期:1977-04-01 00:00:00
abstract::Hypersplenism is a known complication of portal hypertension secondary to cirrhosis of the liver. Although thrombocytopenia secondary to hypersplenism does not cause clinically significant hemostatic defect, it may need to be addressed in selective circumstances, such as preoperative preparation for a surgery. This re...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.SMJ.0000157558.62378.0B
更新日期:2005-04-01 00:00:00
abstract::We describe two patients who had tuberculomas that were initially misdiagnosed as neurosarcoidosis, leading to prolonged steroid therapy before initiation of antituberculous medications. Neither patient was infected with the human immunodeficiency virus, and one of the patients had a negative tuberculosis skin test. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.SMJ.0000048150.02504.99
更新日期:2003-05-01 00:00:00
abstract::Citalopram is the newest selective serotonin reuptake inhibitor (SSRI) available in the United States. It is currently approved by the Food and Drug Administration for the treatment of major depression. However, a number of studies have found it to be effective in the treatment of panic disorder as well. While there h...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:2002-09-01 00:00:00
abstract::Subdural hematomas are among the most common forms of intracranial hemorrhage encountered in clinical practice and are a surgically remediable cause of dementia. When the symptom presentation is subtle or diffuse, a subdural hematoma can be overlooked. This is especially true among elderly people who may exhibit unrel...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199509000-00019
更新日期:1995-09-01 00:00:00
abstract::This article documents distributional patterns of allopathic family practice physicians (including general practitioners) in Texas as compared with allopathic physicians in all other medical specialties in the state during the period 1969-1973, for which there are reliable data. Statistical analysis of this informatio...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197709000-00007
更新日期:1977-09-01 00:00:00
abstract::Prosthetic joint infection with Mycobacterium tuberculosis usually involves the hips or knees and can result from either local reactivation, or less often from hematogenous spread. Predisposing conditions include rheumatoid arthritis, chronic steroid use and pulmonary diseases. The most common symptom at presentation ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.smj.0000232972.50186.4c
更新日期:2007-01-01 00:00:00
abstract::Carcinoma of the fallopian tube is the least common of the gynecologic malignancies. Because of its rarity and the absence of typical symptoms, preoperative diagnosis is seldom made. Patient as well as physician delay in diagnosis is often considerable. There are no reliable laboratory aids available to enhance the di...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197509000-00021
更新日期:1975-09-01 00:00:00
abstract::We have reported a case of Meige's syndrome in a middle-aged man who eventually had a cerebellar degeneration syndrome. The extrapyramidal symptoms preceded cerebellar signs and symptoms by 5 years. Most patients with idiopathic Meige's syndrome show some improvement with high-dose anticholinergic therapy. Our patient...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199103000-00019
更新日期:1991-03-01 00:00:00
abstract::Diagnosis and management of hand infections in the elderly can be challenging. The general principles of rest, elevation, compresses, and drainage when appropriate apply. Antibiotics are important to therapy. Review of data from elderly patients and comparison with a younger population having identical infections show...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198502000-00009
更新日期:1985-02-01 00:00:00
abstract::Chronic pain can be treated by combining hypnosis with brief psychotherapy. Hypnosis alone, though useful for acute pain, is seldom effective in relieving chronic pain because it does not address the significant psychologic components in the patient's illness. Treatment using self-hypnosis in conjunction with brief ps...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198303000-00013
更新日期:1983-03-01 00:00:00
abstract::Thoracic nerve root dysfunction (TNRD) manifested as abdominal pain is an infrequently reported condition. We present data on six patients who had chronic intermittent thoracoabdominal pain originating in the back. Diabetes and osteoarthritis of the spine were the chief causes of these symptoms. The electromyogram in ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198802000-00014
更新日期:1988-02-01 00:00:00