Aspiration pneumonitis and aspiration pneumonia are clinical syndromes caused by aspiration. These conditions are clinically significant due to their high morbidity and mortality. However, aspiration as a preceding event are often unwitnessed, particularly in cases of asymptomatic or silent aspiration. Furthermore, despite the difference in treatment approaches for managing aspiration pneumonitis and aspiration pneumonia, these two disease entities are often difficult to discriminate from one another, resulting in inappropriate treatment. The use of unclear terminologies hinders the comparability among different studies, making it difficult to produce evidence-based conclusions and practical guidelines. We reviewed the most recent studies to define aspiration, aspiration pneumonitis, and aspiration pneumonia, and to further assess these conditions in terms of incidence and epidemiology, pathophysiology, risk factors, diagnosis, management and treatment, and prevention.
Diagnosis ; Epidemiology ; Incidence ; Mortality ; Pneumonia* ; Pneumonia, Aspiration ; Risk Factors

Community-acquired pneumonia is the leading cause of pediatric morbidity and mortality. However, there is a lack of data on the epidemiology of pneumonia in Korean children. In this review, we aimed to summarize pneumonia studies in Korea and suggest diagnostic methods and treatment for Korean children who were referred based on the foreign guidelines for pediatric community-acquired pneumonia. A Korean guideline for pediatric pneumonia in tune with domestic circumstances is needed.
Child* ; Epidemiology ; Humans ; Korea ; Mortality ; Pneumonia*

BACKGROUND: The primary objective of this meta-analysis is aimed at determining whether β-lactams prolonged infusion in patients with nosocomial pneumonia (NP) results in higher cure rate and improved mortality compared to intermittent infusion. MATERIALS AND METHODS: Relevant studies were identified from searches of MEDLINE, EMBASE, and CENTRAL from inception to September 1st, 2015. All published articles which evaluated the outcome of extended/continuous infusion of antimicrobial therapy versus intermittent infusion therapy in the treatment of NP were reviewed. RESULTS: A total of ten studies were included in the analysis involving 1,051 cases of NP. Prolonged infusion of β-lactams was associated with higher clinical cure rate (OR 2.45, 95% CI, 1.12, 5.37) compared to intermittent infusion. However, there was no significant difference in mortality (OR 0.85, 95% CI 0.63-1.15) between the two groups. Subgroup analysis for β-lactam subclasses and for severity of illness showed comparable outcomes. CONCLUSION: The limited data available suggest that reduced clinical failure rates when using prolonged infusions of β-lactam antibiotics in critically ill patients with NP. More detailed studies are needed to determine the impact of such strategy on mortality in this patient population.
Anti-Bacterial Agents ; Critical Illness ; Humans ; Mortality ; Pneumonia*

Mechanical ventilation is currently an indispensable element within a hospital's intensive care unit (ICU). Regrettably, mechanical ventilation is also strongly associated with the risk of contracting ventilator-associated pneumonia (VAP), which is one of the most common causes of mortality and morbidity within the ICU, and has been for many years. The incidence of VAP has decreased in the last 10 years, from 14 to 9-10 cases per 1,000 days of mechanical ventilation. This has been an important achievement; however, hospital-acquired pneumonia and VAP still carry very high rates of morbidity and mortality, not to mention high financial costs as well. This comprehensive review explores our current understanding of the etiology and pathogenesis of VAP and proposes a strategy for its treatment and prevention.
Incidence ; Intensive Care Units ; Mortality ; Pneumonia ; Pneumonia, Ventilator-Associated* ; Respiration, Artificial

PURPOSE: Acute respiratory infection, particularly pneumonia, is the most common cause of hospitalization and death among children in developing nations. This study aimed to investigate the characteristics of children and adolescents with pneumonia who visited Emergency Department (ED) in South Korea in 2012. METHODS: We analyzed National Emergency Department Information System (NEDIS) records from 146 EDs in South Korea for all pediatric patients aged ≤18 years who were diagnosed with pneumonia between January and December 2012. RESULTS: Among 38,415 subjects, the male-to-female ratio was 1:0.8. Patients aged <12 months comprised 18.0% of the study population; those aged 1 to 3 years, 54.4%; those aged 4 to 6 years, 16.8%; those aged 7 to 12 years, 7.4%; and those aged 13 to 18 years, 3.4%. Presentation rates were highest in April, followed by January, March, and May. The hospital admission rate was 43.5%, of which 2.6% were in intensive care units. The mortality rate was 0.02%. Based on the International Classification of Diseases, 10th Revision, diagnostic codes, the types of pneumonia according to cause were viral pneumonia (29.0%), bacterial pneumonia (5.3%), Mycoplasmal pneumonia (4.5%), aspiration pneumonia (1.3%), and pneumonia of unknown origin (59.3%). CONCLUSION: Despite the limited data due to the ED data from the NEDIS lacking laboratory results and treatment information, this study reflects well the outbreak patterns among children and adolescents with pneumonia. Our results provide a basis for future studies regarding ED treatment for children and adolescents with pneumonia.
Adolescent* ; Child* ; Developing Countries ; Emergencies* ; Emergency Service, Hospital* ; Hospitalization ; Humans ; Information Systems ; Intensive Care Units ; International Classification of Diseases ; Korea* ; Mortality ; Pneumonia* ; Pneumonia, Aspiration ; Pneumonia, Bacterial ; Pneumonia, Viral

PURPOSE: Acute respiratory infection, particularly pneumonia, is the most common cause of hospitalization and death among children in developing nations. This study aimed to investigate the characteristics of children and adolescents with pneumonia who visited Emergency Department (ED) in South Korea in 2012. METHODS: We analyzed National Emergency Department Information System (NEDIS) records from 146 EDs in South Korea for all pediatric patients aged ≤18 years who were diagnosed with pneumonia between January and December 2012. RESULTS: Among 38,415 subjects, the male-to-female ratio was 1:0.8. Patients aged <12 months comprised 18.0% of the study population; those aged 1 to 3 years, 54.4%; those aged 4 to 6 years, 16.8%; those aged 7 to 12 years, 7.4%; and those aged 13 to 18 years, 3.4%. Presentation rates were highest in April, followed by January, March, and May. The hospital admission rate was 43.5%, of which 2.6% were in intensive care units. The mortality rate was 0.02%. Based on the International Classification of Diseases, 10th Revision, diagnostic codes, the types of pneumonia according to cause were viral pneumonia (29.0%), bacterial pneumonia (5.3%), Mycoplasmal pneumonia (4.5%), aspiration pneumonia (1.3%), and pneumonia of unknown origin (59.3%). CONCLUSION: Despite the limited data due to the ED data from the NEDIS lacking laboratory results and treatment information, this study reflects well the outbreak patterns among children and adolescents with pneumonia. Our results provide a basis for future studies regarding ED treatment for children and adolescents with pneumonia.
Adolescent* ; Child* ; Developing Countries ; Emergencies* ; Emergency Service, Hospital* ; Hospitalization ; Humans ; Information Systems ; Intensive Care Units ; International Classification of Diseases ; Korea* ; Mortality ; Pneumonia* ; Pneumonia, Aspiration ; Pneumonia, Bacterial ; Pneumonia, Viral

OBJECTIVE: We evaluated the effect of endovascular treatment (EVT) for acute ischemic stroke in patients over 80 years of age. MATERIALS AND METHODS: The records of 156 acute stroke patients aged over 80 years who were considered as candidates for EVT were analyzed. Fifty-six patients (35.9%, EVT group) underwent EVT and 100 patients (64.1%, non-EVT group) did not. Outcomes, in terms of functional outcomes and rates of symptomatic hemorrhage, in-hospital morbidity and mortality, were compared between groups. Each comparison was adjusted for age, time from onset, initial National Institute of Health Stroke Scale, and pre-stroke modified Rankin Scale (mRS). RESULTS: More patients in the EVT group achieved good outcomes (mRS score of 0-2) at 3 months (35.7% vs. 11.0%, adjusted odds ratio [OR] 4.779 [95% confidence interval 1.972-11.579], p = 0.001) and 12 months (35.7% vs. 14.0%, adjusted OR 3.705 [1.574-8.722], p = 0.003) after stroke. During admission, rates of hospital-acquired infection including pneumonia (12.5% vs. 29.0%, adjusted OR 0.262 [0.098-0.703], p = 0.008) and urinary tract infection (16.0% vs. 34.0%, adjusted OR 0.256 [0.099-0.657], p = 0.005) were significantly lower in the EVT group. More symptomatic hemorrhages (10.7% vs. 2.0%, adjusted OR 6.859 [1.139-41.317], p = 0.036) occurred in the EVT group, but no significant difference was observed in in-hospital mortality rate (12.5% vs. 8.0%, adjusted OR 1.380 [0.408-4.664], p = 0.604). CONCLUSION: EVT improved functional outcome and reduced the risk of hospital-acquired infections in acute stroke patients over 80 years of age without increasing the risk of in-hospital mortality, although symptomatic hemorrhage occurred more frequently after EVT.
Hemorrhage ; Hospital Mortality ; Humans ; Mortality ; Odds Ratio ; Pneumonia ; Stroke* ; Thrombolytic Therapy ; Urinary Tract Infections

OBJECTIVE: We evaluated the effect of endovascular treatment (EVT) for acute ischemic stroke in patients over 80 years of age. MATERIALS AND METHODS: The records of 156 acute stroke patients aged over 80 years who were considered as candidates for EVT were analyzed. Fifty-six patients (35.9%, EVT group) underwent EVT and 100 patients (64.1%, non-EVT group) did not. Outcomes, in terms of functional outcomes and rates of symptomatic hemorrhage, in-hospital morbidity and mortality, were compared between groups. Each comparison was adjusted for age, time from onset, initial National Institute of Health Stroke Scale, and pre-stroke modified Rankin Scale (mRS). RESULTS: More patients in the EVT group achieved good outcomes (mRS score of 0-2) at 3 months (35.7% vs. 11.0%, adjusted odds ratio [OR] 4.779 [95% confidence interval 1.972-11.579], p = 0.001) and 12 months (35.7% vs. 14.0%, adjusted OR 3.705 [1.574-8.722], p = 0.003) after stroke. During admission, rates of hospital-acquired infection including pneumonia (12.5% vs. 29.0%, adjusted OR 0.262 [0.098-0.703], p = 0.008) and urinary tract infection (16.0% vs. 34.0%, adjusted OR 0.256 [0.099-0.657], p = 0.005) were significantly lower in the EVT group. More symptomatic hemorrhages (10.7% vs. 2.0%, adjusted OR 6.859 [1.139-41.317], p = 0.036) occurred in the EVT group, but no significant difference was observed in in-hospital mortality rate (12.5% vs. 8.0%, adjusted OR 1.380 [0.408-4.664], p = 0.604). CONCLUSION: EVT improved functional outcome and reduced the risk of hospital-acquired infections in acute stroke patients over 80 years of age without increasing the risk of in-hospital mortality, although symptomatic hemorrhage occurred more frequently after EVT.
Hemorrhage ; Hospital Mortality ; Humans ; Mortality ; Odds Ratio ; Pneumonia ; Stroke* ; Thrombolytic Therapy ; Urinary Tract Infections

Globally, pneumonia is the leading cause of childhood mortality. Pneumonia is the second killer of children less than 5 years of age in China. The World Heath Organization and United Nations Children′s Fund launched the integrated Global Action Plan for the Prevention and Control of Pneumonia and Diarrhea (GAPPD) in 2013. The ambitious goal is to end preventable childhood deaths due to pneumonia by 2025. Countries or regions should achieve the following goals: (1) reduce mortality from pneumonia in children less than 5 years of age to fewer than 3 per 1 000 live births; (2) reduce the incidence of severe pneumonia by 75% in children less than 5 years of age compared to 2010 levels. If the implementation of key interventions is accelerated, the mortality rate of childhood pneumonia will drop substantially every year, which makes the goal achievable.
Child Mortality ; trends ; Child, Preschool ; China ; epidemiology ; Humans ; Infant ; Infant, Newborn ; Pneumonia ; mortality ; Time Factors

OBJECTIVES: To explore and analyze the epidemic features of coronavirus disease 2019 (COVID-19) in Hunan Province from January 21, 2020 to March 14, 2020, as well as to investigate the COVID-19 epidemics in each city of Hunan Province. METHODS: The epidemic data was obtained from the official website of Hunan Province's Health Commission. The data of each city of Hunan Province was analyzed separately. Spatial distribution of cumulative confirmed COVID-19 patients and the cumulative occurrence rate was drawn by ArcGIS software for each city in Hunan Province. Some regional indexes were also compared with that in the whole country. RESULTS: The first patient was diagnosed in January 21, sustained patient growth reached its plateau in around February 17. Up to March 14, the cumulative confirmed COVID-19 patients stopped at 1 018. The cumulative occurrence rate of COVID-19 patients was 0.48 per 0.1 million person. The number of cumulative severe patients was 150 and the number of cumulative dead patients was 4. The mortality rate (0.39%) and the cure rate (99.6%) in Hunan Province was significantly lower and higher respectively than the corresponding average rate in the whole country (0.90% and 96.2%, Hubei excluded). The first 3 cities in numbers of the confirmed patients were Changsha, Yueyang, and Shaoyang. While sorted by the cumulative occurrence rate, the first 3 cities in incidence were Changsha, Yueyang, and Zhuzhou. CONCLUSIONS The epidemic of COVID-19 spread out smoothly in Hunan Province. The cities in Hunan Province implement anti-disease strategies based on specific situations on their own and keep the epidemic in the range of controllable.
Betacoronavirus ; China ; epidemiology ; Cities ; epidemiology ; Coronavirus Infections ; epidemiology ; mortality ; Humans ; Pandemics ; Pneumonia, Viral ; epidemiology ; mortality