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Browsing by Author "Leuschner, P."

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  • Bacterial etiology of community-acquired pneumonia in immunocompetent hospitalized patients and appropriateness of empirical treatment recommendations: an international point-prevalence study
    Publication . Carugati, Manuela; Aliberti, S.; Sotgiu, G.; Blasi, F.; Gori, A.; Menendez, R.; Encheva, M.; Gallego, M.; Leuschner, P.; Ruiz-Buitrago, S.; Battaglia, S.; Fantini, R.; Pascual-Guardia, S.; Marin-Corral, J.; Restrepo, M. I.; Aruj, Patricia Karina; Attorri, Silvia; Barimboim, Enrique; Caeiro, Juan Pablo; Garzón, María I; Cambursano, Victor Hugo; Ceccato, Adrian; Chertcoff, Julio; Lascar, Florencia; Tulio, Fernando Di; Díaz, Ariel Cordon; de Vedia, Lautaro; Ganaha, Maria Cristina; Lambert, Sandra; Lopardo, Gustavo; Luna, Carlos M; Malberti, Alessio Gerardo; Morcillo, Nora; Tartara, Silvina; Pensotti, Claudia; Pereyra, Betiana; Scapellato, Pablo Gustavo; Stagnaro, Juan Pablo; Shah, Sonali; Lötsch, Felix; Thalhammer, Florian; Vincent, Jean Louis; Anseeuw, Kurt; Francois, Camille A; Van Braeckel, Eva; Djimon, Marcel Zannou; Bashi, Jules; Roger, Dodo; Nouér, Simone Aranha; Chipev, Peter; Encheva, Milena; Miteva, Darina; Petkova, Diana; Dodo, Balkissou Adamou; Ngahane, Mbatchou; Hugo, Bertrand; Shen, Ning; Xu, Jin-fu; Rico, Carlos Andres Bustamante; Buitrago, Ricardo; Paternina, Fernando Jose Pereira; Jean-Marie, Kayembe Ntumba; Carevic, Vesna Vladic; Jakopovic, Marko; Jankovic, Mateja; Matkovic, Zinka; Mitrecic, Ivan; Jacobsson, Marie-Laure Bouchy; Christensen, Anette Bro; HeitmannBødtger, Uff e Christian; Meyer, Christian Niels; Jensen, Andreas Vestergaard; Baunbæk-knudsen, Gertrud; Petersen, Pelle Trier; Andersen, Stine; El-Wahhab, Ibrahim El-Said Abd; Morsy, Nesreen Elsayed; Shafiek, Hanaa; Sobh, Eman; Bertrand, Fabrice; Brun-Buisson, Christian; de Montmollin, Etienne; Fartoukh, Muriel; Messika, Jonathan; Tattevin, Pierre; Dreher, Michael; Kolditz, Martin; Meisinger, Matthias; Pletz, Mathias W; Hagel, Stefan; Rupp, Jan; Schaberg, Tom; Spielmanns, Marc; Siaw-Lartey, Beatrice; Dimakou, Katerina; Papapetrou, Dimosthenis; Tsigou, Evdoxia; Ampazis, Dimitrios; Bhatia, Mohit; Dhar, Raja; D’Souza, George; Garg, Rajiv; Koul, Parvaiz A; Mahesh, P A; Jayaraj, B S; Narayan, Kiran Vishnu; Udnur, Hirennappa B; Krishnamurthy, Shashi Bhaskara; Golshani, Keihan; Keatings, Vera M; Martin-Loeches, Ignacio; Maor, Yasmin; Strahilevitz, Jacob; Battaglia, Salvatore; Carrabba, Maria; Ceriana, Piero; Confalonieri, Marco; d’Arminio Monforte, Antonella; Del Prato, Bruno; De Rosa, Marino; Fantini, Riccardo; Fiorentino, Giuseppe; Gammino, Maria Antonia; Menzella, Francesco; Milani, Giuseppe; Nava, Stefano; Palmiero, Gerardo; Petrino, Roberta; Gabrielli, Barbra; Rossi, Paolo; Sorino, Claudio; Steinhilber, Gundi; Zanforlin, Alessandro; Kurahashi, Kiyoyasu; Bacha, Zeina Aoun; Ugalde, Daniel Barajas; Zuñiga, Omar Ceballos; Villegas, José F; Medenica, Milic; van de Garde, E M W; Mihsra, Deebya Raj; Shrestha, Poojan; Ridgeon, Elliott; Awokola, Babatunde Ishola; Nwankwo, Ogonna N O; Olufunlola, Adefuye Bolanle; Olumide, Segaolu; Ukwaja, Kingsley N; Irfan, Muhammad; Minarowski, Lukasz; Szymon, Skoczyński; Froes, Felipe; Leuschner, Pedro; Meireles, Mariana; Ferrão, Cláudia; Leuschner, Pedro; Neves, João; Ravara, Sofia B; da Beira, Cova; Brocovschii, Victoria; Ion, Chesov; Rusu, Doina; Toma, Cristina; Chirita, Daniela; Birkun, Alexei; Kaluzhenina, Anna; Almotairi, Abdullah; Abdulbaqi, Zakeya; Bukhary, Ali; Edathodu, Jameela; Fathy, Amal; Enani, Abdullah Mushira Abdulaziz; Mohamed, Nazik Eltayeb; Memon, Jawed Ulhadi; Bogdanović, Nada; Milenkovic, Branislava; Pesut, Dragica; Borderìas, Luis; Garcia, Noel Manuel Bordon; Alarcón, Hugo Cabello; Cilloniz, Catia; Torres, Antoni; Diaz-Brito, Vicens; Casas, Xavier; González, Alicia Encabo; Fernández-Almira, Maria Luisa; Gallego, Miguel; Gaspar-GarcÍa, Inmaculada; del Castillo, Juan González; Victoria, Patricia Javaloyes; Martínez, Elena Laserna; de Molina, Rosa Malo; Marcos, Pedro J; Menéndez, Rosario; PandoSandova, Ana; Aymerich, Cristina Prat; del la Torre, Alicia Lacoma; García-Olivé, Ignasi; Rello, Jordi; Moyano, Silvia; Sanz, Francisco; Sibila, Oriol; Rodrigo-Troyano, Ana; Solé-Violán, Jordi; Uranga, Ane; van Boven, Job FM; Torra, Ester Vendrell; Pujol, Jordi Almirall; Feldman, Charles; Yum, Ho Kee; Fiogbe, Arnauld Attannon; Yangui, Ferdaous; Bilaceroglu, Semra; Dalar, Levent; Yilmaz, Ufuk; Bogomolov, Artemii; Elahi, Naheed; Dhasmana, Devesh J; Ions, Rhiannon; Skeemer, Julie; Woltmann, Gerrit; Hancock, Carole; Hill, Adam T; Rudran, Banu; Ruiz-Buitrago, Silvia; Campbell, Marion; Whitaker, Paul; Allen, Karen S; Brito, Veronica; Dietz, Jessica; Dysart, Claire E; Kellie, Susan M; Franco-Sadud, Ricardo A; Meier, Garnet; Gaga, Mina; Holland, Thomas L; Bergin, Stephen P; Kheir, Fayez; Landmeier, Mark; Lois, Manuel; Nair, Girish B; Patel, Hemali; Reyes, Katherine; Rodriguez-Cintron, William; Saito, Shigeki; Soni, Nilam J; Noda, Julio; Hinojosa, Cecilia I; Levine, Stephanie M; Angel, Luis F; Anzueto, Antonio; Whitlow, K Scott; Hipskind, John; Sukhija, Kunal; Wunderink, Richard G.; Shah, Ray D; Mateyo, Kondwelani John
    An accurate knowledge of the epidemiology of community-acquired pneumonia (CAP) is key for selecting appropriate antimicrobial treatments. Very few etiological studies assessed the appropriateness of empiric guideline recommendations at a multinational level. This study aims at the following: (i) describing the bacterial etiologic distribution of CAP and (ii) assessing the appropriateness of the empirical treatment recommendations by clinical practice guidelines (CPGs) for CAP in light of the bacterial pathogens diagnosed as causative agents of CAP. Secondary analysis of the GLIMP, a point-prevalence international study which enrolled adults hospitalized with CAP in 2015. The analysis was limited to immunocompetent patients tested for bacterial CAP agents within 24 h of admission. The CAP CPGs evaluated included the following: the 2007 and 2019 American Thoracic Society/Infectious Diseases Society of America (ATS/IDSA), the European Respiratory Society (ERS), and selected country-specific CPGs. Among 2564 patients enrolled, 35.3% had an identifiable pathogen. Streptococcus pneumoniae (8.2%) was the most frequently identified pathogen, followed by Pseudomonas aeruginosa (4.1%) and Klebsiella pneumoniae (3.4%). CPGs appropriately recommend covering more than 90% of all the potential pathogens causing CAP, with the exception of patients enrolled from Germany, Pakistan, and Croatia. The 2019 ATS/IDSA CPGs appropriately recommend covering 93.6% of the cases compared with 90.3% of the ERS CPGs (p < 0.01). S. pneumoniae remains the most common pathogen in patients hospitalized with CAP. Multinational CPG recommendations for patients with CAP seem to appropriately cover the most common pathogens and should be strongly encouraged for the management of CAP patients.
    2020Journal article Open access Show more
  • Clinical Usefulness of Streptococcus pneumoniae Urinary Antigen in Patients Hospitalized with Non-Nosocomial Pneumonia
    Publication . Ferreira, J.; Abreu, M.; Rodrigues, P.; Maia, J.; Leuschner, P.; Correia, J.
    Introduction : Community acquired pneumonia (CAP) is a major cause of hospital admissions and mortality in developed countries. Nevertheless, in about half of the cases a microbial etiology can`t be determined. The need to improve the diagnostic tools of this disease has led to the development of new techniques, such as Streptococcus pneumoniae urinary antigen. Objectives : To analyse the usefulness of the urinary antigen in determining the etiologic diagnosis of pneumonias and its influence in the antibiotherapy modification. Methods : Retrospective analysis of hospitalized patients in 2010 with CAP (n=226) and healthcare associated pneumonia (HCAP) [n=64] diagnosis whose urinary pneumococcal antigen has been analyzed. Results: Median age was significantly greater in HCAP. HCAP patients had more co-morbidities and higher severity scores. Twenty-one patients in the CAP group and 4 patients in the HCAP group had positive pneumococcal antigen. The sensibility of urinary antigen in determining pneumococcal pneumonias was 36% and the specificity 89%. Almost one quarter of the 25 patients with positive urinary antigen had appropriate reductions in antimicrobial spectra, which was not statistically significant when compared with the group with negative urinary antigen. There was a significant relation between a positive urinary antigen and pneumonia severity. Conclusions: Considering its high specificity, the urinary antigen is useful to confirm the presence of pneumococcal pneumonia. Potentially urinary antigen can help to avoid unnecessary treatments in hospitalized patients with CAP.
    2012Journal article Open access Show more
  • Complexo de Von Meyenburg ou Metástases Hepáticas? Caso Clínico e Revisão da Literatura
    Publication . Silveira, I.; Mota, F.; Ferreira, J.; Dias, R.; Leuschner, P.
    Hepatic lesions represent a common finding in clinical practice. Bile ducts hamartomas, also known as Von Meyenburg complex, are benign hepatic malformations composed of small dilated cystic bile ducts lined by fibrous stroma. They represent a rare and asymptomatic clinic-pathological entity. Imagiological findings are variable, and may present as multiple small scattered lesions, or rarely as a single nodule. These findings may resemble secondary lesions and, although benign, there are cases of progression to colangiocarcinoma. Thus it is important to include this complex in the differential diagnoses of focal hepatic lesions, being necessary a detailed investigation for their differentiation. This case represents an atypical presentation of a rare and not frequently considered entity in clinical practice
    2014Journal article Open access Show more
  • Human Immunodeficiency Virus - Associated Neurocognitive Disorders (HANDs)
    Publication . Ferreira, J.; Almeida, F.; Coya, P.; Leuschner, P.; Correia, J.
    As alterações neurocognitivas são prevalentes nos doentes com infecção pelo vírus da imunodeficiência humana (VIH). As manifestações clínicas são muitas vezes subtis, passando facilmente despercebidas na interacção casual. Esta revisão tem como objectivo clarificar e organizar o tema, fornecendo classificações actuais, métodos de diagnóstico e opções terapêuticas. A metodologia utilizada no processo de revisão, centrou-se na análise pormenorizada de um conjunto de artigos, ensaios clínicos e revisões, obtidos por pesquisa na Medline, UpToDate, Medscape e Google, abrangendo os últimos 10 anos de investigação na área. São abordadas as repercussões neuropsiquiátricas do HIV, desde a sua génese, fisiopatologia, diagnóstico e classificação, até ao tratamento e perspectivas futuras. As alterações neurocognitivas associadas ao VIH (HANDs) são patologias de atingimento predominantemente subcortical, condicionando grande variabilidade na sua apresentação e multiplicidade de diagnósticos diferenciais. O índice de suspeição é essencial para a rápida identificação desta patologia em que a intervenção precoce melhora o prognóstico. Embora tenha havido enorme progresso no conhecimento, compreensão e tratamento das HANDs, há um vasto território a explorar, nomeadamente no que respeita à etiologia, prevenção e terapêutica.
    2011-10Journal article Open access Show more