Aim: This mini review summarises the available data on antibiotic stewardship programmes (ASP) for acute respiratory tract infections (ARTI) in paediatric outpatients, particularly the implementation and impact of programmes.
Methods: PubMed was searched from 1 January 2012 to 31 December 2021 for papers with abstracts that used the terms respiratory tract infection, antibiotic, child and guideline. We then saw how many of these included the individual terms impact, implementation or stewardship. After exclusions, we included 10 papers that were published in English on children treated as outpatients for ARTIs. All of these included data on implementing and assessing the impact of ASPs.
Results: The primary care data were mainly from the United States. The ASP programmes did not influence antibiotic prescription rates, but broad-spectrum antibiotics decreased by 43-48%. The emergency department data were mainly from France and the antibiotic prescription rate decreased by 31-35% and the rate for broad-spectrum antibiotics by 63-71%. A nationwide register-based study from France confirmed these results.
Conclusion: ASPs had a low impact on overall antibiotic prescription rates and a modest impact on prescribing broad-spectrum antibiotics. The implementation of ASP protocols needs further development, and more research is necessary on barriers to complying with ASPs.
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http://dx.doi.org/10.1111/apa.16381 | DOI Listing |
Invest Ophthalmol Vis Sci
January 2025
Schepens Eye Research Institute, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States.
Purpose: To investigate the presence of uridine-5'-triphosphate (UTP)-activated P2Y1-like nucleotide receptors (P2Y2R, P2Y4R, and P2Y6R) in conjunctival goblet cells (CGCs) and determine if they increase intracellular Ca2+ concentration ([Ca2+]i) and induce mucin secretion.
Methods: Adult, male rat conjunctiva was used for culture of CGCs. To investigate the expression of P2YRs, mRNA was extracted from CGCs and used for reverse transcription PCR (RT-PCR) with commercially obtained primers specific to P2Y2R, P2Y4R, and P2Y6R.
Am J Respir Crit Care Med
January 2025
University of Utah, Division of Cardiovascular Medicine, Department of Medicine, Salt Lake City, Utah, United States.
Rationale: Guidelines recommend patients with pulmonary arterial hypertension (PAH) be referred to pulmonary hypertension (PH) centers, but little is known about where care is actually delivered in the United States (US).
Objectives: To use prescription patterns to estimate the proportion of PAH care delivered at US PH centers and explore factors associated with location of care.
Methods: This retrospective study analyzed claims from the Komodo database in adults who received ≥1 PAH prescription between March 2021 and February 2022.
Radiol Cardiothorac Imaging
February 2025
From the Department of Biomedical Engineering (X.Z.) and Columbia Magnetic Resonance Research Center (CMRRC) (W.S.), Columbia University, New York, NY; Departments of Medicine (C.B.C., J.P.F.) and Radiology (J.P.F.), University of California at Los Angeles, Los Angeles, Calif; Department of Radiology, Weill Cornell Medicine, New York, NY (M.R.P.); Department of Radiology (M.R.P., S.M.D., S.J.), Department of Medicine (M.C.B., R.G.B.), Department of Epidemiology (R.G.B.), Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics (W.S.), and Institute of Human Nutrition (W.S.), Columbia University Irving Medical Center, 632 W 168th St, PH-17, New York, NY 10032; Department of Radiology (B.A.V., J.A.C.L.) and Division of Pulmonary and Critical Care Medicine, Department of Medicine, School of Medicine (N.N.H.), Johns Hopkins University, Baltimore, Md; Department of Radiology, University of Michigan, Ann Arbor, Mich (P.P.A.); Department of Radiology, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wis (D.A.B.); Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC (D.C.); Departments of Radiology, Medicine, and the Roy J. Carver Department of Biomedical Engineering, University of Iowa, Iowa City, Iowa (E.A.H.); Sections on Cardiology and Geriatrics, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC (D.W.K.); Division of Pulmonary, Critical Care, Sleep, and Allergy (J.A.K.) and Department of Radiology, College of Medicine (M.G.M.), University of Illinois at Chicago, Chicago, Ill; Department of Radiology and Biomedical Imaging (Y.J.L., J.L.), Division of Pulmonary, Critical Care, Sleep, and Allergy, Department of Medicine, School of Medicine (P.G.W.), and Cardiovascular Research Institute (P.G.W.), University of California at San Francisco, San Francisco, Calif; Division of Pulmonary and Critical Care Medicine, Department of Medicine, Wake Forest University, Winston-Salem, NC (J.O., S.P.P.); Division of Pulmonary Medicine, Department of Medicine, Mayo Clinic, Phoenix, Ariz (V.E.O.); Department of Medicine, University of Utah, Salt Lake City, Utah (R.P.); Department of Radiology, Mayo Clinic, Rochester, Minn (J.D.S.); Department of Radiology, Hannover Medical School, Hannover, Germany (J.V.C.); and BREATH, Member of the German Center for Lung Research (DZL), Hannover, Germany (J.V.C.).
Purpose To assess the repeatability of real-time cine pulmonary MRI measures of metronome-paced tachypnea (MPT)-induced dynamic hyperinflation and its relationship with chronic obstructive pulmonary disease (COPD) severity. Materials and Methods SubPopulations and InteRmediate Outcome Measures In COPD Study (SPIROMICS) (ClinicalTrials.gov identifier no.
View Article and Find Full Text PDFRadiology
January 2025
From the Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029 (Y.Z., D.F.Y., C.I.H.); and Department of Radiology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China (Y.Z.).
Lung cancer is the leading cause of cancer deaths globally. In various trials, the ability of low-dose CT screening to diagnose early lung cancers leads to high cure rates. It is widely accepted that the potential benefits of low-dose CT screening for lung cancer outweigh the harms.
View Article and Find Full Text PDFRadiology
January 2025
Stanford University School of Medicine, Department of Radiation Oncology, Stanford, CA, US.
Background Detection and segmentation of lung tumors on CT scans are critical for monitoring cancer progression, evaluating treatment responses, and planning radiation therapy; however, manual delineation is labor-intensive and subject to physician variability. Purpose To develop and evaluate an ensemble deep learning model for automating identification and segmentation of lung tumors on CT scans. Materials and Methods A retrospective study was conducted between July 2019 and November 2024 using a large dataset of CT simulation scans and clinical lung tumor segmentations from radiotherapy plans.
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