The rapid increase in the elderly population is leading to a corresponding increase in the number of people requiring medical care. To date no comparative study between community-acquired pneumonia (CAP) and nursing home-acquired pneumonia (NHAP) has been reported in the very elderly non-intubated patients. The present study was undertaken to compare the clinical characteristics and microbial etiology between CAP and NHAP in elderly patients >/=85-years old. There were 54 patients with NHAP and 47 with CAP. Performance status was significantly worse in the NHAP than in the CAP group. Among all patients, the most frequent pathogens were Chlamydophilia pneumoniae followed by Streptococcus pneumoniae, Mycoplasma pneumoniae influenza virus and Staphylococcus aureus. The frequency of S. peumoniae was significantly higher in NHAP patients than in CAP patients after adjusting for age and sex. Physical activity, nutrition status and dehydration were significant prognostic factors of pneumonia among all patients. In-hospital mortality was significantly higher in NHAP than in CAP after adjusting for age and sex. This study demonstrated that the etiology and clinical outcome differ between CAP and NHAP patients in the very elderly non-intubated population.

The aim of this study was to investigate whether procalcitonin (PCT), neopterin, C-reactive protein (CRP), and mid regional pro-atrial natriuretic peptide (MR-proANP) levels at admission and during the clinical course can be useful for the management of patients with pneumonia. The study population consisted of 75 patients with clinical and radiological diagnosis of pneumonia. Serum samples were collected at admission and during hospitalization. Complications were defined as intensive care unit (ICU) admission or death. The levels of PCT were significantly higher in pneumonia of definite bacterial origin in comparison to probable bacterial or unknown origin. The PCT levels were higher in pneumococcal pneumonia. The PCT and MR-proANP levels increased significantly according to the Pneumonia Severity Index (PSI). All biomarkers levels are higher in patients developing complications and who were dying. The serial levels of MR-proANP remain significantly elevated in patients developing complications and in patients classified in PSI and CURB-65 risk groups. In patients not developing complications, there is a significant decrease in the PCT levels. PCT can be useful for identifying pneumonia etiology. PCT and MR-proANP levels correlate with pneumonia severity rules. PCT and MR-proANP serial measurements can be useful for predicting short-term prognosis. Systemic biomarkers can provide additional information regarding clinical evolution, because these are dynamic and can be measured daily.

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Almost every link in the chain of exploration seismology methods used to process recorded data has been affected by Green’s theorem. Among the seismic processes that can be related to, and/or have benefited from, Green’s theorem are wavelet estimation, multiple elimination, regularization, redatuming, imaging, deghosting, and interferometry. This tutorial on various seismic exploration methods derived from Green’s theorem emphasizes seismic data reconstruction (including regularization and redatuming) and its relationship to interferometry as well as to wavelet estimation and wavefield separation. The last decade has witnessed ever-increasing attention within the energy industry and its concomitant representation in the published literature to methods dealing with wavefield reconstruction through in-terferometry or virtual-source techniques. The attention has re- newed interest in Green’s theorem because all different ap-proaches to interferometry can be derived from it. This tutorial provides a derivation and explication of the limitations of interferometric techniques (when interferometry is used to process measured data from marine surface seismic experiments with controlled sources) as approximations to Green’s theorem. This tutorial provides a definite statement of the comprehensive framework given by Green’s theorem to wavefield reconstruction and shows how different techniques are directly understood as specific mathematical forms and/or approximations to the theorem. The use of approximations can have shortcomings and create artifacts. These artifacts and errors are also analyzed and explained. All methods discussed in this tutorial recognize their foundation on Green’s theorem and have a secure mathematical-physics cornerstone to recognize the assumptions behind distinct approximate solutions and to guide the search for more accurate, effective techniques.