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Acinetobacter baumannii is an opportunistic pathogen that seriously affects sick patients, causing Health Care Associated Infections (HCAI) such as pneumonia associated with mechanical ventilation, urinary tract infections and bacteremia, in recent years this bacterium has become a health problem worldwide, its isolation from infections present in hospitalized patients has been increasing, and it also has various mechanisms of resistance to antibiotics. The present documentary research aims to describe the mechanisms of pathogenicity and resistance to antibiotics used by Acinetobacter baumannii as a causal agent of HCAI. To carry out this work, a literature search was carried out in databases such as: Scielo, PubMed, NCBI, and Elsevier. The pathogenicity mechanisms that allow it to colonize and develop infections in hospitalized patients are: porins, biofilms, pili, lipopolysaccharides, phospholipases, outer membrane vesicles and the production of siderophores. It has enzymatic resistance mechanisms such as beta-lactamases and non-enzymatic mechanisms such as porin modification, efflux pumps, and modifications in DNA gyrase. There are extrinsic factors that favor the development of HCAI, such as the immunological and health condition of the patient, as well as the association with medical equipment. Studies carried out between the years 2005 to 2018 reveal that A. baumannii is one of the main causative agents of pneumonia associated with mechanical ventilation in patients admitted to the Intensive care unit.

Pharma Aim : To know the attitudes of Spanish physicians related antibiotic use in different patterns of acute bronchitis. Design: A cross-sectional survey was set out in November during the Spanish Conference on Medicine Family held in Donosti (Basque Country). Methods : All the participants who filled up a questionnaire were given a present at the Aventis Pharma's stand at the Conference. They were asked if they would prescribe antibiotics in cases of acute bronchitis accompanied with high temperature, purulent sputum, uncertainty in the diagnosis and in the cases in which patients wanted with treatment antibiotic. Results : 843 family doctors filled up the questionnaire and 35 inquiries were dropped out because of illegibility or non responses. Out of the 784 valid responses reported, 569 doctors preferred to use antibiotics in cases of acute bronchitis with a temperature higher than 38ºC (72.6%)-175 physicians strongly agreed with this sentence (22.3%)-, 662 preferred to use them in case of a purulent sputum (84.5%)-234 strongly agreed (29.9)-, 131 stated that they would prescribe antibiotics when patients really wanted them (16.9%) and 603 would prescribed antibacterial agents in case of suspected pneumonia (77.7%)-115 strongly agreed with that sentence (14.8 Conclusions : Despite the fact that antibiotics are ineffective in acute bronchitis many doctors would prescribe them mainly in cases of uncertainty and in cases of purulent sputum justifying the high consumption of antibiotics in our country. ABI034: Additional value of spirometry in risk assessment of acute respiratory disease in winter among patients with mild to moderate asthma or COPD (Prim Care Respir J 2002; 11(2): 66) Background: Spirometry is frequently performed by Dutch general practitioners to diagnose and monitor asthma or COPD. However, its additional value to anamnestic data in predicting the occurrence of acute respiratory disease (ARD) is unknown. We developed a clinical prediction model, assessing the additional value of spirometry, for the risk of asthma/COPD exacerbation or pneumonia during an influenza epidemic. Methods: Data were used from a case-control study among patients with asthma or COPD aged 18-64 years in general practice. During the influenza epidemics of 1998-1999 and 1999-2000, data on demographics, prior health care use, medical consumption, type of lung disease and comorbidity were collected from 87 patients with an exacerbation or pneumonia and 363 controls matched on age en sex using computerized medical records. Additionally, FEV 1 and PEF were measured before and after inhalation of a ß-agonist. Conditional multivariate logistic regression analysis and receiver-operator curve (ROC) analysis was used to assess the discriminative value of anamnestic data and spirometry. Results: Independent predictors of the occurrence of ARD were 'prior exacerbation' (OR 6.3 95% CI 3.3-12.3), 'use of bronchodilators' (OR 2.0, 95% CI 1.3-3.8), 'treatment by pulmonologist' (OR 2.0, 95% CI 1.2-3.4) and 'COPD' (OR 1.7, 95%CI 0.9-3.0)....

Introduction Adult survivors of pediatric Hodgkin Lymphoma (HL) report poor sleep quality and excessive fatigue, often associated with obstructive sleep apnea (OSA). However, little is known about sleep dynamics in HL survivors without sleep disorders. In this exploratory study we evaluated quantitative and qualitative sleep of HL survivors without OSA and examined associations with cancer treatment and functional outcomes. Methods Adult participants completed two consecutive nights of in-home polysomnography (PSG) with at least 4 hours of recorded sleep. For those participants with a sleep efficiency >85% and without OSA (HL survivors N=39, mean[SD] age=35[7.8] years; community controls N=33, age=29[7.4] years) PSG’s were scored following AASM guidelines. Standardized surveys assessed subjective sleep quality (PSQI), fatigue (FACIT-F) and quality-of-life (SF-36). Group differences were evaluated using ANCOVA adjusting for age. Multivariable linear regression was used to evaluate associations between sleep and SF36 measures. Kendall correlations were computed for objective and subjective sleep and chest radiation dosimetry. Results No significative differences between groups were found for standard objective PSG variables (sleep stages, latency, efficiency, etc.). Compared to controls, survivors had higher mean heart rate (HR) during sleep (p< 0.003), higher fatigue (p< 0.004), and lower sleep quality (p=0.005). Among HL survivors, poor PSQI ratings were associated with higher HR (τ = 0.36, p=0.001), lower sleep time (τ = -0.26, p=0.019) and increased fatigue (τ = -0.47, p< 0.001). Higher radiation dosimetry was associated with lower PSG sleep efficiency (τ = -0.23, p=0.042). Among survivors and community controls, mean HR during sleep (p=0.049) and lower sleep efficiency by PSG (p=0.032) were associated with poorer SF36 physical health (p< 0.001). Conclusion HL Survivors demonstrate elevated mean HR during sleep, which is associated with patient reported functional limitations. Interventions to lower mean HR during sleep may have the potential to improve sleep quality, physical function, and overall quality of life. Support (if any) NCI - NCI NIH: 1R01CA215405, T32CA225590