Archive | July 2017

QUOTE FOR MONDAY:

“Stress is your body’s way of responding to any kind of demand or threat. When you sense danger—whether it’s real or imagined—the body’s defenses kick into high gear in a rapid, automatic process known as the “fight-or-flight” reaction or the “stress response.

QUOTE FOR THE WEEKEND:

“Ablation is used to treat abnormal heart rhythms, or arrhythmias. The type of arrhythmia and the presence of other heart disease will determine whether ablation can be performed surgically or non-surgically.”

American Heart Association

Ablation, a resolution created for certain dysrhythmias.

Ablation is used to treat abnormal heart rhythms, or arrhythmias. The type of arrhythmia and the presence of other heart disease will determine whether ablation can be performed surgically or non-surgically.

Ablation therapy using radio frequency waves on the heart is used to cure a variety of cardiac arrhythmiae such as supraventricular tachycardia, Wolff–Parkinson–White syndrome (WPW), ventricular tachycardia, and more recently as management of atrial fibrillation (especially when its newly diagnosed when medical management can’t change it back to normal sinus rhythm, which is the normal cardiac rhythm seen on a telemetry monitor or of an EKG taken on a patient).

An arrhythmia is a change in the heart’s normal rate or rhythm, normally between 60 and 100 beats per minute. Arrhythmias are classified by their location in the heart and by their speed or rhythm. An atrial arrhythmia is an abnormality that occurs in one of the two upper chambers of the heart, the left or right atrium. Arrhythmias are associated with aging and typically happen more frequently during middle age. At least 10 to 15 percent of people older than 70 years experience arrhythmias.  We have what we call our human pacemaker of the heart that naturally sends conduction for the heart to pump, which is called the sinus node.  This is in the upper left corner of the right chamber of the heart.  That is where the name sinus rhythm derives from (the sinus node) which is the best rhythm a human can be in as long as the pulse rate stays above 60 and stays under 100. Now if that sinus node for some reason breaks down and no longer works; so than the pace site starts somewhere in the right atrium below the sinus node (the heart is compensating for whatever is the reason the sinus node is not working).  So now the rhythms are called atrial rhythms because of where the new natural pacemaker site is in the heart.  This is where ablation comes into play if the type of atrial rhythm they have is detrimental to the patient; including if that patient is a candidate for this procedure.  Between our heart chambers on the top (called atriums) and below (called the ventricles) is a AV (meaning atrioventricular valve).  Rhythms above the ventricles are also grouped as supraventricular rhythms.  Which is what ablation is used for.

Types of rhythms a patient would be considered for ablation as a possible treatment:

Atrial fibrillation. The electrical signal that circles uncoordinated through the muscles of the atria (the upper chambers of the heart), causing them to quiver (sometimes more than 400 times per minute) without contracting. The ventricles (the lower chambers of the heart) do not receive regular impulses and contract out of rhythm, and the heartbeat becomes uncontrolled and irregular. It is the most common atrial arrhythmia, and 85 percent of people who experience it are older than 65 years.

Atrial fibrillation can cause a blood clot to form, which can enter the bloodstream and trigger a stroke. Underlying heart disease or hypertension increases the risk of stroke from atrial fibrillation as does age even without heart disease or hypertension.

Premature atrial contraction (PAC or premature atrial impulses). A common and benign arrhythmia, a PAC is a heartbeat that originates away from the sinus node, which sends electrical signals through the upper chamber. It typically occurs after the sinus node has initiated one heartbeat and before the next regular sinus discharge. A PAC can cause a feeling of a skipped heartbeat. Use of caffeine, tobacco, and/or alcohol, or stress can bring on PACs or increase their frequency.

Supraventricular tachycardia (SVT). Characterized by a rapid heart rate that ranges between 100 and 240 beats per minute, SVT usually begins and ends suddenly. SVT occurs when an electrical impulse ‘re-enters’ the atrial muscles. A disorder that a person may have at birth, SVT is commonly caused by a variation in the electrical system of the heart. SVT often begins in childhood or adolescence and can be triggered by exercise, alcohol, or caffeine. SVT is rarely dangerous, but can cause a drop in blood pressure, causing lightheadedness or near-fainting episodes, and, rarely, fainting episodes.

Atrial flutter. Differentiated from atrial fibrillation by its coordinated, regular pattern, atrial flutter is a coordinated rapid beating of the atria. Most who experience atrial flutter are 60 years and older and have some heart disorder, such as heart valve problems or a thickening of the heart muscle. Atrial flutter is classified into two types, according to the pathways responsible for it. Type I normally causes the heart rate to increase to and remain at 150 beats per minute. Rarely, the rate may reach 300 beats per minute; sometimes it decreases to 75 beats per minute. Type II increases the atrial rate faster, so the ventricular rate may be 160 to 170 beats per minute. As with atrial fibrillation, atrial flutter increases the risk of stroke.

Sick sinus syndrome (SSS). Common among older people, SSS is an improper firing of electrical impulses caused by disease or scarring in the sinus or Sinoatrial node (SA node). SSS normally causes the heart rate to slow, but sometimes it alternates between abnormally slow and fast. A progressive condition, with episodes increasing in frequency and duration, SSS can be caused by:

  • Degeneration of the heart’s electrical system; or
  • Diseases of the atrial muscle.

Sinus tachycardia. The sinus node emits abnormally fast electrical signals, which increases the heart rate to between 100 beats per minute to 140 beats per minute at rest, and 200 beats per minute during exercise. A normal response to exercise or stress, it can also be caused by:

  • Adrenaline;
  • Consumption of caffeine, nicotine, or alcohol; and
  • Heart conditions.

Sinus bradycardia. Associated with impaired impulse generation in the SA node, it causes the heart rate to decrease to fewer than 60 beats per minute. Commonly caused by SSS, drugs like beta-blockers and calcium-channel blockers can also cause sinus bradycardia. Occasionally sinus bradycardia can be caused by impaired conduction of impulses to the atrial muscles.

Wolff-Parkinson-White syndrome (WPW). WPW syndrome occurs when electrical signals fail to pause in the atrioventricular node because an extra pathway allows the impulse to “bypass” the normal pathway; and the syndrome is sometimes called bypass tract. WPW syndrome causes heart rates approaching 240 beats per minute.

Occasionally, impulses can go down one extra pathway and up another, creating a “loop” or “short circuit,” (called SVT because of WPW). Patients with WPW syndrome may develop atrial fibrillation and are at increased risk for developing a dangerous ventricular arrhythmia when this occurs.

CAUSES AND RISK FACTORS

Problems with the heart’s electrical system or with the muscles’ response to the signal can cause arrhythmias. Physicians have categorized arrhythmias to their type:

  • Disorders of impulse generation – A signal that generates part of the heart’s electrical system other than the SA node.
  • Disorders of impulse conduction – “block” the heart’s electrical impulse and prevent it from traveling its normal pathway.
  • Heart attack – causes scarring of the heart, which can interrupt electrical impulses.

People without heart disease can develop an arrhythmia for unknown causes, but risk factors can include:

  • Emotional stress;
  • Consumption of alcohol, caffeine, diet pills, and tobacco; and
  • Some prescription medications (certain heart drugs and certain cold, cough, allergy medications and anti-depressants).

WHAT ARE THE SYMPTOMS?

The onset and duration of arrhythmia symptoms vary according to its type, frequency, duration, and whether structural heart disease is present.

Common symptoms that people experience may include:

  • Palpitations (the sensation of skipped heartbeats);
  • Lightheadedness;
  • Shortness of breath;
  • Fatigue;
  • Chest pain;
  • Fainting; and
  • Urge to urinate.

Certain arrhythmias may cause fainting, and, occasionally stroke, while others (‘silent’ arrhythmias) cause no symptoms.

DIAGNOSIS

Arrhythmias can be difficult to diagnose because they can be unpredictable and brief. A physician will typically take a person’s medical history, and perform a physical examination, during which the physician may detect an arrhythmia using a stethoscope. Arrhythmias that occur infrequently, last for short periods of time, or do not cause noticeable symptoms may require more detailed tests, such as:

  • Electrocardiogram (ECG);
  • A Holter monitor (an ambulatory ECG); and/or
  • A loop ECG.

 

 

 

 

QUOTE FOR FRIDAY:

“Acne is the most common skin condition in the United States. Although it’s common, accurate information about acne can be scarce.”

American Academy of Dermatology

ACNE

 

  

 

Acne is a skin condition that occurs when your hair follicles become plugged with oil and dead skin cells. Acne usually appears on your face, neck, chest, back and shoulders. Effective treatments are available, but acne can be persistent. The pimples and bumps heal slowly, and when one begins to go away, others seem to crop up.

Acne is most common among teenagers, with a reported prevalence of 70 to 87 percent. Increasingly, younger children are getting acne as well.

Depending on its severity, acne can cause emotional distress and scar the skin. The earlier you start treatment, the lower your risk of lasting physical and emotional damage.

Acne signs and symptoms vary depending on the severity of your condition:

  • Whiteheads (closed plugged pores)
  • Blackheads (open plugged pores — the oil turns brown when it is exposed to air)
  • Small red, tender bumps (papules)
  • Pimples (pustules), which are papules with pus at their tips
  • Large, solid, painful lumps beneath the surface of the skin (nodules)
  • Painful, pus-filled lumps beneath the surface of the skin (cystic lesions)

When to see a doctor

If home care remedies don’t work to clear up your acne, see your primary care doctor. He or she can prescribe stronger medications. If acne persists or is severe, you may want to seek medical treatment from a doctor who specializes in the skin (dermatologist).

The Food and Drug Administration warns that some popular nonprescription acne lotions, cleansers and other skin products can cause a serious reaction. This type of reaction is quite rare, so don’t confuse it with the redness, irritation or itchiness where you’ve applied medications or products.

Seek emergency medical help if after using a nonprescription skin product you experience:

  • Faintness
  • Difficulty breathing
  • Swelling of the eyes, face, lips or tongue
  • Tightness of the throat

Four main factors cause acne:

  • Oil production
  • Dead skin cells
  • Clogged pores
  • Bacteria

Acne typically appears on your face, neck, chest, back and shoulders. These areas of skin have the most oil (sebaceous) glands. Acne occurs when hair follicles become plugged with oil and dead skin cells.

Hair follicles are connected to oil glands. These glands secrete an oily substance (sebum) to lubricate your hair and skin. Sebum normally travels along the hair shafts and through the openings of the hair follicles onto the surface of your skin.

 

When your body produces an excess amount of sebum and dead skin cells, the two can build up in the hair follicles. They form a soft plug, creating an environment where bacteria can thrive. If the clogged pore becomes infected with bacteria, inflammation results.

The plugged pore may cause the follicle wall to bulge and produce a whitehead. Or the plug may be open to the surface and may darken, causing a blackhead. A blackhead may look like dirt stuck in pores. But actually the pore is congested with bacteria and oil, which turns brown when it’s exposed to the air.

Pimples are raised red spots with a white center that develop when blocked hair follicles become inflamed or infected. Blockages and inflammation that develop deep inside hair follicles produce cyst-like lumps beneath the surface of your skin. Other pores in your skin, which are the openings of the sweat glands, aren’t usually involved in acne.

Factors that may worsen acne

These factors can trigger or aggravate an existing case of acne:

  • Androgens are hormones that increase in boys and girls during puberty and cause the sebaceous glands to enlarge and make more sebum. Hormonal changes related to pregnancy and the use of oral contraceptives also can affect sebum production. And low amounts of androgens circulate in the blood of women and can worsen acne.
  • Certain medications. Drugs containing corticosteroids, androgens or lithium can worsen acne.
  • Studies indicate that certain dietary factors, including dairy products and carbohydrate-rich foods — such as bread, bagels and chips — may trigger acne. Chocolate has long been suspected of making acne worse. A recent study of 14 men with acne showed that eating chocolate was related to an increase in acne. Further study is needed to examine why this happens or whether acne patients need to follow specific dietary restrictions.
  • Stress can make acne worse.

Acne myths

These factors have little effect on acne:

  • Greasy foods. Eating greasy food has little to no effect on acne. Though working in a greasy area, such as a kitchen with fry vats, does because the oil can stick to the skin and block the hair follicles. This further irritates the skin or promotes acne.
  • Dirty skin. Acne isn’t caused by dirt. In fact, scrubbing the skin too hard or cleansing with harsh soaps or chemicals irritates the skin and can make acne worse. Though it does help to gently remove oil, dead skin and other substances.
  • Cosmetics don’t necessarily worsen acne, especially if you use oil-free makeup that doesn’t clog pores (noncomedogenics) and remove makeup regularly. Nonoily cosmetics don’t interfere with the effectiveness of acne drugs.

Risk factors for acne include:

  • Hormonal changes. Such changes are common in teenagers, women and girls, and people using certain medications, including those containing corticosteroids, androgens or lithium.
  • Family history. Genetics plays a role in acne. If both parents had acne, you’re likely to develop it, too.
  • Greasy or oily substances. You may develop acne where your skin comes into contact with oily lotions and creams or with grease in a work area, such as a kitchen with fry vats.
  • Friction or pressure on your skin. This can be caused by items such as telephones, cellphones, helmets, tight collars and backpacks.
  • This doesn’t cause acne, but if you have acne already, stress may make it worse.

 

 

QUOTE FOR THURSDAY:

“Diabetes Mellitus (DM) is a complex chronic disease involving disorders in carbohydrate, protein, and fat metabolism and the development of macro-vascular, micro-vascular, neurological complications that don’t occur over a few nights or weeks or months.”

American Diabetes Association

QUOTE FOR WEDNESDAY:

“We have an many enzymes in our body from our saliva to our pancrease. Enzymes are specialized proteins that are produced by living cells to catalyze reactions in the body=breakdown.”

What allows vital operations to keep the body alive and working – ENZYMES!

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enzyme3

Enzymes are vital for processes to take place in our body without them they couldn’t take place. What are enzymes exactly?  We have an many enzymes in our body from our saliva to our pancrease. Enzymes are specialized proteins that are produced by living cells to catalyze reactions in the body=breakdown.   Protein in the form of an enzyme acts as a catalyst. A catalyst in action brakes down something, any chemical substance affected with the speed of reaction without being permanently altered by the reaction. For a chemical or biochemical reaction to occur, a certain amount of energy is required=the activation energy. Energy can be transformed from one state to another. The role of an enzyme is to decrease the amount of energy needed to start the reaction. Exactly how enzymes lower activation energies is not completely and fully understood but it is known that an enzyme attaches itself to one of the reacting molecules, this is called a substrate complex. Thousands of enzymes exist but each kind can attach ONLY to one kind of substrate. The enzyme molecule must fit exactly with the substrate molecule (just like how pieces in a jigsaw puzzle have to fit in their specific space of the picture). Well, if the substrate and enzyme don’t perfectly match or fit properly no reaction takes place. When they do fit perfectly the substrate molecule can react with other molecules in a synthesis reaction and when completed the enzyme is free to move on elsewhere to connect with another substrate molecule. This whole process takes place quickly. Clearly, enzymes are essential to the body’s overall homeostasis. (In order to lead a healthy life, we need to bring a balance in the way we lead our lifestyle. Homeostasis is nothing but a mechanism which helps the human body maintain a balance between the internal and external environment). Enzymes quickly perform catalyze chemical reactions and they also govern the reactions that occur.  Enzymes are named by adding the suffix “ase” to the name of their substrates. For example there is:

The breaking down of starches = the enzyme that does this function is amylase.  (Know this about amylase, it is present in human saliva where it begins the chemical process of digestion; that starts in our mouth. Foods that contain much starch but little sugar, such as rice and potato, taste slightly sweet as they are chewed because amylase turns some of their starch into sugar in the mouth. The pancreas also makes amylase (alpha amylase) to hydrolyse dietary starch into disaccharides and trisaccharides which are converted by other enzymes to glucose to supply the body with energy. There is even b and y amylases. Ending product on enzymes breaking down starches or carbohydrates gives us one thing only sugar.)

The breaking down of sugars, like sucrose = the enzyme is sucrase. The ending product of the enzyme is it breaks down complex sugars to more simple sugars in the body.

The breaking down of fats (lipids) = the enzyme is lipase. Lipase perform essential roles in the digestion, transport and processing of dietary lipids in most if not all living organisms (example (triglycerides, fats, oils). Most lipases act at a specific position on glycerol backbone of lipid substrate (A1,A2 or A3 in the small intestines). For example, human pancreatic lipase (HPL) is the main enzyme that breaks down dietary fats in the digestive system, converts triglyceride substrates found in ingested oils to monoglycerides and two fatty acids. Know that glycerol is a simple sugar compound. Enzymes deal with breaking down our foods because they take a major role in what we call the process digestion in the human body but notice what the ending result is of mostly every ingredient out of 3 of our food groups, which is SUGAR. It’s because of the food already having some sugar in it but more importantly also the chemical reaction with the enzyme to allow the food to break down into smaller compounds to be utilized in the body=simpler sugar compounds which also plays a part in the entire digestion process.

So know sugar in the body is our fuel for energy but with our digestion process, in how it works is like this: when the body gets a meal within 1 hour digestion starts in the stomach and complete in 6 to 8 hours depending on how large the meal is, especially if 3 large meals a day. The foods if contain starches, fat, lipids they all break down to simple sugars that transfer to the bloodstream and whatever energy the body needs at that point the tissues with cells utilize it but when enough sugar is used and we have excess in the blood we than have the body store the extra sugar that first converts the glucose (active sugar) to glycogen (inactive sugar) in our liver. The liver is only so big and when it reaches its optimal level of storage than the sugar gets stored in our fat tissue = WEIGHT GAIN. This is the problem with people in America not understanding this process. Plus as most people get older from 30 than to 40 years old and every 10 years after that till heaven we put cellulite on the body for 2 major reasons not eating as healthy due to the bikini and speedo fit not being the priority in life but getting the feet up after a hard day’s work is. The other reason is we aren’t as active as when we were 20 or 30 years old and the metabolism naturally slows down unless you’re a Jack la Lanne.

How do we deal with this to prevent obesity? Do what I did go on a 6 small meal diet. Eat a meal every 3 hours with keeping fat, calories/sugar, carbohydrates in proper proportions to prevent excess sugar in the meals to not allow fat storage=weight gain. Of course some exercise or activity daily or every other day helps tone the muscle and not let it flab due to cellulite. Live healthier habits of living not a month, 3 months or 6 months but make it your daily routine with treating yourself to foods you don’t eat daily to maintain a good weight and increase your health status to allow you to live a happier, longer and more exciting life. Dr. Anderson with his book “Dr. A’s Habits of Health” is a great book to check out with so many others and than the network.   You learn how all 4 food groups are divided up in your meals.

Let’s not forget with enzymes they also break proteins down in our body:  The breaking down of proteins=Trypsin Proteins are large biological molecules consisting of one or more chains of amino acids. Proteins perform a vast array of functions within living organisms, including catalyzing metabolic reactions, replicating DNA, responding to stimuli, and transporting molecules from one location to another. Trypsin is a enzyme catalyst, which allows the catalysis of chemical reactions.   The ending product of the break down is amino acids not sugar. Know high on a protein diet continuously for years can hurt the body also.

Enzymes deal with breaking down our foods because they take a major role in what we call the process digestion in the human body. but notice what the ending result is of mostly every ingredient in our 4 food groups is; SUGAR. It because of the food has some sugar in it but also the chemical reaction with the enzyme to allow the food to break down into smaller compounds to be utilized in the body with send through the entire digestion process.

There are risks with eating just high protein diets for long periods of time. You put yourself at risk for: Osteoporosis: Research shows that women who eat high protein diets based on meat have a higher rate of bone density loss than those who don’t. Women who eat meat lose an average of 35% of their bone density by age 65, while women who don’t eat meat lose an average of 18%. In the long run, bone density loss leads to osteoporosis.

Kidneys: A high protein diet puts strain on the kidneys. It is well known that patients with kidney problems suffer from eating a high protein diet which is due to the high amino acids levels.  A high-protein diet may worsen kidney function in people with kidney disease because your body may have trouble eliminating all the waste products of protein metabolism.

However, the risks of using a high-protein diet with carbohydrate restriction for the long term are still being studied. Several health problems may result if a high-protein diet is followed for an extended time:

Some high-protein diets restrict carbohydrate intake so much that they can result in nutritional deficiencies or insufficient fiber, which can cause health problems such as constipation and diverticulitis.

Some high-protein diets promote foods such as red meat and full-fat dairy products, which may increase your risk of heart disease.

If you want to follow a high-protein diet, do so only as a short-term weight-loss aid. Also, choose your protein wisely. Good choices include fish, skinless chicken, lean beef, pork and low-fat dairy products. Choose carbs that are high in fiber, such as whole grains and nutrient-dense vegetables and fruit.

It’s always a good idea to talk with your doctor before starting a weight-loss diet. And that’s especially important in this case if you have kidney disease, diabetes or other chronic health condition.

So if you want to continue on high protein diets longer than 6 months know how to alkalize the body chemicals to decrease the proteins and there are supplements that can do that via the pharmacy or look up even online.

Before changing your diet check with your doctor to make sure its cleared ok by the doctor since he knows your entire medical history.

QUOTE FOR TUESDAY:

“Pneumonia does not have effective advocacy.It is not the subject of fund-raising walks or runs. It does not have a ribbon or other symbol around which people rally. It does not get the attention it needs from biomedical scientists or from research funders. More effort is needed now.”

American Thoracic Association

Know the statistics about Pneumonia and see how serious a illness this Dx. is!

   

Final Important facts to know about pneumonia via The American Thoracic Society (https://www.thoracic.org):

 

  1. Pneumonia is an infection of the lung.

The lungs fill with fluid and make breathing difficult. Pneumonia disproportionately affects the young, the elderly, and the immunocompromised. It preys on weakness and vulnerability.

 

  1. Pneumonia is the world’s leading cause of death among children under 5 years of age, accounting for 15% of all deaths of children under 5 years old.There are 120 million episodes of pneumonia per year in children under 5, over 10% of which (14 million) progress to severe episodes. There was an estimated 935,000 deaths from pneumonia in children under the age of five in 2013.

 

  1. In the US, pneumonia is less often fatal for children, but it is still a big problem.  Pneumonia is the #1 most common reason for US children to be hospitalized.

 

  1. For US adults, pneumonia is the most common cause of hospital admissions other than women giving birth. About 1 million adults in the US are hospitalized with pneumonia every year, and about 50,000 die from this disease.

 

  1. While young healthy adults have less risk of pneumonia than the age extremes, it is always a threat.  Half of all non-immunocompromised adults hospitalized for severe pneumonia in the US are younger adults (18-57 years of age). Half the deaths from bacteremic pneumococcal pneumonia occur in people ages 18-64.

 

  1. Older people have higher risk of getting pneumonia, and are more likely to die from it. For most geriatrics it harder for their body to fight infection overall and pneumonia terribly weakens the person’s overall system with many geriatrics already immune compromised in someway.

For US seniors, hospitalization for pneumonia has a greater risk of death compared to any of the other top reasons for hospitalization.

  1. Pneumonia is the most common cause of sepsis and septic shock, causing 50% of all episodes. Sepsis is so common today in acute hospitals that is has gone national to have what we call s “septic code” like how a cardiac arrest in hospitals is either “blue code” or still in some a “red code” (since most hospitals have a “red code” for fires in the hospital. This is how much sepsis is common.  Sepsis is hard to fight which can lead to SARS which in short is all systems in the body failing.  To give you some tangibility in how high let us go to a great resource, The World Health Organization (WHO).  They estimated that today the overall fatality rate for SARS (severe acute respiratory syndrome) patients at 14% to 15%, significantly higher than previous estimates. The agency estimated the rate for people older than 64 years to be more than 50%.  That is how serious the diagnosis sepsis/SARS can be, especially for geriatrics!                                                                                                                                                                                                            
  2. Pneumonia can develop in patients already in the hospital for other reasons. Hospital-acquired pneumonia has a higher mortality rate than any other hospital-acquired infection.

 

  1. Pneumonia can be caused by lots of different types of microbes, and no single one is responsible for as many as 10% of pneumonia cases. For most pneumonia patients, the microbe causing the infection is never identified.

 

  1. Vaccines are available for some but not many causes of pneumonia. The influenza vaccine is effective for those strains circulating that year, so it should be taken again every year. The pneumococcal pneumonia vaccines are recommended for those in higher risk groups (children, immunocompromised individuals, and seniors).                                                                             
  2. In the US and the rest of the world, viral pneumonias arethe leading cause of hospitalization of infants.  The World Health Organization has set a high priority on developing new vaccines and new therapeutic drugs to tackle theseviral pneumonias that largely have no currently available vaccines or treatments.
  3. Antibiotics can be effective for many of the bacteria that cause pneumonia.For viral causes of pneumonia, antibiotics are ineffective and should not be used. There are few or no treatments for most viral causes of pneumonia.
  4. Antibiotic resistance is growing amongst the bacteria that cause pneumonia.This often arises from the overuse and misuse of antibiotics in and out of the hospital. New and more effective antibiotics are urgently needed.

 

  1. Being on a ventilator raises especially high risk for serious pneumonia.Ventilator-associated pneumonia is more likely to be caused by antibiotic-resistant microbes and can require the highest antibiotic use in the critically ill population.

 

  1. Our changing interactions with the microbial world mean constantly developing new pneumonia risks.Emerging infections can lead to epidemics or pandemics, such as from avian influenza viruses (bird flu), severe acute respiratory system (SARS) coronavirus, Middle East Respiratory Syndrome (MERS) virus, and more. Environmental reservoirs or sources can cause clusters of infection, such as Legionella pneumonia. Bioweapons can cause pneumonia such as from anthrax. Vigilance is needed to prevent pneumonia from becoming an even worse problem than it already is.

 

  1. Patients with pneumonia may need to be hospitalized or even go to the intensive care unit (ICU).After developing pneumonia, it often takes 6-8 weeks until a patient returns to their normal level of functioning and wellbeing.

 

  1. While successful pneumonia treatment often leads to full recovery, it can have longer term consequences.Children who survive pneumonia have increased risk for chronic lung diseases. Adults who survive pneumonia may have worsened exercise ability, cardiovascular disease, cognitive decline, and quality of life for months or years.

 

  1. Pneumonia is a huge burden on our healthcare systems.In the US, pneumonia was one of the top ten most expensive conditions seen during inpatient hospitalizations.  In 2011, pneumonia had an aggregate cost of nearly $10.6 billion for 1.1 million hospital stays.

 

  1. The death rate from pneumonia in the US has had little or no improvement since antibiotics became widespread more than half a century ago.We are not yet winning the battle against pneumonia.

 

  1. Pneumonia does not have effective advocacy.It is not the subject of fund-raising walks or runs. It does not have a ribbon or other symbol around which people rally. It does not get the attention it needs from biomedical scientists or from research funders. More effort is needed now.