Isabel Turner (April 6, 1936 – October 26, 2021) was a British-born Canadian politician, who was Mayor of Kingston, Ontario from 2000 to 2003. She served as a board member of the St. Lawrence Parks Commission of the Ontario Ministry of Tourism and Culture between 2006 and 2012.
101-517: Turner died of pneumonia at Kingston General Hospital on October 26, 2021, at the age of 85. Turner was born in the village of Kingston in Moray , Scotland, and emigrated to Canada in 1956. She married dentist John Turner, also from Kingston, and they had three children, and six grandchildren together. She lived in Kingston, Ontario , from 1968 until her death. Turner entered politics in 1980 and became
202-725: A decreased level of consciousness . Bacterial and viral cases of pneumonia usually result in similar symptoms. Some causes are associated with classic, but non-specific, clinical characteristics. Pneumonia caused by Legionella may occur with abdominal pain, diarrhea , or confusion. Pneumonia caused by Streptococcus pneumoniae is associated with rusty colored sputum. Pneumonia caused by Klebsiella may have bloody sputum often described as "currant jelly". Bloody sputum (known as hemoptysis ) may also occur with tuberculosis , Gram-negative pneumonia, lung abscesses and more commonly acute bronchitis . Pneumonia caused by Mycoplasma pneumoniae may occur in association with swelling of
303-516: A leading cause of death in developing countries, and also among the very old, the very young, and the chronically ill. Pneumonia often shortens the period of suffering among those already close to death and has thus been called "the old man's friend". People with infectious pneumonia often have a productive cough , fever accompanied by shaking chills , shortness of breath , sharp or stabbing chest pain during deep breaths, and an increased rate of breathing . In elderly people, confusion may be
404-401: A stethoscope or increased respiratory rate. Grunting and nasal flaring may be other useful signs in children less than five years old. Lack of wheezing is an indicator of Mycoplasma pneumoniae in children with pneumonia, but as an indicator it is not accurate enough to decide whether or not macrolide treatment should be used. The presence of chest pain in children with pneumonia doubles
505-459: A " toxic food environment ", where fat- and sugar-laden foods have taken precedence over healthy nutritious foods. In these developed countries, overnutrition can be prevented by choosing the right kind of food. More fast food is consumed per capita in the United States than in any other country. This mass consumption of fast food results from its affordability and accessibility. Fast food, which
606-418: A chest radiograph is recommended. Findings do not always match the severity of disease and do not reliably separate between bacterial and viral infection. X-ray presentations of pneumonia may be classified as lobar pneumonia , bronchopneumonia , lobular pneumonia , and interstitial pneumonia . Bacterial, community-acquired pneumonia classically show lung consolidation of one lung segmental lobe , which
707-645: A community. In the study by Ghattas et al. (2020), the probability of overnutrition is significantly higher in higher-income families than in disadvantaged families. High food prices is a major factor preventing low income households from getting nutritious food For example, Khan and Kraemer (2009) found that in Bangladesh , low socioeconomic status was associated with chronic malnutrition since it inhibited purchase of nutritious foods (like milk, meat, poultry, and fruits). Food shortages may also contribute to malnutritions in countries which lack technology. However, in
808-493: A cough of longer duration, and pulmonary emboli present with acute onset sharp chest pain and shortness of breath. Mild pneumonia should be differentiated from upper respiratory tract infection (URTI). Severe pneumonia should be differentiated from acute heart failure . Pulmonary infiltrates that resolved after giving mechanical ventilation should point to heart failure and atelectasis rather than pneumonia. For recurrent pneumonia, underlying lung cancer, metastasis , tuberculosis,
909-479: A cough or difficulty breathing and a rapid respiratory rate, chest indrawing, or a decreased level of consciousness. A rapid respiratory rate is defined as greater than 60 breaths per minute in children under 2 months old, greater than 50 breaths per minute in children 2 months to 1 year old, or greater than 40 breaths per minute in children 1 to 5 years old. In children, low oxygen levels and lower chest indrawing are more sensitive than hearing chest crackles with
1010-415: A day or two before other signs. Examination of the chest may be normal, but it may show decreased expansion on the affected side. Harsh breath sounds from the larger airways that are transmitted through the inflamed lung are termed bronchial breathing and are heard on auscultation with a stethoscope. Crackles (rales) may be heard over the affected area during inspiration . Percussion may be dulled over
1111-800: A foreign bodies, immunosuppression, and hypersensitivity should be suspected. Prevention includes vaccination , environmental measures, and appropriate treatment of other health problems. It is believed that, if appropriate preventive measures were instituted globally, mortality among children could be reduced by 400,000; and, if proper treatment were universally available, childhood deaths could be decreased by another 600,000. Vaccination prevents against certain bacterial and viral pneumonias both in children and adults. Influenza vaccines are modestly effective at preventing symptoms of influenza, The Centers for Disease Control and Prevention (CDC) recommends yearly influenza vaccination for every person 6 months and older. Immunizing health care workers decreases
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#17328910848211212-418: A global increase in food insecurity and hunger between 2011 and 2020. In 2015, 795 million people (about one in ten people on earth) had undernutrition. It is estimated that between 691 and 783 million people in the world faced hunger in 2022. According to UNICEF, 2.4 billion people were moderately or severely food insecure in 2022, 391 million more than in 2019. These increases are partially related to
1313-486: A group of undernourished children in a hospital in Mexico City , Mexico. They defined three categories of malnutrition: first, second, and third degree. The degree of malnutrition is calculated based on a child's body size compared to the median weight for their age. The risk of death increases with increasing degrees of malnutrition. An adaptation of Gomez's original classification is still used today. While it provides
1414-400: A higher dose of radiation, and cannot be done at bedside. Lung ultrasound may also be useful in helping to make the diagnosis. Ultrasound is radiation free and can be done at bedside. However, ultrasound requires specific skills to operate the machine and interpret the findings. It may be more accurate than chest X-ray. In people managed in the community, determining the causative agent
1515-462: A history of smoking, a poor ability to cough (such as following a stroke), and a weak immune system . Vaccines to prevent certain types of pneumonia (such as those caused by Streptococcus pneumoniae bacteria, linked to influenza , or linked to COVID-19 ) are available. Other methods of prevention include hand washing to prevent infection, and not smoking. Treatment depends on the underlying cause. Pneumonia believed to be due to bacteria
1616-403: A lack of breastfeeding may contribute to undernourishment. Anorexia nervosa and bariatric surgery can also cause malnutrition. Undernutrition due to lack of adequate breastfeeding is associated with the deaths of an estimated one million children annually. Illegal advertising of breast-milk substitutes contributed to malnutrition and continued three decades after its 1981 prohibition under
1717-422: A lack of education about proper nutrition, only having access to a single food source, or from poor healthcare access and unhealthy environments. It is not just the total amount of calories that matters but specific nutritional deficiencies such as vitamin A deficiency, iron deficiency or zinc deficiency can also increase risk of death. Overnutrition caused by overeating is also a form of malnutrition. In
1818-612: A nation's development." Among those affected, very few people experience the most visible and severe effects: disabling goiters , cretinism and dwarfism . These effects occur most commonly in mountain villages. However, 16 percent of the world's people have at least mild goiter (a swollen thyroid gland in the neck)." Social conditions have a significant influence on the health of people. The social determinants of undernutrition mainly include poor education, poverty, disease burden and lack of women's empowerment. Identifying and addressing these determinants can eliminate undernutrition in
1919-595: A new classification system for malnutrition. Instead of using just weight for age measurements, Waterlow's system combines weight-for-height (indicating acute episodes of malnutrition) with height-for-age to show the stunting that results from chronic malnutrition. One advantage of the Waterlow classification is that weight for height can be calculated even if a child's age is unknown. The World Health Organization frequently uses these classifications of malnutrition, with some modifications. Undernutrition weakens every part of
2020-877: A result of micronutrient deficiencies. It adversely affects physical and mental functioning, and causes changes in body composition and body cell mass. Undernutrition is a major health problem, causing the highest mortality rate in children, particularly in those under 5 years, and is responsible for long-lasting physiologic effects. It is a barrier to the complete physical and mental development of children. Undernutrition can manifest as stunting, wasting, and underweight. If undernutrition occurs during pregnancy, or before two years of age, it may result in permanent problems with physical and mental development. Extreme undernutrition can cause starvation , chronic hunger, Severe Acute Malnutrition (SAM), and/or Moderate Acute Malnutrition (MAM). The signs and symptoms of micronutrient deficiencies depend on which micronutrient
2121-412: A sustained diet that is deficient in both protein and energy. This causes their metabolism to adapt to prolong survival. The primary symptoms are severe wasting, leaving little or no edema ; minimal subcutaneous fat ; and abnormal serum albumin levels. It is traditionally seen in cases of famine , significant food restriction, or severe anorexia . Conditions are characterized by extreme wasting of
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#17328910848212222-437: A very dry mouth; decreased urine output and/or dark urine; increased heart rate with decreasing blood pressure; and altered mental status . Protein-calorie malnutrition can cause cognitive impairments . This most commonly occurs in people who were malnourished during a "critical period ... from the final third of gestation to the first 2 years of life". For example, in children under two years of age, iron deficiency anemia
2323-420: A way to compare malnutrition within and between populations, this classification system has been criticized for being " arbitrary " and for not considering overweight as a form of malnutrition. Also, height alone may not be the best indicator of malnutrition; children who are born prematurely may be considered short for their age even if they have good nutrition. In the 1970s, John Conrad Waterlow established
2424-465: Is a deficiency , excess, or imbalance of energy, protein and other nutrients which adversely affects the body's tissues and form. Malnutrition is a category of diseases that includes undernutrition and overnutrition . Undernutrition is a lack of nutrients, which can result in stunted growth , wasting , and underweight . A surplus of nutrients causes overnutrition, which can result in obesity . In some developing countries , overnutrition in
2525-411: Is another rare cause due to lipids entering the lung. These lipids can either be inhaled or spread to the lungs from elsewhere in the body. Pneumonia frequently starts as an upper respiratory tract infection that moves into the lower respiratory tract. It is a type of pneumonitis (lung inflammation). The normal flora of the upper airway give protection by competing with pathogens for nutrients. In
2626-996: Is associated with Chlamydia psittaci ; farm animals with Coxiella burnetti ; aspiration of stomach contents with anaerobic organisms; and cystic fibrosis with Pseudomonas aeruginosa and Staphylococcus aureus . Streptococcus pneumoniae is more common in the winter, and it should be suspected in persons aspirating a large number of anaerobic organisms. In adults, viruses account for about one third of pneumonia cases, and in children for about 15% of them. Commonly implicated agents include rhinoviruses , coronaviruses , influenza virus , respiratory syncytial virus (RSV), adenovirus , and parainfluenza . Herpes simplex virus rarely causes pneumonia, except in groups such as newborns, persons with cancer, transplant recipients, and people with significant burns. After organ transplantation or in otherwise immunocompromised persons, there are high rates of cytomegalovirus pneumonia. Those with viral infections may be secondarily infected with
2727-448: Is associated with an increased risk of pneumonia. Approximately 10% of people who require mechanical ventilation develop ventilator-associated pneumonia , and people with a gastric feeding tube have an increased risk of developing aspiration pneumonia . Moreover, the misplacement of a feeding tube can lead to aspiration pneumonia. 28% of tube malposition results in pneumonia. As with Avanos Medical 's feeding tube placement system,
2828-506: Is available for adults, and has been found to decrease the risk of invasive pneumococcal disease by 74%, but there is insufficient evidence to suggest using the pneumococcal vaccine to prevent pneumonia or death in the general adult population. The CDC recommends that young children and adults over the age of 65 receive the pneumococcal vaccine, as well as older children or younger adults who have an increased risk of getting pneumococcal disease. The pneumococcal vaccine has been shown to reduce
2929-644: Is due primarily to cytokine -induced systemic inflammation . In the developed world , these infections are most common in people returning from travel or in immigrants. Around the world, parasitic pneumonia is most common in the immunodeficient. Idiopathic interstitial pneumonia or noninfectious pneumonia is a class of diffuse lung diseases . They include diffuse alveolar damage , organizing pneumonia , nonspecific interstitial pneumonia , lymphocytic interstitial pneumonia , desquamative interstitial pneumonia , respiratory bronchiolitis interstitial lung disease , and usual interstitial pneumonia . Lipoid pneumonia
3030-796: Is due to infections caused primarily by bacteria or viruses and less commonly by fungi and parasites . Although more than 100 strains of infectious agents have been identified, only a few are responsible for the majority of cases. Mixed infections with both viruses and bacteria may occur in roughly 45% of infections in children and 15% of infections in adults. A causative agent may not be isolated in about half of cases despite careful testing. In an active population-based surveillance for community-acquired pneumonia requiring hospitalization in five hospitals in Chicago and Nashville from January 2010 through June 2012, 2259 patients were identified who had radiographic evidence of pneumonia and specimens that could be tested for
3131-574: Is highest among children under five. In 2021, 148.1 million children under five years old were stunted, 45 million were wasted, and 37 million were overweight or obese. The same year, an estimated 45% of deaths in children were linked to undernutrition. As of 2020 , the prevalence of wasting among children under five in South Asia was reported to be 16% moderately or severely wasted. As of 2022 , UNICEF reported this prevalence as having slightly improved, but still being at 14.8%. In Asia, India has one of
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3232-460: Is important to treatment, as it correlates to which pathogens are likely suspects, which mechanisms are likely, which antibiotics are likely to work or fail, and which complications can be expected based on the person's health status. Community-acquired pneumonia (CAP) is acquired in the community, outside of health care facilities. Compared with healthcare-associated pneumonia, it is less likely to involve multidrug-resistant bacteria. Although
3333-445: Is increased. Bacteria are the most common cause of community-acquired pneumonia (CAP), with Streptococcus pneumoniae isolated in nearly 50% of cases. Other commonly isolated bacteria include Haemophilus influenzae in 20%, Chlamydophila pneumoniae in 13%, and Mycoplasma pneumoniae in 3% of cases; Staphylococcus aureus ; Moraxella catarrhalis ; and Legionella pneumophila . A number of drug-resistant versions of
3434-448: Is known as lobar pneumonia. However, findings may vary, and other patterns are common in other types of pneumonia. Aspiration pneumonia may present with bilateral opacities primarily in the bases of the lungs and on the right side. Radiographs of viral pneumonia may appear normal, appear hyper-inflated, have bilateral patchy areas, or present similar to bacterial pneumonia with lobar consolidation. Radiologic findings may not be present in
3535-534: Is lacking. However, undernourished people are often thin and short, with very poor energy levels; and swelling in the legs and abdomen is also common. People who are undernourished often get infections and frequently feel cold. Micronutrient undernutrition results from insufficient intake of vitamins and minerals. Worldwide, deficiencies in iodine , Vitamin A , and iron are the most common. Children and pregnant women in low-income countries are at especially high risk for micronutrient deficiencies. Anemia
3636-403: Is likely to affect brain function acutely, and probably also chronically. Similarly, folate deficiency has been linked to neural tube defects . Iodine deficiency is "the most common preventable cause of mental impairment worldwide." "Even moderate [iodine] deficiency, especially in pregnant women and infants , lowers intelligence by 10 to 15 I.Q. points , shaving incalculable potential off
3737-493: Is low in cost and nutrition, is high in calories. Due to increasing urbanization and automation , people are living more sedentary lifestyles. These factors combine to make weight gain difficult to avoid. Overnutrition also occurs in developing countries. It has appeared in parts of developing countries where income is on the rise. It is also a problem in countries where hunger and poverty persist. Economic development, rapid urbanisation and shifting dietary patterns have increased
3838-449: Is more common in developing countries . Stunting is more prevalent in urban slums than in rural areas. Studies on malnutrition have the population categorised into different groups including infants, under-five children, children, adolescents, pregnant women, adults and the elderly population. The use of different growth references in different studies leads to variances in the undernutrition prevalence reported in different studies. Some of
3939-576: Is most common in the Southwestern United States. The number of cases of fungal pneumonia has been increasing in the latter half of the 20th century due to increasing travel and rates of immunosuppression in the population. For people infected with HIV/AIDS , PCP is a common opportunistic infection . A variety of parasites can affect the lungs, including Toxoplasma gondii , Strongyloides stercoralis , Ascaris lumbricoides , and Plasmodium malariae . These organisms typically enter
4040-666: Is most commonly caused by iron deficiency , but can also result from other micronutrient deficiencies and diseases. This condition can have major health consequences. It is possible to have overnutrition simultaneously with micronutrient deficiencies; this condition is termed the double burden of malnutrition . 'Undernutrition' sometimes refers specifically to protein–energy malnutrition (PEM). This condition involves both micronutrient deficiencies and an imbalance of protein intake and energy expenditure. It differs from calorie restriction in that calorie restriction may not result in negative health effects. Hypoalimentation (underfeeding)
4141-530: Is not cost-effective and typically does not alter management. For people who do not respond to treatment, sputum culture should be considered, and culture for Mycobacterium tuberculosis should be carried out in persons with a chronic productive cough. Microbiological evaluation is also indicated in severe pneumonia, alcoholism, asplenia , immunosuppression, HIV infection, and those being empirically treated for MRSA of pseudomonas. Although positive blood culture and pleural fluid culture definitively establish
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4242-406: Is one cause of undernutrition. Two forms of PEM are kwashiorkor and marasmus ; both commonly coexist. Kwashiorkor is primarily caused by inadequate protein intake. Its symptoms include edema , wasting, liver enlargement , hypoalbuminaemia , and steatosis ; the condition may also cause depigmentation of skin and hair. The disorder is further identified by a characteristic swelling of
4343-465: Is sometimes called MCAP (medical care–associated pneumonia). People may become infected with pneumonia in a hospital; this is defined as pneumonia not present at the time of admission (symptoms must start at least 48 hours after admission). It is likely to involve hospital-acquired infections , with higher risk of multidrug-resistant pathogens. People in a hospital often have other medical conditions, which may make them more susceptible to pathogens in
4444-723: Is sometimes more broadly applied to any condition resulting in inflammation of the lungs (caused for example by autoimmune diseases , chemical burns or drug reactions); however, this inflammation is more accurately referred to as pneumonitis . Factors that predispose to pneumonia include smoking, immunodeficiency , alcoholism, chronic obstructive pulmonary disease , sickle cell disease (SCD), asthma , chronic kidney disease , liver disease , and biological aging . Additional risks in children include not being breastfed , exposure to cigarette smoke and other air pollution, malnutrition, and poverty. The use of acid-suppressing medications – such as proton-pump inhibitors or H2 blockers –
4545-432: Is treated with antibiotics . If the pneumonia is severe, the affected person is generally hospitalized. Oxygen therapy may be used if oxygen levels are low. Each year, pneumonia affects about 450 million people globally (7% of the population) and results in about 4 million deaths. With the introduction of antibiotics and vaccines in the 20th century, survival has greatly improved. Nevertheless, pneumonia remains
4646-490: Is uncommon, but occurs more commonly in individuals with weakened immune systems due to AIDS, immunosuppressive drugs , or other medical problems. It is most often caused by Histoplasma capsulatum , Blastomyces , Cryptococcus neoformans , Pneumocystis jiroveci ( pneumocystis pneumonia , or PCP), and Coccidioides immitis . Histoplasmosis is most common in the Mississippi River basin , and coccidioidomycosis
4747-486: The WHO International Code of Marketing Breast Milk Substitutes . Maternal malnutrition can also factor into the poor health or death of a baby. Over 800,000 neonatal deaths have occurred because of deficient growth of the fetus in the mother's womb . Deriving too much of one's diet from a single source, such as eating almost exclusively potato, maize or rice, can cause malnutrition. This may either be from
4848-480: The immune system . Protein and energy undernutrition increases susceptibility to infection; so do deficiencies of specific micronutrients (including iron, zinc , and vitamins). In communities or areas that lack access to safe drinking water , these additional health risks present a critical problem. Undernutrition plays a major role in the onset of active tuberculosis . It also raises the risk of HIV transmission from mother to child, and increases replication of
4949-536: The prevalence of moderate and severe wasting could increase by 14% due to COVID-19; coupled with reductions in nutrition and health services coverage, this could result in over 128,000 additional deaths among children under 5 in 2020 alone. Although COVID-19 is less severe in children than in adults, the risk of severe disease increases with undernutrition. Other major causes of hunger include manmade conflicts, climate changes , and economic downturns. Undernutrition can occur either due to protein-energy wasting or as
5050-447: The right to food , Jean Ziegler proposes that agricultural waste , such as corn cobs and banana leaves , should be used as fuel instead of crops. In some developing countries, overnutrition (in the form of obesity) is beginning to appear in the same communities where malnutrition occurs. Overnutrition increases with urbanisation, food commercialisation and technological developments and increases physical inactivity. Variations in
5151-630: The CORTRAK* 2 EAS, which was recalled in May 2022 by the FDA due to adverse events reported, including pneumonia, caused a total of 60 injuries and 23 patient deaths, as communicated by the FDA. For people with certain variants of the FER gene , the risk of death is reduced in sepsis caused by pneumonia. However, for those with TLR6 variants, the risk of getting Legionnaires' disease
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#17328910848215252-556: The Kingston community, and she thereafter had a public library branch in the Kingston Frontenac Public Library system named in her honour. Pneumonia Pneumonia is an inflammatory condition of the lung primarily affecting the small air sacs known as alveoli . Symptoms typically include some combination of productive or dry cough , chest pain , fever, and difficulty breathing . The severity of
5353-511: The United States, more than half of all adults are now overweight—a condition that, like hunger, increases susceptibility to disease and disability, reduces worker productivity , and lowers life expectancy . Overeating is much more common in the United States, since most people have adequate access to food. Many parts of the world have access to a surplus of non-nutritious food. Increased sedentary lifestyles also contribute to overnutrition. Yale University psychologist Kelly Brownell calls this
5454-513: The above infections are becoming more common, including drug-resistant Streptococcus pneumoniae (DRSP) and methicillin-resistant Staphylococcus aureus (MRSA). The spreading of organisms is facilitated by certain risk factors. Alcoholism is associated with Streptococcus pneumoniae , anaerobic organisms , and Mycobacterium tuberculosis ; smoking facilitates the effects of Streptococcus pneumoniae , Haemophilus influenzae , Moraxella catarrhalis , and Legionella pneumophila . Exposure to birds
5555-560: The additional feature of pulmonary consolidation . Pneumonia is most commonly classified by where or how it was acquired: community-acquired, aspiration, healthcare-associated , hospital-acquired , and ventilator-associated pneumonia. It may also be classified by the area of the lung affected: lobar, bronchial pneumonia and acute interstitial pneumonia ; or by the causative organism. Pneumonia in children may additionally be classified based on signs and symptoms as non-severe, severe, or very severe. The setting in which pneumonia develops
5656-421: The affected lung, and increased, rather than decreased, vocal resonance distinguishes pneumonia from a pleural effusion . A chest radiograph is frequently used in diagnosis. In people with mild disease, imaging is needed only in those with potential complications, those not having improved with treatment, or those in which the cause is uncertain. If a person is sufficiently sick to require hospitalization,
5757-421: The alveoli, resulting in the consolidation seen on chest X-ray. Viruses may reach the lung by a number of different routes. Respiratory syncytial virus is typically contracted when people touch contaminated objects and then touch their eyes or nose. Other viral infections occur when contaminated airborne droplets are inhaled through the nose or mouth. Once in the upper airway, the viruses may make their way into
5858-517: The bacteria Streptococcus pneumoniae , Staphylococcus aureus , or Haemophilus influenzae , particularly when other health problems are present. Different viruses predominate at different times of the year; during flu season , for example, influenza may account for more than half of all viral cases. Outbreaks of other viruses also occur occasionally, including hantaviruses and coronaviruses. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can also result in pneumonia. Fungal pneumonia
5959-544: The belly , and extremities which disguises the patient's undernourished condition. 'Kwashiorkor' means 'displaced child' and is derived from the Ga language of coastal Ghana in West Africa. It means "the sickness the baby gets when the next baby is born," as it often occurs when the older child is deprived of breastfeeding and weaned to a diet composed largely of carbohydrates. Marasmus (meaning 'to waste away') can result from
6060-449: The blood. Once in the lungs, bacteria may invade the spaces between cells and between alveoli, where the macrophages and neutrophils (defensive white blood cells ) attempt to inactivate the bacteria. The neutrophils also release cytokines, causing a general activation of the immune system. This leads to the fever, chills, and fatigue common in bacterial pneumonia. The neutrophils, bacteria, and fluid from surrounding blood vessels fill
6161-511: The body through direct contact with the skin, ingestion, or via an insect vector. Except for Paragonimus westermani , most parasites do not specifically affect the lungs but involve the lungs secondarily to other sites. Some parasites, in particular those belonging to the Ascaris and Strongyloides genera, stimulate a strong eosinophilic reaction, which may result in eosinophilic pneumonia . In other infections, such as malaria, lung involvement
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#17328910848216262-546: The cause and support decisions about who should receive antibiotics. Antibiotics are encouraged if the procalcitonin level reaches 0.25 μg/L, strongly encouraged if it reaches 0.5 μg/L, and strongly discouraged if the level is below 0.10 μg/L. In people requiring hospitalization, pulse oximetry , chest radiography and blood tests – including a complete blood count , serum electrolytes , C-reactive protein level, and possibly liver function tests – are recommended. The diagnosis of influenza-like illness can be made based on
6363-652: The condition is variable. Pneumonia is usually caused by infection with viruses or bacteria, and less commonly by other microorganisms . Identifying the responsible pathogen can be difficult. Diagnosis is often based on symptoms and physical examination . Chest X-rays , blood tests, and culture of the sputum may help confirm the diagnosis. The disease may be classified by where it was acquired, such as community- or hospital-acquired or healthcare-associated pneumonia. Risk factors for pneumonia include cystic fibrosis , chronic obstructive pulmonary disease (COPD), sickle cell disease , asthma , diabetes , heart failure,
6464-427: The condition, but they are associated with side effects. Zanamivir or oseltamivir decrease the chance that people who are exposed to the virus will develop symptoms; however, it is recommended that potential side effects are taken into account. Smoking cessation and reducing indoor air pollution , such as that from cooking indoors with wood, crop residues or dung , are both recommended. Smoking appears to be
6565-611: The definition of malnutrition to include "all its forms, including obesity, undernutrition, and other dietary risks." The World Health Organization and The Lancet Commission have also identified "[t]he double burden of malnutrition", which occurs from "the coexistence of overnutrition (overweight and obesity) alongside undernutrition (stunted growth and wasting)." It is estimated that nearly one in three persons globally has at least one form of malnutrition: wasting , stunting , vitamin or mineral deficiency, overweight, obesity, or diet-related noncommunicable diseases. Undernutrition
6666-524: The developing world, eighty percent of malnourished children live in countries that produce food surpluses, according to estimates from the Food and Agriculture Organization (FAO) . The economist Amartya Sen observes that, in recent decades, famine has always been a problem of food distribution , purchasing power , and/or poverty, since there has always been enough food for everyone in the world. There are also sociopolitical causes of malnutrition. For example,
6767-404: The diagnosis is unlikely. However, the underlying cause can be difficult to confirm, as there is no definitive test able to distinguish between bacterial and non-bacterial cause. The overall impression of a physician appears to be at least as good as decision rules for making or excluding the diagnosis. The World Health Organization has defined pneumonia in children clinically based on either
6868-508: The diagnosis of the type of micro-organism involved, a positive sputum culture has to be interpreted with care for the possibility of colonisation of respiratory tract. Testing for other specific organisms may be recommended during outbreaks, for public health reasons. In those hospitalized for severe disease, both sputum and blood cultures are recommended, as well as testing the urine for antigens to Legionella and Streptococcus . Viral infections, can be confirmed via detection of either
6969-758: The early stages of the disease, especially in the presence of dehydration, or may be difficult to interpret in the obese or those with a history of lung disease. Complications such as pleural effusion may also be found on chest radiographs. Laterolateral chest radiographs can increase the diagnostic accuracy of lung consolidation and pleural effusion. A CT scan can give additional information in indeterminate cases and provide more details in those with an unclear chest radiograph (for example occult pneumonia in chronic obstructive pulmonary disease). They can be used to exclude pulmonary embolism and fungal pneumonia , and detect lung abscesses in those who are not responding to treatments. However, CT scans are more expensive, have
7070-515: The elderly, undernutrition is more commonly due to physical, psychological, and social factors, not a lack of food. Age-related reduced dietary intake due to chewing and swallowing problems, sensory decline, depression, imbalanced gut microbiome, poverty and loneliness are major contributors to undernutrition in the elderly population. Malnutrition is also attributed due to wrong diet plan adopted by people who aim to reduce their weight without medical practitioners or nutritionist advice. There has been
7171-543: The first woman councillor on Kingston Township Council. Elected in 1985, she went on to serve as reeve for the next 12 years, as well as on the Frontenac County Council. She was elected mayor of the amalgamated City of Kingston in 2000 and served in that position until 2003, when she was succeeded by Harvey Rosen . In 2002, she was awarded the Queen's Golden Jubilee Medal in recognition of her many contributions to
7272-428: The form of obesity is beginning to appear within the same communities as undernutrition. Most clinical studies use the term 'malnutrition' to refer to undernutrition. However, the use of 'malnutrition' instead of 'undernutrition' makes it impossible to distinguish between undernutrition and overnutrition, a less acknowledged form of malnutrition. Accordingly, a 2019 report by The Lancet Commission suggested expanding
7373-460: The growth references used in studies include the National Center for Health Statistics (NCHS) growth charts, WHO reference 2007, Centers for Disease Control and Prevention (CDC) growth charts, National Health and Nutrition Examination Survey (NHANES), WHO reference 1995, Obesity Task Force (IOTF) criteria and Indian Academy of Pediatrics (IAP) growth charts. The prevalence of undernutrition
7474-698: The health status of individuals in the same society are associated with the societal structure and an individual's socioeconomic status which leads to income inequality, racism, educational differences and lack of opportunities. Infectious diseases which increase nutrient requirements, such as gastroenteritis , pneumonia , malaria , and measles , can cause malnutrition. So can some chronic illnesses, especially HIV/AIDS . Malnutrition can also result from abnormal nutrient loss due to diarrhea or chronic small bowel illnesses, like Crohn's disease or untreated coeliac disease . "Secondary malnutrition" can result from increased energy expenditure. In infants,
7575-615: The highest burden of wasting with over 20% wasted children. However, the burden of undernutrition among under-five children in African countries is much higher. A pooled analysis of the prevalence of chronic undernutrition among under-five children in East Africa was identified to be 33.3%. This prevalence of undernutrition among under-five children ranged from 21.9% in Kenya to 53% in Burundi. In Tanzania,
7676-634: The hospital. Ventilator-associated pneumonia occurs in people breathing with the help of mechanical ventilation. Ventilator-associated pneumonia is specifically defined as pneumonia that arises more than 48 to 72 hours after endotracheal intubation . Several diseases can present with similar signs and symptoms to pneumonia, such as: chronic obstructive pulmonary disease, asthma, pulmonary edema , bronchiectasis , lung cancer, and pulmonary emboli . Unlike pneumonia, asthma and COPD typically present with wheezing, pulmonary edema presents with an abnormal electrocardiogram , cancer and bronchiectasis present with
7777-423: The immediate risk factors has become a major health priority. The recent evidence on the impact of diet-induced obesity in fathers and mothers around the time of conception is identified to negatively program the health outcomes of multiple generations. According to UNICEF, at least 1 in every 10 children under five is overweight in 33 countries. In 1956, Gómez and Galvan studied factors associated with death in
7878-582: The latter are no longer rare in CAP, they are still less likely. Prior stays in healthcare-related environments such as hospitals, nursing homes, or hemodialysis centers or a history of receiving domiciliary care can increase patients' risk for CAP caused by multidrug-resistant bacteria. Health care–associated pneumonia (HCAP) is an infection associated with recent exposure to the health care system, including hospitals, outpatient clinics, nursing homes , dialysis centers, chemotherapy treatment, or home care . HCAP
7979-430: The long term. Identification of the social conditions that causes malnutrition in children under five has received significant research attention as it is a major public health problem. Undernutrition most commonly results from a lack of access to high-quality, nutritious food. The household income is a socio-economic variable that influences the access to nutritious food and the probability of under and overnutrition in
8080-431: The lower airways, reflexes of the glottis , actions of complement proteins and immunoglobulins are important for protection. Micro aspiration of contaminated secretions can infect the lower airways and cause pneumonia. The progress of pneumonia is determined by the virulence of the organism; the amount of organism required to start an infection; and the body's immune response against the infection. Most bacteria enter
8181-464: The lungs via small aspirations of organisms residing in the throat or nose. Half of normal people have these small aspirations during sleep. While the throat always contains bacteria, potentially infectious ones reside there only at certain times and under certain conditions. A minority of types of bacteria such as Mycobacterium tuberculosis and Legionella pneumophila reach the lungs via contaminated airborne droplets. Bacteria can also spread via
8282-418: The lungs, many viruses simultaneously affect other organs and thus disrupt other body functions. Viruses also make the body more susceptible to bacterial infections; in this way, bacterial pneumonia can occur at the same time as viral pneumonia. Pneumonia is typically diagnosed based on a combination of physical signs and often a chest X-ray . In adults with normal vital signs and a normal lung examination,
8383-433: The lungs, where they invade the cells lining the airways, alveoli, or lung parenchyma . Some viruses such as measles and herpes simplex may reach the lungs via the blood. The invasion of the lungs may lead to varying degrees of cell death. When the immune system responds to the infection, even more lung damage may occur. Primarily white blood cells, mainly mononuclear cells , generate the inflammation. As well as damaging
8484-400: The lymph nodes in the neck , joint pain , or a middle ear infection . Viral pneumonia presents more commonly with wheezing than bacterial pneumonia. Pneumonia was historically divided into "typical" and "atypical" based on the belief that the presentation predicted the underlying cause. However, evidence has not supported this distinction, therefore it is no longer emphasized. Pneumonia
8585-524: The most prominent sign. The typical signs and symptoms in children under five are fever, cough, and fast or difficult breathing. Fever is not very specific, as it occurs in many other common illnesses and may be absent in those with severe disease, malnutrition or in the elderly. In addition, a cough is frequently absent in children less than 2 months old. More severe signs and symptoms in children may include blue-tinged skin , unwillingness to drink, convulsions, ongoing vomiting, extremes of temperature, or
8686-482: The muscles and a gaunt expression. Excessive consumption of energy-dense foods and drinks and limited physical activity causes overnutrition. It causes overweight, defined as a body mass index (BMI) of 25 or more, and can lead to obesity (a BMI of 30 or more). Obesity has become a major health issue worldwide. Overnutrition is linked to chronic non-communicable diseases like diabetes , certain cancers, and cardiovascular diseases . Hence identifying and addressing
8787-471: The ongoing COVID-19 pandemic , which continues to highlight the weaknesses of current food and health systems. It has contributed to food insecurity , increasing hunger worldwide; meanwhile, lower physical activity during lockdowns has contributed to increases in overweight and obesity. In 2020, experts estimated that by the end of the year, the pandemic could have double the number of people at risk of suffering acute hunger. Similarly, experts estimated that
8888-602: The population of a community might be at increased risk for malnutrition if government is poor and the area lacks health-related services. On a smaller scale, certain households or individuals may be at an even higher risk due to differences in income levels , access to land, or levels of education. Community plays a crucial role in addressing the social causes of malnutrition. For example, communities with high social support and knowledge sharing about social protection programs can enable better public service demands. Better public service demands and social protection programs minimise
8989-566: The prevalence of stunting, among children under five varied from 41% in lowland and 64.5% in highland areas. Undernutrition by underweight and wasting was 11.5% and 2.5% in lowland and 22.% and 1.4% in the highland areas of Tanzania respectively. In South Sudan, the prevalence of undernutrition explained by stunting, underweight and wasting in under-five children were 23.8%, 4.8% and 2.3% respectively. In 28 countries, at least 30% of children were still affected by stunting in 2022. Vitamin A deficiency affects one third of children under age 5 around
9090-421: The probability of Mycoplasma pneumoniae . In general, in adults, investigations are not needed in mild cases. There is a very low risk of pneumonia if all vital signs and auscultation are normal. C-reactive protein (CRP) may help support the diagnosis. For those with CRP less than 20 mg/L without convincing evidence of pneumonia, antibiotics are not recommended. Procalcitonin may help determine
9191-500: The responsible pathogen. Most patients (62%) had no detectable pathogens in their sample, and unexpectedly, respiratory viruses were detected more frequently than bacteria. Specifically, 23% had one or more viruses, 11% had one or more bacteria, 3% had both bacterial and viral pathogens, and 1% had a fungal or mycobacterial infection. "The most common pathogens were human rhinovirus (in 9% of patients), influenza virus (in 6%), and Streptococcus pneumoniae (in 5%)." The term pneumonia
9292-442: The risk and severity of disease. In people with HIV/AIDS and a CD4 count of less than 200 cells/uL the antibiotic trimethoprim/sulfamethoxazole decreases the risk of Pneumocystis pneumonia and is also useful for prevention in those that are immunocompromised but do not have HIV. Malnutrition Malnutrition occurs when an organism gets too few or too many nutrients , resulting in health problems. Specifically, it
9393-519: The risk of community acquired pneumonia in people with chronic obstructive pulmonary disease, but does not reduce mortality or the risk of hospitalization for people with this condition. People with COPD are recommended by a number of guidelines to have a pneumococcal vaccination. Other vaccines for which there is support for a protective effect against pneumonia include pertussis , varicella , and measles . When influenza outbreaks occur, medications such as amantadine or rimantadine may help prevent
9494-455: The risk of malnutrition in these communities. It is argued that commodity speculators are increasing the cost of food. As the real-estate bubble in the United States was collapsing, it is said that trillions of dollars moved to invest in food and primary commodities, causing the 2007–2008 food price crisis . The use of biofuels as a replacement for traditional fuels raises the price of food. The United Nations special rapporteur on
9595-521: The risk of viral pneumonia among their patients. Vaccinations against Haemophilus influenzae and Streptococcus pneumoniae have good evidence to support their use. There is strong evidence for vaccinating children under the age of 2 against Streptococcus pneumoniae ( pneumococcal conjugate vaccine ). Vaccinating children against Streptococcus pneumoniae has led to a decreased rate of these infections in adults, because many adults acquire infections from children. A Streptococcus pneumoniae vaccine
9696-527: The signs and symptoms; however, confirmation of an influenza infection requires testing. Thus, treatment is frequently based on the presence of influenza in the community or a rapid influenza test . Adults 65 years old or older, as well as cigarette smokers and people with ongoing medical conditions are at increased risk for pneumonia. Physical examination may sometimes reveal low blood pressure , high heart rate , or low oxygen saturation . The respiratory rate may be faster than normal, and this may occur
9797-468: The single biggest risk factor for pneumococcal pneumonia in otherwise-healthy adults. Hand hygiene and coughing into one's sleeve may also be effective preventative measures. Wearing surgical masks by the sick may also prevent illness. Appropriately treating underlying illnesses (such as HIV/AIDS, diabetes mellitus , and malnutrition) can decrease the risk of pneumonia. In children less than 6 months of age, exclusive breast feeding reduces both
9898-844: The virus . Undernutrition can cause vitamin-deficiency-related diseases like scurvy and rickets . As undernutrition worsens, those affected have less energy and experience impairment in brain functions. This can make it difficult (or impossible) for them to perform the tasks needed to acquire food, earn an income, or gain an education. Undernutrition can also cause acute problems, like hypoglycemia (low blood sugar ). This condition can cause lethargy, limpness, seizures , and loss of consciousness . Children are particularly at risk and can become hypoglycemic after 4 to 6 hours without food. Dehydration can also occur in malnourished people, and can be life-threatening, especially in babies and small children. There are many different signs of dehydration in undernourished people. These can include sunken eyes;
9999-496: The virus or its antigens with culture or polymerase chain reaction (PCR), among other techniques. Mycoplasma , Legionella , Streptococcus , and Chlamydia can also be detected using PCR techniques on bronchoalveolar lavage and nasopharyngeal swab . The causative agent is determined in only 15% of cases with routine microbiological tests. Pneumonitis refers to lung inflammation; pneumonia refers to pneumonitis, usually due to infection but sometimes non-infectious, that has
10100-420: The world – 42% – were unable to afford a healthy diet in 2021. Certain groups have higher rates of undernutrition, including elderly people and women (in particular while pregnant or breastfeeding children under five years of age). Undernutrition is an increasing health problem in people aged over 65 years, even in developed countries, especially among nursing home residents and in acute care hospitals. In
10201-472: The world, leading to 670,000 deaths and 250,000–500,000 cases of blindness . Vitamin A supplementation has been shown to reduce all-cause mortality by 12 to 24%. As of June 2021, 1.9 billion adults were overweight or obese, and 462 million adults were underweight. Globally, two billion people had iodine deficiency in 2017. In 2020, 900 million women and children had anemia, which is often caused by iron deficiency. More than 3.1 billion people in
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