The impact of adherence to community-acquired pneumonia (CAP) management guidelines on improving clinical outcomes in hospitalized patients

Objectives: Community-acquired pneumonia (CAP) is linked with high morbidity and mortality, particularly among the elderly. Because of the high incidence and accompanying financial expenses, accurate diagnosis and adequate care of this group hospitalized with CAP are required. The purpose of the study was to assess the level of adherence to CAP national guidelines at a private hospital, as well as the impact of adherence to these national recommendations on clinical outcomes. Methods: Data from electronic medical records of adult patients hospitalized with CAP between 2018 and 2019 were retrieved for a quantitative observational retrospective cohort research. Results: This study comprised 159 patients, with 76 patients (47.8%) receiving therapy according to the recommendations of the guidelines. A total of 75 (98.7%) of those patients were hospitalized across the ICU wards. In contrast, 98.4% (64/65) of patients who had received empiric antibiotic treatment within isolation floors were non-compliant. There was a statistically significant relationship between the level of adherence to CAP clinical guidelines and the following variables: The 72-hour reassessment (P = 0.01), medications altered OR retained when culture findings were revealed (P = 0.01), primary diagnosis (P = 0.028), and total intended period of antibiotic therapy (P = 0.007). Conclusions: According to the findings of this study, higher adherence to the guidelines amongst ICU patients was linked to better outcomes, such as a significant reduction in the overall planned period of antibiotic therapy. (AU)

Quantification of Total Phenols and Antioxidants in Coffee Samples of Different Origins and Evaluation of the Effect of Degree of Roasting on Their Levels.

Phenolic and antioxidant compounds have received considerable attention due to their beneficial effects on human health. The aim of this study is to determine the content of total phenols and antioxidants in fifty-two coffee samples of different origins, purchased from the Jordanian local market, and investigate the effect of the degree of roasting on the levels of these compounds. The coffee samples were extracted using the hot water extraction method, while Folin−Ciocalteu (FC) and 1,1-diphenyl-2-picrylhydrazyl (DPPH) assay methods were used to analyze these compounds. The results showed that the highest content of total phenol (16.55 mg/g equivalent to GAE) was found in the medium roasted coffee, and the highest content of antioxidants (1.07 mg/g equivalent to TEAC) content was found in the green coffee. Only light and medium roasted coffee showed a significant correlation (p < 0.05, R2 > 0.95) between the average of total phenolic and antioxidant content. A negative correlation between the antioxidant content and the degree of roasting (p < 0.05, R2 > 0.95) were shown, while it did not correlate with phenolic contents. Previously, a positive correlation between antioxidant and chlorogenic acids content was observed, with no correlation between the origin of coffee samples nor heavy metal content, which was previously determined for the same coffee samples. These findings suggest that the antioxidant content for coffee extracts is largely determined by its chlorogenic acid content, rather than the coffee origin or total phenolic and heavy metals content.

Quantification of Caffeine and Chlorogenic Acid in Green and Roasted Coffee Samples Using HPLC-DAD and Evaluation of the Effect of Degree of Roasting on Their Levels.

Chlorogenic acid and caffeine are among the important components in coffee beans, determining the taste and aroma. In addition, phenols and antioxidants content possess vital health values. The main aim of this study is to determine the levels of caffeine and chlorogenic acid in several coffee samples of different origins and degrees of roasting. The coffee samples were extracted using hot water. The levels of caffeine and chlorogenic acid were quantified using high-performance liquid chromatography (HPLC) equipped with a diode array detector, a reverse phase system, and an ODS column (C18). Total phenol and antioxidant contents were previously determined for the same samples. The results showed that the highest content of caffeine was found in the medium roasted coffee (203.63 mg/L), and the highest content of chlorogenic acid content was found in the green coffee (543.23 mg/L). The results demonstrated a negative correlation between the chlorogenic acid levels with the degree of roasting, while it showed a positive correlation between the caffeine levels with the degree of roasting till a certain point where the levels dropped in the dark roasted coffee. The origin of coffee samples did not show any effect on any of the measured variables. Antioxidant effects of coffee samples were largely determined by chlorogenic acid content.