eligible ages (years): 17.0-65.0,  All  Crimean-Congo Hemorrhagic Fever Lassa Fever An individual will be enrolled in this study if the patient Meets the case definition for a probable or a suspected case of CCHF or LF (see below) Has read and signed the Informed Consent Is at least 18 years of age (17, if active military) and not greater than 65 years of age Has a blood sample drawn and a type and cross-match ordered for transfusion Agrees to collection of required specimens Agrees to report any Adverse Events, Serious and Unexpected Adverse Events for the duration of the study Agrees to a follow-up visit and to donate blood and urine specimens at day 14 (±2 days) and once between days 28 and 60 after the first dose of IV Ribavirin and to all follow-up visits for anemia or other medical conditions as required by the attending physician Woman of childbearing age must have a pregnancy test performed. If negative, she must agree not to become pregnant during treatment and for 7 months after receiving Ribavirin. She also must agree to not breast feed during treatment and for 7 months after receiving Ribavirin. Two reliable forms of effective contraception must be used including one barrier method during treatment and during the 7 month post-treatment period. She will be counseled concerning the risks of IV Ribavirin versus no treatment if the pregnancy test is positive Man agrees not to have intercourse with pregnant woman during treatment and for 7 months after receiving Ribavirin, and take precautions to avoid producing pregnancies during treatment and for 7 months after receiving Ribavirin. At least two reliable forms of effective contraception must be used including one barrier method during treatment and during the 7 month post-treatment period to avoid a pregnancy  Has known intolerance to Ribavirin Is irreversibly ill on presentation, as defined by presence of profound shock (shock which does not respond to supportive therapy within 3 hours after admission) Has hemoglobin less than 10 g/dL that cannot be corrected to 10 g/dL before initiation of IV Ribavirin Has history of hemoglobinopathies (i.e., sickle-cell anemia or thalassemia major) Has history of autoimmune hepatitis Has a calculated serum creatinine clearance of < 30 mL/min History of such as second or third degree heart block or sick sinus syndrome and without a pacemaker and no capability of a pacemaker placement or Wolfe-Parkinson-White Syndrome A sinus bradycardia of less than 40 beats per minute Is currently being treated with Didanosine (ddI). ddI must be discontinued before starting IV Ribavirin Relative


An 18-year-old male returning from a recent vacation in Asia presents to the ER with a sudden onset of high fever, chills, facial flushing, epistaxis and severe headache and joint pain. His complete blood count reveals leukopenia, increased hematocrit concentration and thrombocytopenia.

eligible ages (years): 18.0-45.0,  All  Dengue Male or female at least 18 and less than or equal to 45 years old at time of screening In good health as determined by medical history, physical examination including height and weight, and clinical safety laboratory examinations. For creatinine and alkaline phosphatase levels the applicable cut-offs for determination are the upper limits of normal only, as there is no clinical significance associated with results below the lower limits of normal for these laboratory values. For aspartate aminotransferase (AST) and alanine aminotransferase (ALT), the applicable cut-offs for determination are less than 1.5 times the upper limits of normal, as there is no clinical significance associated with results below the lower limits of normal for these laboratory values or with mild elevations above the upper limits of normal Laboratory values not listed in Table 3 which are obtained as part of a reference laboratory pre-determined panel will be considered as acceptable for enrollment if they are either within reference laboratory normal range or within the ranges specified for a grade I AE per the protocol Toxicology Tables in Appendix B. Values within reference laboratory normal ranges or within ranges specified for a grade I AE per the Toxicology Tables in Appendix B will be considered as discussed with the medical monitor and may be enrolled with no further discussion. Values with deviations outside the ranges specified for a grade 1 AE in the Toxciology Tables in Appendix B will be discussed further between the PI and the medical monitor prior to vaccination and assessed for impact on volunteer safety. Urinalyses obtained from female volunteers on their menses may be repeated after their menses have concluded without discussion with the medical monitor. Laboratory values which are not listed in the Toxicology Tables in Appendix B and which are out of the reference laboratory normal range will be discussed with the DMID medical monitor to determine its relevance for safety and impact on enrollment and follow-up vaccinations Blood tests negative for antibodies to human immunodeficiency virus (HIV)-1, Hepatitis C, dengue, West Nile, and negative for Hepatitis B surface antigen No history of dengue or West Nile infection or participation in a previous dengue or West Nile vaccine trial Females of child bearing potential must have a negative urine pregnancy test result during screening and a negative urine pregnancy test immediately prior to vaccination and be willing to use oral, implantable, transdermal or injectable contraceptives or another reliable means of contraception approved by the Investigator (intrauterine device, female condom, diaphragm with spermicidal, cervical cap, use of condom by the sexual partner or a sterile sexual partner, or abstinence) from screening until after the last blood sample (at day 270) Willing and able to give written informed consent to participate Willing and able to communicate with the investigator and understand the requirements of the study Electrocardiogram (ECG) in absence of clinical significance (e.g., complete left or right bundle branch block, incomplete left bundle branch block or sustained ventricular arrhythmia, or two premature ventricular contraction's (PVC's) in a row, or ST elevation consistent with ischemia) Weight: greater than or equal to 110 lb  Any condition which would limit the subject's ability to complete the study in the opinion of the Investigator Clinically significant hematological, renal, hepatic, pulmonary, central nervous, cardiovascular, thromboembolic, autoimmune, coagulopathic, or gastrointestinal disorders or history of such disorders Any history of malignancy with the exception of basal cell carcinoma Previous history , or current diagnosis of diabetes mellitus Pulse >95 or <40 at rest or irregular, systolic blood pressure (bp) >170 or <90 at rest or diastolic bp >90 or <50 at rest, body temperature >100 F, respirations >25 per minute at rest History of allergy to penicillin, neomycin, streptomycin or gentamicin History of hypersensitivity to any vaccine History of previous vaccination with Yellow Fever (YF) vaccine or Japanese Encephalitis (JE) vaccine or planned receipt of either YF or JE vaccine during the course of the study Previous history of infection with dengue or West Nile or seropositive antibody status to dengue or West Nile virus or participation in a vaccine trial for either of these Travel or planned travel to a dengue-endemic area including the Caribbean, Mexico, Central America, South America or Asia during the study period or in the month prior to screening. An updated map of dengue endemic areas is available at the CDC Yellow Book 2010 website (http://wwwnc.cdc.gov/travel/yellowbook/2010/chapter-5/dengue-fever-dengue-hemorrhagic-fever.aspx) and a list of dengue endemic countries is provided in the Manual of Procedures (MOP)


eligible ages (years): 0.115-45.0,  All  Typhoid Fever Main Subjects belonging to 4 age groups will be enrolled into the trial: adults (18 to 45 years of age), children (24 to 59 months of age), older infants (9 to 12 months of age at enrollment) and infants (6 weeks of age at enrolment) Written informed consent will be obtained by the all subjects or their parents/ guardians (depending on the age group) before enrollment into the trial Only females with a negative pregnancy test and willing to participate in family planning consultations (organized by the site study team) will be allowed to participate to the trial Infants who have been vaccinated with 1 dose of BCG, HBV and OPV at birth can be enrolled into the trial, while infants who have received DTwP+HBV+Hib or OPV due at 6 weeks of age as per local EPI schedule cannot be enrolled into the trial


eligible ages (years): 1.0-1.083,  All  Dengue Dengue Hemorrhagic Fever Yellow Fever Aged 12 to 13 months on the day of inclusion Born at full term of pregnancy (≥37 weeks) and with a birth weight ≥2.5 kg as reported by the parent/legally acceptable representative Subject in good health, based on medical history and physical examination Subject has completed his/her vaccination schedule according to the official immunization calendar of Colombia and/or Peru, respectively Informed consent form has been signed and dated by the parent(s) or other legally acceptable representative (and by 2 independent witnesses if required by local regulations) Subject and parent/legally acceptable representative/tutor able to attend all scheduled visits and to comply with all trial procedures  Participation in another clinical trial investigating a vaccine, drug, medical device, or medical procedure in the 4 weeks preceding the first trial vaccination Planned participation in another clinical trial during the present trial period Planned receipt of any vaccine in the 4 weeks following first trial vaccination Previous vaccination against yellow fever (YF), hepatitis A, or measles, mumps and rubella Receipt of blood or blood-derived products in the past 3 months which might interfere with assessment of the immune response Known or suspected congenital or acquired immunodeficiency; or receipt of immunosuppressive therapy such as anti-cancer chemotherapy or radiation therapy within the preceding 6 weeks or long-term systemic corticosteroid therapy (prednisone or equivalent for more than 2 consecutive weeks within the past 3 months) Personal known seropositivity for human immunodeficiency virus (HIV) as reported by the parent/legally acceptable representative History of previous maternal vaccination against YF as reported by the parent/legally acceptable representative Personal history of YF or dengue infection/disease as reported by the parent/legally acceptable representative Known systemic hypersensitivity to any of the vaccine components of the vaccines that will be used in the trial, or history of a life-threatening reaction to the vaccines used in the trial or to vaccines containing any of the same substances


eligible ages (years): 18.0-50.0,  All  Chikungunya Virus Vaccines, Virus-like Particles Viral Vaccines Humoral Immunity Chikungunya Fever A participant must meet all of the following < TAB> 18 to 50 years old < TAB> Available for clinical follow-up through Week 44 < TAB> Able to provide proof of identity to the satisfaction of the study clinician completing the enrollment process < TAB> Complete an Assessment of Understanding prior to enrollment and verbalize understanding of all questions answered incorrectly < TAB> Able and willing to complete the informed consent process < TAB> Willing to donate blood for sample storage to be used for future research < TAB> In good general health, with a BMI less than or equal to 40, without clinically significant medical history, and has satisfactorily completed screening < TAB> Physical examination and laboratory results without clinically significant findings within the 56 days prior to enrollment Laboratory within 56 days prior to enrollment  A participant will be excluded if one or more of the following conditions apply Female-Specific < TAB> Woman who is breast-feeding or planning to become pregnant during the time projected for individual study participation < TAB> Systemic immunosuppressive medications or cytotoxic medications within 12 weeks prior to enrollment [with the exceptions that a short course of corticosteroids (less than or equal to10 days duration or a single injection) for a self-limited condition at least 2 weeks prior to enrollment will not study participation] < TAB> Blood products within 16 weeks prior to enrollment < TAB> Immunoglobulin within 8 weeks prior to enrollment < TAB> Prior vaccinations with an investigational CHIKV vaccine < TAB> Investigational research agents within 4 weeks prior to enrollment < TAB> Live attenuated vaccines within 4 weeks prior to enrollment < TAB> Medically indicated subunit or killed vaccines, e.g. influenza, pneumococcal, or allergy treatment with antigen injections, within 2 weeks prior to enrollment


eligible ages (years): 18.0-50.0,  All  Dengue Disease Dengue Fever Male or female age 18 to 50 (inclusive) years old at the time of enrollment Have negative anti-dengue, Japanese encephalitis, West Nile, and yellow fever ELISA serological tests Be informed of the nature of the study and provide written informed consent If the subject is of child-producing potential, he/she agrees to practice adequate birth control or abstain from sex Have access to the WRAIR Clinical Trials for at least 270 days, and be willing to refrain from participation in other investigational clinical trials Be in good general health  -Subjects meeting any of the following will be excluded from the study History of Flavivirus infection or history of Flavivirus vaccine (experimental or licensed product) including Japanese encephalitis, yellow fever, and dengue Have a known or suspected hypersensitivity or adverse reaction to vaccines including anaphylaxis and related symptoms such as hives, respiratory difficulty, angioedema, and/or abdominal pain Have received a live-attenuated vaccine within 42 days prior to the initial injection on Day 0 or a subunit or killed vaccine within 30 days of the initial injection on Day 0 Have a positive screen for hepatitis B surface antigen (HBsAg), hepatitis C antibody, or HIV antibody Are pregnant or breastfeeding Have donated or received blood, blood products, or plasma within 30 days prior to Day 0 Have any acute illness, including an oral body temperature >100.4°F, within 7 days before the initial injection on Day 0 Have a past or current history of malignant disease except for adequately treated skin cancer Exclusions but are not limited to conditions pertaining to or evidence of immunodeficiency; allergies requiring treatment with antigen injections; autoimmune disease; severe migraine headaches; unstable asthma; clinically significant cardiac arrhythmias, diabetes mellitus, thyroid disease, a bleeding disorder or a seizure disorder


eligible ages (years): 11.0-17.0,  All  Immunization Rate Age 11-17 years old Active patient (visit in last 2 years) of clinics in study Need one or more vaccines or well-care visit  Up to date on vaccines and well-care


eligible ages (years): 65.0-999.0,  All  Pneumococcal Vaccines Pneumococcal Conjugate Vaccine Healthy Japanese male and female adults aged 65 years old and older at time of enrollment. Subjects with preexisting stable disease, defined as disease not requiring significant change in therapy or hospitalization for worsening disease 12 weeks before receipt of the study vaccine, are eligible Male and female subjects of childbearing potential must agree to use a highly effective method of contraception throughout the study or for at least 28 days after the last dose of the study vaccine whichever is longer  History of severe adverse reaction including hypersensitivity such as anaphylaxis associated with a vaccine or vaccine component Previous vaccination with any licensed or experimental pneumococcal vaccine Documented Streptococcus pneumoniae infection within the past 5 years Residence in a nursing home, long-term care facility, or other institution or requirement of semiskilled nursing care


eligible ages (years): 1.0-14.0,  All  Japanese Encephalitis Children aged between 1 and 14 years who had clinically diagnosed encephalitis on the basis of history of fever that lasted less than 14 days, altered consciousness with or without a history of new onset seizures with CSF finding of white cell count less than 1000 cells/mm3 with no organisms on Gram stain and a CSF: plasma glucose ratio > 40% admitted in Kanti Children's Hospital and BP Koirala Institute of Health Sciences, Nepal  Asexual Plasmodium falciparum parasites in blood Coma appears secondary to other systemic condition, eg hepatic failure, cardiac failure, toxins Patients who have documented antibiotic treatment before admission and in whom partially treated bacterial meningitis appears more likely than encephalitis Children with simple febrile convulsions, defined as a single seizure lasting less than 15 minutes followed by full recovery of consciousness within 60 minutes Pregnant or breastfeeding females Children with a GCS of 3/15, who were receiving artificial ventilation without signs of spontaneous respiration, and with absent oculocephalic reflex


eligible ages (years): 7.0-16.0,  All  Dengue Dengue Fever Dengue Hemorrhagic Fever Ongoing participation in study CYD23 at the time of enrollment Assent form has been signed and dated by the subject (for subjects ≥ 7 years old), and informed consent form has been signed and dated by the parent(s) or another legally acceptable representative and by 2 independent witnesses Subject and parent/legally acceptable representative are able to attend all scheduled visits and to comply with all study procedures  Planned participation in another dengue clinical trial during the present study Deprived of freedom by an administrative or court order, or in an emergency setting, or hospitalized involuntarily


eligible ages (years): 18.0-999.0,  All  Diabetic Foot Ulcer Infection Non-hospitalized subjects with Type 1 or Type 2 diabetes mellitus as defined by the American Diabetes Association diagnostic (ADA, 2010). Diabetes may be treated with insulin, oral hypoglycemic agents, diet, or a combination of these therapies. Subjects whose diabetes is considered "controlled" by diet or medication in the opinion of the physician Males or females at least 18 years old Subjects must be considered by the investigator to be reliable, willing and able to give signed informed consent, and must sign the informed consent form Subjects must have a full thickness (i.e., extending through dermis but not involving tendon, bone, or joint capsule) ulcer on the foot distal to the malleoli with a surface area ≥1 cm2 after the wound has undergone appropriate debridement. Subjects must have localized mild infection of the ulcer, as defined by the IDSA as per Appendix C, with in the PGN1300 Protocol, which the investigator believes would ordinarily be treated on an outpatient basis IDSA mild infection of an ulcer is defined as The presence of ≥2 of the following items Local swelling or induration Erythema Local tenderness or pain Local warmth  Subjects with IDSA-defined moderate infection as per Appendix C, including cellulitis extending > 2 cm; lymphangitis; spread beneath the fascia; deep tissue abscess; osteomyelitis; gangrene; muscle, joint, or bone involvement Subjects with IDSA-defined severe infection as per Appendix C, within PGN1300 Protocol including systemic toxicity or metabolic instability (e.g., fever, chills, tachycardia, hypotension, confusion, vomiting, leukocytosis, acidosis, hyperglycemia, or azotemia) Subjects with systemic inflammatory response signs, as manifested by ≥2 of the following  Temperature >38°C or <36°C Heart rate >90 beats/min Respiratory rate >20 breaths/min or PaCO2 <32 mm Hg White blood cell count >12 000 or <4000 cells/μL or ≥10% immature (band) forms Subjects with local wound complications (e.g., prosthetic materials) Subjects currently receiving antibiotic treatment for a localized infection of the study ulcer and whose infection is improving in response to treatment Subjects requiring concurrent systemic antimicrobials during the study period for any infection, including diabetic foot ulcer


eligible ages (years): 14.0-17.0,  All  Overweight Adolescent Behavior Family Research Weight Loss Adolescent ages 14-17 years old living at home with at least one parent/guardian BMI ≥ 85th percentile assent from adolescent consent from a parent/guardian willingness of one parent/guardian living with adolescent to participate in the study English speaking  Adolescent BMI ≥ 40 (requires additional medical attention the intervention is unable to provide) previously diagnosed type 1 or type 2 diabetes blood pressure in the range of stage 2 hypertension which requires medication treatment which interferes with outcomes related to blood pressure and glucose medications that significantly interfere with weight gain such as oral steroid use greater than two consecutive weeks antipsychotic medications participation in a standardized weight loss program within the previous 6 months inability to provide informed assent no parent/guardian consent insufficient reading ability to comprehend the self-administered assessment instruments (approximately 5th grade reading level)


eligible ages (years): 0.25-16.0,  All  Dengue Disease Progression Age >3 months and <16 years Clinical suspicion of dengue hemorrhagic fever. (Revised WHO Classification System) Not a prisoner or ward of the state Parents able and willing to give consent. Children older then 7 able and willing to give assent  Allergic to Ultrasound gel Prisoners or wards of the state Unstable patients Known pleural effusion, ascites, or gallbladder wall thickening


eligible ages (years): 45.0-999.0,  All  Infected by Chikungunya Virus Age at onset of symptoms ≥ 45 years Seen in consultation at the University Hospital of Fort-de-France Suspected chikungunya infection (fever and sudden onset of joint pain affecting the wrists, hands, ankles or knees) Duration of symptoms suggestive of infection chikungunya less than or equal to 10 days Presence of joint pain on the day of No history of inflammatory arthritis Absence of steroidal or non-steroidal anti-inflammatory drugs taken within two weeks prior to Ability to participate in the study throughout its duration (12 months) Patient affiliated or beneficiary of a social health care Acceptance to participate in the study and monitoring proposed and signed informed consent  Age at onset of symptoms <45 years Duration of symptoms suggestive of chikungunya for more than 10 days Lack of joint pain on the day of History of inflammatory arthritis Nonsteroidal anti-inflammatory drugs or Taking in the two weeks preceding the Inability to participate in the study throughout its duration (12 months) Patient is not affiliated or beneficiary of a social health care Refusal to participate in the study or to sign a consent


eligible ages (years): 18.0-999.0,  All  Influenza clinical presentation that suggest influenza virus infection, including sudden onset of high fever, cough, headache, muscle and joint pain, severe malaise, sore throat and runny nose positive to influenza virus by PCR test anti viral treatment was indicated  Immune compromised patients: patients after solid organ transplant, post bone marrow transplantation, with inherited or acquired immune deficiency, or patients treated chronically with immunosuppressive drugs Pregnant women Patients who were treated with oseltamivir in the previous 6 months


eligible ages (years): 0.0-999.0,  All  Dengue Fever Stage 1 Discharge diagnosis with International Classification of Disease (ICD) code A90 A99 Availability of minimal dataset (name, IC, age, sex, diagnosis, date admit, date discharge, discharge status) Stage 2 Laboratory confirmed dengue (Non-structural 1 antigen, dengue IgM, high-titre dengue IgG, and dengue polymerase chain reaction (PCR) positive)


eligible ages (years): 0.5-50.0,  All  Dengue Subject and/or subject's parent(s)/legally acceptable representative(s) (LAR[s]) who, in the opinion of the investigator, can and will comply with the requirements of the protocol. (e.g., willingness to go to the hospital/clinic for visit[s] in case of AFI, able to observe the signs of dengue and to understand how to take and report body temperature, etc.) Signed/thumb-printed (and video recorded if required by law) informed consent (and assent if applicable) must be obtained from the subject/subject's parent(s)/LAR(s) at the hospital/clinic or during a home visit. If the subject/subject's parent(s)/LAR(s) are illiterate, the informed consent form (ICF) (or informed assent form [IAF] when applicable) will be countersigned by an impartial witness Subject is part of a household with at least one child (aged less than 18 years) and in which informed consent (and assent if applicable) to study participation was obtained from at least one adult and one child Male or female aged between and including 6 months and 50 years at the time of enrolment Subject who plans, at the time of enrolment, to remain at same residence/study area during the two-year study period  Child in care Participation (current or planned) in another epidemiological study or in a clinical trial that would conflict with the current study, based on investigator's judgement Terminal illness based on investigator's judgement Mental incapacity based on investigator's judgement


eligible ages (years): 18.0-65.0,  All  Dengue Fever Dengue patients confirmed by dengue virus NS1 or RNA  Pregnant women Fever diseases caused by other viruses Combined bacterial infection Without complications such as diabetes and tumor


eligible ages (years): 13.0-22.0,  All  Dengue Fever Dengue Hemorrhagic Fever Has been identified as a potential subject by the Sponsor and is included in the list provided to the Investigator (i.e., aged 9 to 16 years on the day of first vaccination of CYD dengue vaccine in CYD13/CYD30 and has a post-dose 3 serum sample available [at least 400 µL of serum]) Presently in good health, based on medical history and physical examination Assent form or informed consent form (ICF) has been signed and dated by the subject (based on local regulations), and ICF has been signed and dated by the parent(s) or another legally acceptable representative (and by an independent witness if required by local regulations) Subject and parent(s)/legally acceptable representative(s) able to attend all scheduled visits and to comply with all trial procedures  Subject who received any other dengue vaccination that was not part of the CYD13 and CYD30 trials Subject is pregnant, or lactating, or of childbearing potential (to be considered of non childbearing potential, a female must be pre-menarche or post-menopausal for at least 1 year, surgically sterile, or using an effective method of contraception or abstinence from at least 4 weeks prior to vaccination until at least 4 weeks after vaccination) Participation at the time of study enrollment (or in the 4 weeks preceding the trial vaccination) or planned participation during the present trial period in another clinical trial investigating a vaccine, drug, medical device, or medical procedure Receipt of any vaccine in the 4 weeks preceding the trial vaccination or planned receipt of any vaccine in the 4 weeks following the trial vaccination Receipt of immune globulins, blood or blood-derived products in the past 3 months Known or suspected congenital or acquired immunodeficiency; or receipt of immunosuppressive therapy, such as anti-cancer chemotherapy or radiation therapy, within the preceding 6 months; or long-term systemic corticosteroid therapy (prednisone or equivalent for more than 2 consecutive weeks within the past 3 months) Known systemic hypersensitivity to any of the vaccine components, or history of a life-threatening reaction to the vaccines used in the trial or to a vaccine containing any of the same substances Chronic illness that, in the opinion of the Investigator, is at a stage where it might interfere with trial conduct or completion Receipt of blood or blood-derived products in the past 3 months, which might interfere with assessment of the immune response Deprived of freedom by an administrative or court order, or in an emergency setting, or hospitalized involuntarily


A 31 yo male with no significant past medical history presents with productive cough and chest pain. He reports developing cold symptoms one week ago that were improving until two days ago, when he developed a new fever, chills, and worsening cough. He has right-sided chest pain that is aggravated by coughing. His wife also had cold symptoms a week ago but is now feeling well. Vitals signs include temperature 103.4, pulse 105, blood pressure 120/80, and respiratory rate 15. Lung exam reveals expiratory wheezing, decreased breath sounds, and egophany in the left lower lung field.

eligible ages (years): 18.0-999.0,  All  Pneumonia, Pneumocystis Carinii HIV Infections   Co-existing Condition Patients with the following are excluded Previous history of adverse reaction to pentamidine History of asthma Pulmonary Kaposi's sarcoma Patients with the following are excluded Previous history of adverse reaction to pentamidine History of asthma Pulmonary Kaposi's sarcoma Inability to understand the consent procedure


eligible ages (years): 0.0-999.0,  All  Spinal Cord Injuries Spinal cord injury of >= 1 year in duration, and no other neuromuscular diseases


eligible ages (years): 18.0-999.0,  All  Pneumonia Sepsis Current diagnosis of community-acquired pneumonia Evidence of systemic inflammatory response to infection  Atypical or viral pneumonia based on clinical or epidemiologic suspicion by the investigator Presence of organ failure


eligible ages (years): 19.0-120.0,  All  Lung Cancer Histologically or cytologically confirmed non-small cell lung cancer Stage IIIA (T1-3, N2) Positive (pathological) ipsilateral mediastinal node Selective stage IIIB meeting all of the following No pleural/pericardial effusion or superior vena cava syndrome T4 due to invasion of carina, trachea, or mediastinal structures Mediastinal N3 nodes (without supraclavicular or cervical adenopathy) Proof of N2 or N3 status requires surgical staging of the mediastinum (mediastinoscopy, mediastinotomy, or exploration) Expression of epidermal growth factor receptor (at least 1+) by immunohistochemistry Measurable disease by contrast CT scan allowed


eligible ages (years): 18.0-999.0,  All  Pneumonia years of age or older acute respiratory tract infection patients from outpatient clinics and the emergency department  under the age of 18 suspected hospital-acquired pneumonia suspected aspiration pneumonia inpatients


eligible ages (years): 18.0-999.0,  All  Pneumonia Greater than or equal to 18 years of age Orally/nasally intubated and receiving mechanical ventilation for <24 hours prior to scheduled randomization and administration of the first dose of Study Drug, and in the judgment of the attending physician, expected to remain intubated and mechanically ventilated for at least 48 hours Expected to survive for at least 21 days and to remain at the investigational site and not transferred to another institution while intubated during the 21-day study period Willing and able to provide written informed consent, or if unconscious or have altered sensorium, have a surrogate provide written informed consent as approved by the institution Negative pregnancy test within 7 days prior to randomization if a female of childbearing potential (Negative pregnancy test results [urine or serum] obtained for reason other than the purposes of this study are acceptable.)  Current diagnosis of pneumonia (Patients currently receiving antibiotics for treatment of pneumonia and patients who meet the study definition of clinically defined pneumonia at the time of screening will be excluded.) Absolute neutrophil count less than 1000/mm3 Human immunodeficiency virus infection with a last known CD4 count less than 500/mm3 Recipient of organ transplantation and receiving immunosuppressive therapy Current hematologic malignancy Previously documented cystic fibrosis Severe cranio-facial trauma or other medical condition expected to require imminent tracheostomy Patient, patient’s family and/or physician not in favor of aggressive medical management or presence of an advanced directive to withhold life-sustaining treatment Moribund state or expected to survive less than 21 days due to an uncorrectable medical condition Participation in a clinical trial of any unlicensed drug, biologic or device within 30 days prior to the first dose of study drug


eligible ages (years): 18.0-35.0,  All  Respiratory Tract Infections Chronic Bronchitis Pneumonia Subjects meeting all of the following will be considered for enrollment into the study Male and female adult outpatient subjects diagnosed with AECB or CAP Female subjects must be either postmenopausal for ≥ 1 year or surgically incapable of bearing children. Women of childbearing potential must have a normal menstrual flow ≤ 1 month before study entry, a negative serum pregnancy test immediately prior to study entry, and meet the for acceptable birth control Informed consent must be obtained in writing for all subjects upon enrollment Subjects will have a diagnosis of AECB or CAP, as defined below AECB-Specific Subjects greater than or equal to 35 years of age Subjects with a documented history of chronic bronchitis: with a basal forced expiratory volume in one second (FEV1) < 70% and > 35%; who have had at least one or more AECB in the previous year; and with FEV1/forced vital capacity (FVC) < 70% Subjects with a clinical diagnosis of AECB, presumed to be due to bacterial infection based on increased sputum purulence with either increased dyspnea or sputum volume Subjects producing spontaneous sputum  Subjects presenting with any of the following will not be included in the study Subjects with a known history of congenital long-QTc syndrome Subjects who are pregnant or breast-feeding Subjects who have hypersensitivity to telithromycin, azithromycin, or the macrolide classes of antibiotics Subjects who require or receive treatment with rifampin (Rifadin), phenytoin (Dilantin), carbamazepine (Carbatrol, Tegretol), phenobarbital, or St. John's wort (herbal supplement) within 2 weeks prior to Visit 1 or during the study Subjects who require treatment during the study with ergot alkaloid derivatives, cisapride (Propulsid), pimozide (Orap), bromocriptine, cabergoline (Dostinex), or pergolide (Permax) Subjects who have previously participated in this study Subjects with a previous history of myasthenia gravis Subjects with current acute respiratory failure or subjects who require aggressive airway management Hospitalized subjects and subjects from institutional care facilities


eligible ages (years): 64.0-999.0,  All  Pneumonia Lower Respiratory Tract Infection Symptoms or signs of lower respiratory tract infection as defined by standardized criteria  Residents were excluded if they were not expected to live longer than 30 days from the date of enrollment, had a previous anaphylactic or serious allergic reaction to quinolones, had advanced directives that they are not be transferred to hospital for treatment


eligible ages (years): 18.0-999.0,  All  Mycoplasma Pneumoniae Working at hospital facility where outbreak of Mycoplasma pneumoniae occured  Pregnant, on antiseizure medications, allergic to macrolide antibiotics


eligible ages (years): 8.0-17.0,  All  Asthma Allergy Children and adolescents between 8 and 17 years of age at the start of the trial (born after 01 March '88, but before 01 September '97) Bronchial asthma, diagnosed by a physician, and confirmed by a physician at a paediatric department of a Norwegian Hospital Allergy against dogs, confirmed by skin prick test. Average infiltrate at least 4 millimetres against dog, diagnosed by a new skin prick test at entry. For details about skin prick test, see attachment no. 6 Having had nose or breathing symptoms by contact with dogs, when no drugs against asthma or allergy have been taken Able to co-operate at cold air hyperventilation test and spirometry (see attachment no. 2) Given written consent (by parents of children below 12; by parents and child when above 12, but below 16; by patient when above 16)  Positive house dust mite skin prick test, with a more than 3 mm infiltrate Having taken oral beta-2-agonists or theophylline preparations for the last 2 weeks before trial start, or oral steroids for the last 3 months before start of the trial Active smoking Dogs or cats in the home Staying away from the home continuously for more than 14 days in the trial period or during the last month before trial start Being an in-patient in a special department or institution for asthma and allergy in the trial period or the last 3 months before the trial Having another chronic disease that can influence the results of ECP or cold air hyperreactivity tests Other types of mechanical ventilation or air filtration systems in the homes, except for those for kitchen stoves


eligible ages (years): 0.167-17.0,  All  Bacterial Infection Parent or legal guardian has signed the informed consent Age greater than 48 weeks post-conception and less than 18 years of age Requiring mechanical ventilation in the intensive care unit (subjects will not be intubated solely for the purpose of this study) Presence of an abnormal chest x-ray (CXR) as determined by the primary care team (Note: if the attending radiologist disagrees with the reading of "abnormal CXR," the subject will be followed for safety and replaced for analysis) Initiation of antibiotics by the assigned health care providers for suspected bacterial pneumonia (must be less than or equal to 12 hours prior to undergoing non-bronchoscopic bronchoalveolar lavage [NB-BAL])  Presence of severe hypoxia (PaO2/FIO2 < 120) Documented or suspected increased intracranial pressure Hemodynamic instability, defined as one of the following in the 4 hours preceding study entry Initiation of any inotropic or vasopressor agents at any dose to improve blood pressure or tissue perfusion Increase in infusion rate of any inotropic or vasopressor agents to improve blood pressure or tissue perfusion Receipt of intravenous (IV) or oral (PO) antibiotics for suspected bacterial pneumonia for greater than or equal to 12 hours prior to non-bronchoscopic bronchoalveolar lavage (NB-BAL) Treatment for a previous episode of suspected bacterial pneumonia within three days prior to NB-BAL Coagulopathy Documented platelet count <50,000 x 10^6/mL at the time of enrollment (Exception: The subject may be enrolled if he/she receives a platelet infusion as a part of routine care that is completed within one hour of NB-BAL initiation) Extra-corporeal circuit, requiring anticoagulation, or


eligible ages (years): 18.0-999.0,  All  Community-Acquired Pneumonia Age: 18 years and above Clinical and radiological diagnosis of community-acquired pneumonia Informed consent of patient Hospital admission  Prior hospital admission (less than 15 days) Alternative diagnosis at the discharge Immunosuppression (HIV infection, immunosuppressive therapies, neutropenia) Risk factors for unusual etiologies Patient is pregnant


eligible ages (years): 18.0-999.0,  All  Community Acquired Pneumonia Community acquired pneumonia Hospitalization  Immunocompromised patients Patients under chemotherapy treatment Patients under steroids treament


eligible ages (years): 18.0-999.0,  All  Ventilator Associated Pneumonia Respiratory Infection Tracheobronchitis be on mechanical ventilation greater than 3 days greater than or equal to 18 years of age survival greater than 14 days greater than 2 ccs of tracheal secretions/4 hours  allergy to drugs, pregnancy


eligible ages (years): 18.0-70.0,  All  Spinal Cord Injury Chronic spinal cord injury that occurred more than 6 months ago An impaired ability to cough (cough peak flow less than 300 L/min) Oxygen saturation greater than or equal to 95% when awake and not receiving supplemental oxygen End-tidal carbon dioxide level less than 43 mm Hg Without a fever or other signs of an acute illness for the previous 2 weeks Able to learn the treatment protocol and have someone available at home to assist if needed to help set-up and use the equipment  Under 18 years of age Currently have a tracheotomy tube Have a history of an acute illness in the last 2 weeks Have lung disease as seen on chest x-ray that results in a baseline oxygen saturation decreasing below 95% during daytime hours and cannot be normalized by usual way of coughing Already utilizing an oximetry protocol Have a significant medical complication and psychiatric condition that would interfere with the conduct of the study or interpretation of the study results


eligible ages (years): 0.167-4.917,  All  Severe Pneumonia Age: 2 to 59 months Sex: Both boys and girls Severe pneumonia according to WHO (Severe pneumonia is defined as cough or difficult breathing with lower chest wall in drawing with or without fast breathing which is defined as the respiratory rate ≥ 50 breaths per minute for children aged 2-11 months and ≥ 40 breaths per minute for children aged 12-59 months) Attend the Radda Clinic and ICHSH between 8:00 am to 4:00 pm (Sunday through Saturday) Written informed consent by respective parents/guardians  Very severe and non-severe pneumonia Nosocomial pneumonia History of taking antibiotics for pneumonia within 48 hour prior to enrollment Chronic illnesses like tuberculosis, cystic fibrosis Congenital deformities/anomalies e.g. Down's Syndrome, congenital heart disease Immunodeficiency Trauma/burn Bronchiolitis Bronchial asthma Lives far away from the Radda Clinic and ICHSH (outside 5 km radius from the respective study site)


eligible ages (years): 18.0-999.0,  All  Community Acquired Pneumonia Symptoms of lower airway infection and radiologic sings of pneumonia  Age<18 Serious psychiatric illness Mentally retarded Hospitalized last 14 days


eligible ages (years): 5.0-999.0,  All  Anemia, Sickle Cell Diagnosis of sickle cell anemia (Hgb SS) or sickle-β0-thalassemia (Hgb Sβ0) Current episode of ACS, defined as a new lobar or segmental pulmonary infiltrate seen on a chest radiograph and two or more of the following findings Temperature of 38.5°C or higher Tachypnea (i.e., rapid breathing) Dyspnea or increased work of breathing Chest wall pain Oxygen saturation of less than 90% in room air by pulse oximetry Current episode of ACS diagnosed in the 24 hours prior to study entry Ability to take medication in capsule form  Prior participation in this study Diagnosed with any medical condition that will likely be worsened by corticosteroid therapy, including any of the following conditions Diabetes mellitus High blood pressure Esophageal or gastrointestinal ulceration or bleeding Known avascular necrosis Diagnosis of ACS in the 6 months prior to study entry Treatment with oral or parenteral corticosteroid therapy for any reason in the 14 days prior to study entry Use of inhaled corticosteroids or systemic corticosteroids for respiratory illness in the 3 months prior to study entry Long-term lung condition that requires treatment with corticosteroids


eligible ages (years): 18.0-999.0,  All  Pneumonia, Bacterial Provide signed and dated informed consent Adults, 18 years of age or older of either gender and of any race weighing up to 150 kg. Female patients of childbearing potential MUST be nonpregnant (confirmed by negative serum pregnancy test), nonlactating, and must be willing to practice reliable birth control measures during and for at least 30 days after treatment with study drug(s) Have a new pulmonary infiltrate on chest radiograph Exhibit at least two of the following clinical symptoms of pneumonia on history or physical Cough Production of purulent sputum or change in character of sputum Auscultatory findings on pulmonary examination of rales and/or evidence of pulmonary consolidation (dullness to percussion, bronchial breath sounds, or egophony) Dyspnea or tachypnea Documented fever, defined as body temperature >38.0 ºC (100.4 ºF) taken orally; >38.5 ºC (101.2 ºF) tympanically; or >39.0 ºC (102.2 ºF) rectally or hypothermia, defined as core body temperature of <35.0 ºC (95.0 ºF) An elevated total peripheral white blood cell count (WBC >10,000/mm3); or >15% immature neutrophils (bands), regardless of total peripheral white count; or leukopenia with total WBC <4500/mm3  Patients with Grade V pneumonia (based on Fine Score; Attachment 8) Patients in respiratory failure or incipient respiratory failure if the patient is not a candidate for mechanical ventilation (for any reason) Any of the following pulmonary conditions that may preclude interpretation of study results Cystic fibrosis Primary lung cancer or another malignancy metastatic to the lungs Known bronchial obstruction or a history of post-obstructive pneumonia Known or suspected active tuberculosis Severe shock (systolic blood pressure <90 mm Hg for >30 minutes not corrected by fluid bolus) Clinical evidence of bacterial meningitis (based on lumbar puncture results) Severe renal impairment (calculated creatinine clearance <30 mL/min)


eligible ages (years): 18.0-999.0,  All  Post Nasal Drip Postnasal Drip with chronic cough Postnasal drip by rhinoscopy Cough by visual analog scale Patients have to be 18 years old or older Cough-variant asthma must be excluded by a negative methacholine challenge test within one year, or documented failure of chronic cough to resolve after administration of inhaled corticosteroid (> one-month duration). Asthma is defined by the ATS guidelines Subjects must have a negative chest radiogram or Chest CT scan within 6 months No active GERD symptoms (< 7 RSI score) & a stable dose of Proton Pump Inhibitor (4 weeks) of Postnasal Drip without cough Postnasal drip by rhinoscopy No cough by visual analog scale  Subject for Postnasal Drip with Chronic Cough Presence of nasal polyposis and/or sinusitis or active GERD symptoms on examination Current smokers (smoking within the 2 months prior to the study) will be excluded Patients with an upper respiratory tract infection within the preceding 8 weeks Patients taking angiotensin converting enzyme inhibitors Patients on leukotriene receptor antagonist and/ or nasal topical corticosteroids or inhaled corticosteroids. Patient must be off nasal or inhaled corticosteroid by at least 4 weeks Same for Post Nasal Drip without cough except A chest radiogram is not necessary in this group Patients taking leukotriene inhibitors, or using nasal steroid therapy


eligible ages (years): 13.0-999.0,  All  Ventilator Associated Pneumonia Etiological Organisms Antimicrobial Drug Susceptibility Pattern Stress Ulcer Prophylaxis Age greater than 12 years Those on mechanical ventilation for more than 48 hours  Pre-existing pneumonia at the beginning of ventilation or Developing pneumonia within 48 hours of ventilation Patients on oral antibiotics


eligible ages (years): 1.0-45.0,  All  Respiratory Sounds Patient and/or parents/guardian signed informed consent Patients with cough or shortness of breath  Chest tubes Skin lesions precluding attachment of sensors Respiratory distress Pregnant women


eligible ages (years): 0.0-16.0,  All  Bacterial Infections Bacteremia Meningitis Urinary Tract Infection Mastoiditis Lobar Pneumonia Septic Arthritis Cellulitis Osteomyelitis Positive blood, urine, synovial, bone, pleural effusion, abscess or CSF culture Cellulitis, lobar pneumonia, osteomyelitis


eligible ages (years): 0.167-5.0,  All  Pneumonia, Bacterial Healthy children aged between 2 months and 5 years attending the well baby clinic in hospital Informed consent obtained from parents or legal guardian


eligible ages (years): 0.167-4.917,  All  Acute Respiratory Infections Pneumonia Children aged 2 to 59 months attending the outpatient's clinics of participating sites WHO defined non-severe pneumonia Accessibility for follow-up Written informed consent by a parent or legal guardian  WHO signs of severe pneumonia recognised by lower chest wall retraction. Children who present with wheezing will be evaluated for lower chest wall indrawing after treatments with nebulised salbutamol. WHO signs of very severe disease/pneumonia defined as any of the following Cyanosis Inability to drink Convulsions Abnormally sleepy or difficult to wake Severe malnutrition recognised by weight for age less than third percentile by the NCHS (National Child Health Statistics) growth chart and/or oedema (see chart) All patients with a previous history of 3 or more episodes of wheeze or diagnosed to have asthma Known or clinically recognisable congenital heart disease with cyanosis or, congestive heart failure or cardiomegaly Known or clinically recognisable acute/chronic organ system disorders including jaundice, nephrotic syndrome, severe anaemia manifested as extreme pallor etc Other infectious conditions requiring antibiotic therapy at the day of contact including meningitis, tuberculosis, dysentery, osteomyelitis, septic arthritis etc


eligible ages (years): 18.0-80.0,  All  Chronic Cough Healthy Volunteers Over 18 years old Measurable cough reflex sensitivity No current or past history of chronic cough or chronic respiratory disease No symptoms of gastro-oesophageal reflux disease, asthma or post-nasal drip Chronic Cough Patients Over 18 years old Chronic persistent cough (> 8 weeks) despite investigation and/or treatment trials for cough variant asthma/post nasal drip and gastro-oesophageal reflux disease Normal CXR Normal lung function  Recent Upper Respiratory Tract Infection (4 weeks) Pregnancy/breast feeding Current smokers or ex-smokers with < 6 months abstinence or cumulative history of > 10 packyears Diabetes Mellitus Opiate or ACE Inhibitor use Any centrally acting medication which has the potential to alter cough reflex sensitivity Significant and ongoing chronic respiratory, cardiovascular (in particular hypertension), gastro-intestinal, haematological (porphyria), neurological or psychiatric illness Drug or alcohol abuse History of allergy or reaction to ketamine of other NMDA receptor antagonists


eligible ages (years): 0.493-999.0,  All  Pneumonia presumed community-acquired pneumonia as diagnosed by the attending emergency department physician  age > 6 months immunodeficiency (primary, advanced HIV) cystic fibrosis malignancy known cardiac or lung defects bronchiectasis previous pneumonia or lung abscess in past 6 months conditions requiring treatment with immune suppressants


eligible ages (years): 18.0-999.0,  All  Pneumonia CAP Those pneumonia patients have not been admitted within 14 days before diagnosing pneumonia Those pneumonia patients are not met the of HCAP as stated below HCAP Regular hemodialysis, peritoneal dialysis or infusion therapy (ex TPN, repeated blood transfusion etc ) at a hospital or hemodialysis clinic Receive radiation therapy or chemotherapy at out-patient clinics within 90 days to be admitted to an acute care hospital for two or more days within 90 days before the onset of pneumonia Resided in a nursing home or long-term care  The patients with HAP: pneumonia developed two days after admission or within 14 days after discharge (except RCW) VAP: HAP and with mechanical ventilation for at least 48h (except RCW patients) HIV positive with a CD4+ < 200


eligible ages (years): 18.0-999.0,  All  Pneumonia Adult (age>18 years) hospitalized patient with hospital-acquired pneumonia due to Gram negative bacteria  pregnancy lactating woman colistin allergy severe renal impairment epilepsy


eligible ages (years): 50.0-999.0,  All  Community Acquired Pneumonia Adult subjects 50 years of age or older Subject must reside in the surveillance area Subjects who present to a study healthcare facility where the treating physician clinically suspects CAP  Any subject who is transferred to a study healthcare facility after already being hospitalized for 48 hours or more at any other in-patient facility (such as a community hospital) Hospital Acquired pneumonia (ie, develops signs and symptoms of pneumonia after being hospitalized for 48 hours or more)


eligible ages (years): 18.0-999.0,  All  Cough Healthy Controls Healthy volunteers Over 18 years Measurable cough reflex sensitivity − required as is the primary end−point No current or past history of chronic cough or chronic respiratory disease Chronic Cough Patients Over 18 years Chronic persistent cough (> 8 weeks) despite investigation and/or treatment trials for cough variant asthma/post−nasal drip and gastro−oesophageal reflux Normal chest radiograph − primary respiratory cause for cough excluded Normal lung function − primary respiratory cause for cough excluded Measurable cough reflex sensitivity − required as primary end−point  Recent upper respiratory tract infection (<4 weeks) − this can lead to increased sensitivity of the cough reflex which resolves as the infection settles Pregnancy/breast−feeding − unknown effects of oesophageal acid infusion Current smokers or ex−smokers with < 6 month abstinence or history > 20 pack years − smoking can alter the sensitivity of the cough reflex Opiate or ACE inhibitor use or centrally acting medication − can alter the cough reflex sensitivity Symptomatic gastro−oesophageal reflux, post−nasal drip or asthma (chronic cough cohort may have been treated for these in the past but cough did not resolve) − these conditions are known to cause cough and alter cough reflex sensitivity Significant ongoing chronic respiratory/cardiovascular/gastro−intestinal/haematological/ neurological/psychiatric illness. We are aiming to recruit healthy volunteers and chronic cough patients who are otherwise healthy


eligible ages (years): 1.0-12.0,  All  Pneumonia Children aged 1 to 12 years with acute community-acquired pneumonia (cough, tachypnea, fever and with a chest radiography with lobar, segmental or bronchopneumonia within the first 48 hours)  Severely ill patients (hospitalized in intensive care units) Pleural effusion treated with chest drainage Atelectasis detected by x-ray Pneumonia or pleural effusion in the previous six months Other pulmonary underlying disease, heart disease, cerebral palsy or immune deficiency


eligible ages (years): 18.0-80.0,  All  Sleep Apnea Syndrome Polygraphy Community Acquired Pneumonia Infections Group A Hospital admission and Community acquired pneumonia  Nosocomial infections Low level of conscientiousness Neurological disease Impossibility to complete the questionnaires Group B Hospital admission and other infections different to respiratory infections


eligible ages (years): 18.0-999.0,  All  Respiratory Tract Infection Adults, equal to or more than 18 years years of age Patients with respiratory tract infections, including any of the following Acute tracheitis, acute tracheobronchitis Acute sinusitis Chronic sinusitis Acute tonsillopharyngitis Acute bronchitis Mild community-acquired pneumonia Acute exacerbation of chronic bronchitis  Known hypersensitivity to or previously intolerant of macrolides Illness severe enough to warrant hospitalization or parenteral therapy Concomitant use of any of the following medications Drugs metabolized by CYP3A isozyme: alprazolam, astemizole, carbamazepine, cilostazol, cisapride, cyclosporin, disopyramide, ergot alkaloids, lovastatin, methylprednisolone, midazolam, omeprazole, oral anticoagulants (e.g. warfarin), pimozide, quinidine, rifabutin, sildenafil, simvastatin, tacrolimus, terfenadine, triazolam and vinblastine Drugs metabolized by other isozymes within CYP450 system: phenytoin, theophylline and valproate Colchicine, Digoxin, Some antiretrovirals: zidovudine and ritonavir Severe immunodeficiency and chronic disease conditions Renal or hepatic impairment (creatinine clearance under 30 mL/min, aspartate aminotransferase (AST), alanine aminotransferase (ALT) and gamma-glutamyltransferase (GGT) equal or more than 3x higher level in comparison with the norm) Mental condition rendering the subject unable to understand the nature of the study


eligible ages (years): 18.0-999.0,  All  Ventilator Associated Pneumonia All patients admitted to intensive care units,with score in the Glasgow Coma scale less than nine Requiring mechanical ventilation for more than 48 hours Includes all patients with structural or metabolic coma  Pregnant women History of allergic reactions to ampicillin sulbactam Patients admitted as potential organ donors Patients with an indication of antibiotic therapy, or who have received more than 2 doses of any antibiotic previously Hospital stay for more than 48 hours before intubation


eligible ages (years): 0.167-4.917,  All  Severe Pneumonia Age between 2 to 59 months who present to LHWs with severe pneumonia Informed consent given by a legal guardian  Very severe disease Persistent vomiting Parental or caretaker refusal to participate in the study Children currently being treated for non-severe pneumonia who advance to severe pneumonia Suspected or known kerosene oil ingestion Prior enrollment in the study within 2 weeks of last follow up Children with severe malnutrition . Children with severe diarrhea with signs of dehydration


eligible ages (years): 18.0-999.0,  All  Pneumonia Male or female patients aged ≧18 years old Patients with nosocomial bacterial pneumonia at least 48 hours after hospitalization or patients with healthcare-associated pneumonia(HCAP*) Clinical findings At least two of the following signs Cough Fever: axillary temperature > 37.5℃ or tympanic temperature > 38.5℃ Hypothermia: axillary temperature < 34℃ or tympanic temperature < 35℃ Purulent sputum production or respiratory secretion Total peripheral white blood cell (WBC) count > 10,000/mm3; or > 15% band forms, regardless of total peripheral white count; or leucopenia with total WBC < 4500/mm3 Auscultatory findings on pulmonary examination of rales and/or evidence of pulmonary consolidation (dullness on percussion, bronchial breath sounds, or egophony)  Woman who are pregnant (determined by urine test) or lactating state Patients with known bronchial obstruction or a history of postobstructive pneumonia. (This does not patients who have chronic obstructive pulmonary disease) A neutrophil count <1000/mm3 Patients with pneumonia due to viral, fungal, or mycobacterial infection Patients who were known to have been infected with human immunodeficiency virus Documented Legionella pneumonia Patients were infected with gram negative (G-) microorganism known to be resistant to one of the study antibiotics during trial Subjects with sputum gram stain of PMN>25, epithelial cell <10, and gram positive (G+) cocci in cluster predominant and phagocytosis Patients who have received any other investigational drug within 30 days prior to enrollment Patients who have received medications like cefoperazone, cefoperazone/sulbactam and cefepime within 30 days prior to enrollment


eligible ages (years): 0.5-1.917,  All  Pneumonia Laboratory Confirmed Influenza Children will be included if they are de jure residents 6 months to 23 months old at the time of first dose vaccination residing in households under surveillance  Children will be excluded if they have known chronic respiratory, cardiac, or neurological (including seizure disorders) illnesses, are severely malnourished or require hospitalisation for any other reason, are suspected of having tuberculosis (WHO guidelines) [83], are known to have egg allergy, or parents withhold consent


eligible ages (years): 18.0-999.0,  All  Stage III Non-small Cell Lung Cancer Adult patients 18 years and older with histology proven NSCLC with inoperable stage III A or IIIB disease Inoperable stage III A defined by multiple and or/bulky N2 mediastinal lymph nodes on computed tomography (CT) scan such that in opinion of treating investigator, the patient was not a candidate for surgical resection N2 disease must be documented by either biopsy, fluorodeoxyglucose positron emission tomography (PET), and or CT scan if nodes are more than 2 cm Stage IIIB patients must have N3 or T4 status. N3 status must be documented by presence of contralateral (to the primary tumor) mediastinal lymph node or supraclavicular or scalene lymph node proven by either biopsy, fluorodeoxyglucose PET, or more than 2 cm on CT scan No prior treatment for lung cancer ECOG Performance status of 0-1 Initiation of consolidation chemotherapy within 4-8 weeks of concurrent chemo-radiotherapy without progression Adequate organ function leukocytes >3,000/mcL absolute neutrophil count >1,500/mcL  Patient who have had prior treatment for lung cancer Prior history of radiation to chest Known malignancy other than the current cancer Uncontrolled intercurrent illness including but not limited to ongoing active infection, history of cardiac disease, e.g. uncontrolled hypertension, unstable angina, congestive heart failure, myocardial infarction within last six months or ventricular arrhythmias requiring medication, psychiatric illness that would impair patients ability to comply with study requirements Pregnant or lactating women (any women becoming pregnant during the study will be withdrawn from the study) Patient with documented or symptoms of peripheral neuropathy History of allergic reaction to compounds similar to the ones used in this study Malignant effusions (pleural or pericardial) Superior sulcus (Pancoast) tumors Any condition that would hamper ability to give informed consent or ability to comply with study protocol


eligible ages (years): 0.25-5.0,  All  Streptococcus Pneumoniae Nasopharyngeal Carriage To estimate the nasopharyngeal carriage rate and longitudinal pattern of Streptococcus pneumoniae in healthy children aged less than 5 years living in the area of Milan, Italy To describe the circulation of antimicrobial non-susceptible Streptococcus pneumoniae strains in healthy children aged less than5 years  To describe the nasopharyngeal carriage distribution of Streptococcus pneumoniae strains in healthy subjects less than 5 years old To examine the role of risk factors in the Streptococcus pneumoniae carriage rate in healthy children To evaluate the possible impact of vaccination policy in the referenced population


eligible ages (years): 0.0-2.0,  All  Wheezing Bronchiolitis Age less than or equal to 24 months Presenting to the pediatric ED with wheezing  On home oxygen at baseline Cyanotic congenital cardiac disease (including: ToF, TAPVR, HLHS, d-TGA, TA, pulm atresia, critical pulm stenosis, but not including VSD, ASD, Coarctation of the Aorta) Endotracheal tube or tracheostomy in place and/or receiving mechanical ventilation Transferred from an outside hospital


eligible ages (years): 18.0-999.0,  All  Novel H1N1 Influenzal Acute Respiratory Infection > 18years Suspected or confirmed influenza (Appendix A) Requirement for ICU admission due to respiratory distress or critical illness defined as one of:a) Inspired oxygen need of >50% for at least 4 hours (For FiO2 for non-intubated patients see Appendix B) b) mechanical ventilation c) Patient is receiving inotrope or vasopressor  Age less than 18 years


eligible ages (years): 18.0-999.0,  All  Pneumonia Severe community acquired pneumonia treated with azithromycin age over 18 years  Azithromycin initiated before hospitalization technically undecipherable ECG Permanent pacemaker


eligible ages (years): 18.0-999.0,  All  Pneumonia, Bacterial New diagnosis of pneumonia Patient in medical or surgical intensive care unit Age greater or equal than 18 years old  Neutropenia Recipient of a solid organ or bone marrow transplant Bacteremia Presence of Acinetobacter baumannii or Stenotrophomonas maltophilia from a respiratory tract culture Presence of a second infection requiring antibiotic therapy Pregnancy Enrollment in another clinical study Patient or surrogate unable to provide informed consent Attending intensive care unit physician declined enrollment in the study


eligible ages (years): 20.0-999.0,  All  Pneumonia Males and non-pregnant, non-lactating females with written informed consent, 20 years of age or older Within 48 hours prior to the first study drug administration, all patients should have the pathogens identified with appropriate specimens (e.g., sputum, tracheal aspirate, bronchoalveolar lavage [BAL], protected brushing specimen [PBS]), or should have appropriate specimens highly likely to identify the pathogens sampled. (However, the patients with Legionellosis is enrolled when the test of Legionella antigen is positive.) The following severe bacterial pneumonia meeting the diagnostic of pneumonia or secondary infection of chronic respiratory disease Severe pneumonia Community-acquired pneumonia: PORT score III, IV or V Hospital-acquired pneumonia [HAP]-Group B and with a low risk for multidrug-resistant pathogens Patients with [HAP]-Group A whose pathogen is suspected to be Pseudomonas aeruginosa Hospitalized patients with bacterial pneumonia with a poor response to other antimicrobials Note: The patients should be limited to CAP patients with PORT score III, IV or V and HAP patients with-Group A or B who don't respond to or have a poor response to other antimicrobials over 3day's treatment.2 Secondary infection of chronic respiratory disease Patients who are hospitalized for the treatment of secondary infection of chronic respiratory disease  Creatinine clearance (Ccr) ≤ 30 mL/min or nephrotic syndrome Patient with chronic treatment of immunosuppressive drug Decompensated congestive heart failure Subject who received more than 24 hours of an antibacterial drug for the current infection Patient who requires Intensive Care Unit (ICU) management [In case subjects who don't correspond to the severity for ICU management need to be admitted to ICU due to a circumstance of the site (e.g. shortage of hospital beds), those subjects shall not be excluded] Patients with infections other than pneumonia or secondary infection of chronic pulmonary disease Lung abscess, or empyema Viral, fungal, mycobacterial, or atypical pneumonia as a primary diagnosis Known or suspected bacteremia secondary to Staphylococcus aureus Known causative microorganisms other than indication (microorganisms) of the study drug, or positive in urinary antigen test of Streptococcus pneumonia


eligible ages (years): 18.0-999.0,  All  Bacterial Pneumonia Written informed consent by the subject/subject's LAR Hospitalized males or females ≥ 18 yrs with respiratory failure requiring mechanical ventilation and clinical suspicion of HABP, HCAP or VABP Onset or exacerbation of pneumonia at least 48 hours after admission to any patient health care facility or onset of pneumonia in a nursing home or rehabilitation facility with subsequent transfer to an acute care facility Women of childbearing potential if their pregnancy test is negative Subjects who have received previous antibacterial therapy within 14 days of pre-treatment bronchoscopy entry may be entered only if the subject has not responded clinically.). While less than 24 hours of pre-treatment antibiotics is preferential, recovery of >104 CFU/ml in the quantitative Bronchoscopic BAL will be seen as primary evidence that the prior therapy was not efficacious and enrollment will be allowed.) Patients should have clinical findings that support a diagnosis of HABP/VABP/HCAP Within 48 hours before starting empiric therapy a subject's chest radiograph should show the presence of a NEW or progressive infiltrate, cavitation, or effusion suggestive of pneumonia Within 36 hours before the start of empiric study therapy, a quantitative culture of Bronchoscopic BAL fluid must be obtained Patients with VABP should have a Clinical Pulmonary Infection Score of >/= 5  Subjects with pneumonia caused by pathogens resistant to meropenem (MIC greater than or equal to 16µg/ml) or a prior meropenem therapy failure Subjects with contra-indications to ANY study medication, in particular with known or suspected allergy or hypersensitivity Women who are pregnant or lactating Subjects taking anticonvulsant medications for a known seizure disorder.Patients with a history of seizures, AND who are stabilized on anti-seizure medication, may be enrolled into the study at the discretion of the site investigator Subjects with known or suspected community acquired bacterial pneumonia (CABP) or viral pneumonia; or Subjects with acute exacerbation of chronic bronchitis without evidence of pneumonia Subjects with primary lung cancer or another malignancy metastatic to the lungs Subjects who were previously enrolled in this study Subjects who have had an investigational drug or have used an investigational device within 30 days prior to entering the study Subjects with another focus of infection requiring concurrent antibiotics that would interfere with evaluation of the response to study drug Subjects with cystic fibrosis, AIDS with a CD4 lymphocyte count <200 cells/µl, neutropenia (absolute neutrophil count <500 cells/ml), known or suspected active tuberculosis


eligible ages (years): 19.0-92.0,  All  COPD Men of ages 18 and 30 (Dates of birth 1973-1985) or 55-92 years old (Dates of birth 1911-1948) Must not currently be a cigarette smoker. If an ex-smoker then has not smoked for at least 10 years and consumption were no more than 10 pack years Agrees to volunteers for the study and willing to sign the informed consent form There were negative/normal screening tests for the following Responses to the questionnaire deny current and prior respiratory diseases (including asthma, emphysema, chronic bronchitis, sinusitis and interstitial lung d9sase) and no current respiratory complaints (e.g., cough, wheezing, shortness of breath, allergic rhinitis, and sinusitis). Subjects must not be taking any cardiac medications or admit to a physician-diagnosed cardiac condition "Normal" spirometry measurements with FEV1 & FVC greater than 75% predicted and FEV1/FVC more than 69% Impedance oscillometry were within normal limits "Negative" physical examination of the chest with absence of wheezing and crackles on auscultation of the chest Exhaled nitric oxide concentration is less than 35 ppb for younger and less than 65 ppb for older groups  men of: ages < 18, 31-54 and >92 years old current cigarette smokers or exsmokers who have smoked within the past 10 years and/or smoked more than 10 pack/years refusal to volunteer for the study and not willing to sign the informed consent form screening test not considered "normal" by physician/PI and showing one or more of the following one or more positive response to the questionnaire(e.g., current or past respiratory diseases including asthma, emphysema, chronic bronchitis, sinusitis and interstitial lung disease; and/or; current respiratory complaints (e.g., cough, wheezing, shortness of breath, allergic rhinitis, and sinusitis) and/or; admitting to taking a cardiac medication and/or; or physician-diagnosed cardiac condition (e.g., coronary heart disease, angina, myocardial infarction, valvular heart disease, cardiomyopathy, etc.) Abnormal spirometry measurements (FEV1 &/or FVC <75% predicted and FEV1/FVC <69%) "Positive" physical examination (performed by Physician/PI) with presence of wheezing and/or crackles on auscultation of the chest Impulse oscillometry >4 times normal limits Exhaled nitric oxide of >35ppb for younger group and >65 ppb for older group. -


eligible ages (years): 2.0-18.0,  All  Community-acquired Pneumonia Children hospitalized for community-acquired pneumonia 18 years old  Pulmonary chronic disease (including asthma) Immunodeficiency Diseases wich requires corticosteroids therapy (i.e. rheumatic diseases) Wheezing in current disease Previous hospitalization (14 days prior to admission) Pleural effusion on admission Malnutrition


eligible ages (years): 18.0-999.0,  All  Community Acquired Pneumonia or older admitted with CAP will be included sequentially. Pneumonia is defined as pulmonary infiltrate shown in a thoracic X-ray not known to be old  patients with human immunodeficiency virus infection immunosupressed patients (with a solid organ transplant, spelenectomy, treated with a prednisone dose of 10 mg/day or equivalent for longer than 30 days or with other immunodepressors, with neutropenia) those hospitalized in the 14 days prior and those living in assisted care facilities pneumonia cases caused by infrequent agents (i.e. P. aerouginosa, S. Aureus) will also be excluded, as well as infectious processes requiring an extended treatment with antibiotocs (i.e. bacterial endocarditis, abscesses) pneumonia cases with pleural effusion requiring a drainage tube patients who were deceased or admitted to ICU before randomization and those not giving their informed consent


eligible ages (years): 18.0-999.0,  All  Community-acquired Pneumonia ● Adult patients greater than age 17 years who are initially evaluated in the ED with symptoms of CAP. This includes those who will be treated as outpatients and those admitted to the hospital (both ward and ICU) The definition of CAP is as follows Presence of pulmonary infiltrates on chest radiography. (Initial reading may be performed by the ED physician but has to be confirmed by board certified radiologist for in the study) At least 2 of the following: new onset of cough, productive sputum, shortness of breath, chest pain, fever > 380C, abnormal chest auscultation, WBC > 12,000 cells/mL Able to provide informed consent Read, signed, and dated informed consent document Available for follow-up for the planned duration of the study  Patients with underlying immunosuppressive illness (HIV, neutropenia, asplenia, transplant recipient, cystic fibrosis, receipt of immunosuppressive medications including corticosteroids, (equivalent of prednisone > 10 mg) cancer chemotherapy, or anti-tumor necrosis factor agents Patients residing in long-term care facilities


eligible ages (years): 18.0-75.0,  All  Healthy Volunteers and Asthma Understanding of the study and a signed informed consent form before any study-related procedures Willing and able to adhere to the restrictions specified in the protocol Results of the following laboratory tests within the following limits: serum alanine aminotransferase (ALT) levels ≤2 x ULN; serum aspartate aminotransferase (AST) levels ≤2 x ULN Part 1 (healthy participants) a). Body weight in the range of 40 to 125 kg, inclusive. Have a body mass index (BMI) of 19 to 32 kg/m2, inclusive b). Healthy with no clinically significant abnormalities as determined by medical history, physical examination, blood chemistry assessments, hematologic assessments, coagulation and urinalysis, measurement of vital signs, and 12-lead electrocardiogram (ECG) performed at Screening Visit 2 Part 2 a). (BMI) of 19 to 40 kg/m2, inclusive; have a physician-documented diagnosis of asthma for at least 6 months prior to Screening Visit 2; have stable asthma based on physician assessment at Screening Visit 2 b). Have an Asthma Control Questionnaire (ACQ) symptom score less than (<)2.5 at Screening Visit 2 c). Have a prebronchodilator forced expiratory volume in the first second (FEV1) greater than or equal to (>=) 65 percent of predicted normal value at Screening Visit 2  Part 1 (healthy participants): Has any condition that in the opinion of the investigators, would constitute a risk or a contraindication for participating in the study, prevent the participant from meeting or performing study requirements, or could interfere with the study objectives, conduct, or evaluation At Screening Visit 1 and throughout the study, works with (or lives with a family member who cares for) the elderly, (eg, nursing home), or lives with someone who may be at risk from transmission of the human rhinovirus type 16 (HRV-16) challenge agent, including, but not limited to, individuals with chronic lung disease (including asthma), a premature infant, or an immunocompromised individual Has had any acute illness, including a common cold, within 4 weeks prior to Screening Visit 1, or has had a major illness or hospitalization within 6 months prior to Screening Visit 1 Has active allergic rhinitis or perennial allergy symptoms (eg, due to ragweed) at Screening Visit 2 or expects to have active allergic rhinitis or perennial allergy symptoms during the study Has a current infection (eg, sepsis, pneumonia or pyelonephritis), or has been hospitalized and/or received antimicrobials for a serious infection during the 6 months prior to Screening Visit 1 Part 2 (asthmatic patients): Has a history of any other chronic lung disease, including chronic obstructive pulmonary disease (COPD), bronchiolitis, bronchiectasis, allergic bronchopulmonary aspergillosis (mycosis), occupational asthma, sleep apnea, pulmonary hypertension, or any other obstructive pulmonary disease, liver or renal insufficiency; significant unstable cardiac, vascular, pulmonary, gastrointestinal, endocrine, neurologic, hematologic, rheumatologic, psychiatric, or metabolic disturbances, or other body system disorders that are clinically significant in the opinion of the investigator Has ever had an episode of life-threatening asthma defined as respiratory arrest or requiring intubation for asthma Has been hospitalized (for greater than 24 hours) due to asthma in the 5 years prior to Screening Visit 1 Has experienced an asthma exacerbation in the 12 weeks prior to Screening Visit 1 requiring management with systemic steroids Is receiving a high-dose inhaled corticosteroid (ICS) (>500 µg/day to fluticasone or equivalent). Use of low or medium dose ICS (≤500 µg/day fluticasone or equivalent) with or without permitted controller medications, eg, long-acting Beta2 agonists (LABA), leukotriene receptor antagonists (LTRA), is allowed


eligible ages (years): 1.0-10.0,  All  Pneumonia children aged 1-10 y presenting to the emergency department must fulfil definition of 'pneumonia', ie any one of fever in the ED a recorded fever at home in the 48h prior to presentation, or WBC > 12 or WBC < 5 in the ED any one of tachypnoea on exam cough on exam or by history increased work of breathing on exam; or  or more episodes of emesis in the emergency history of CF, anatomic lung disease, bronchiectasis, congenital heart disease, repeated aspirations, malignancy, immune suppression, recent prolonged admission to hospital, pneumonia diagnosed within the last month, lung abscess within the past six months, > 24 hours of beta-lactam antibiotic therapy prior to presentation, allergy to penicillin, allergy to food colouring evidence of empyaema or necrotizing pneumonia on chest radiograph


eligible ages (years): 18.0-999.0,  All  Pneumonia, Bacterial Nosocomial Infection Intraabdominal Infections Urinary Tract Infection Patients who are diagnosed with nosocomial pneumonia including ventilator-associated pneumonia, complicated intra-abdominal infections or complicated urinary tract infection Patients who are eligible for doripenem treatment  Pregnant or lactating females Patients with hypersensitivity to doripenem and/or its derivatives Known at study entry to have an infection caused by pathogen(s) resistant to doripenem Patients taking probenecid History of severe allergies to certain antibiotics such as penicillins, cephalosporins, and carbapenems Severe impairment of renal function including a calculated creatinine clearance of less than 10 mL per minute, requirement for peritoneal dialysis, hemodialysis or hemofiltration, or oliguria (less than 20 mL urine output per hour over 24 hours)


eligible ages (years): 18.0-45.0,  All  Neonatal Infection Pregnant women (aged 18 to 45 years) in labour attending a health centre in western Gambia for delivery  Known HIV infection Any chronic or acute conditions of the women that might interfere with the study as judged by the research clinician Planned travelling out of the catchment area during the following 2 months (follow-up period) Planned caesarean section Known required referral Known multiple pregnancy Known severe congenital malformation Intrauterine death confirmed before randomization Known allergy to macrolides Consumption of antibiotic within the week before randomisation


eligible ages (years): 18.0-999.0,  All  Lung Transplant Infection Lower Respiratory Tract Infection. Post bilateral sequential lung transplant Capable of performing airway clearance techniques / nebulisers Pulmonary exacerbation as defined by Fuchs et al Must be productive of sputum Able to provide informed consent within 48 hours of presentation *Fuchs Scale(8): Treatment with / without parenteral antibiotics for 4/12 signs and symptoms Change in sputum New or increased haemoptysis Increased cough Increased dyspnoea  Paediatric transplant <18yrs Single lung transplant native lung physiology may confound outcome measures Interstate unable to complete follow up Unable to perform lung function testing Unable to complete subjective outcome measures unable to read English fluently Critically unwell / ICU / ventilator dependent Within 2 months of transplant date *Cystic Fibrosis will be stratified


eligible ages (years): 0.0-5.0,  All  Pneumonia Bronchiolitis Asthma All children below 5 exceeding WHO age-dependent tachypnea criteria


eligible ages (years): 40.0-999.0,  All  Idiopathic Pulmonary Fibrosis Males/females aged 40 years and over, at the time of signing the informed consent A female patient is eligible to participate if she is of: Non child-bearing potential, where females are post-menopausal, defined as 12 months of spontaneous amenorrhea [in questionable cases a blood sample with simultaneous follicle stimulating hormone (FSH) >40 milliinternational units per milliliter (MlU/mL) and estradiol < 40 picograms per mililiter (pg/mL) (<147 pmol/L) is confirmatory. Peri-menopausal or pre-menopausal, and have a negative pregnancy test as determined by serum or urine human chorionic gonadotropin (hCG) test, confirmed at screening, and then at each subsequent clinic visit before the CT scanning is conducted BMI within the range 18 kilogram per meter^2 (kg/m^2) (inclusive) Capable of giving written informed consent, which includes compliance with the requirements and restrictions listed in the consent form Patients will have a diagnosis of IPF as determined by a responsible and experienced Respiratory physician and based on established defined by the American Thoracic Society/European Respiratory Society: American Thoracic Society/European Respiratory Society International Multidisciplinary Consensus Classification of the Idiopathic Interstitial Pneumonias Patient's lung function measurements of Forced vital capacity (FVC) and Diffusing capacity of the Lung for Carbon Monoxide (DLCO) at screening must fall within the category below to be included in this study: FVC >=40 % predicted and DLCO >=30 % predicted  Patients with a current Idiopathic Pulmonary Fibrosis (IPF) exacerbation Patients with a known underlying cause of pulmonary fibrosis Patients that have both IPF and Chronic obstructive pulmonary disease (COPD) that requires therapy with more than an intermittent bronchodilator or a long acting muscarinic antagonist, or where the Forced Expiratory Volume in One Second (FEV1)/ Forced vital capacity (FVC) ratio is <0.65 Patients with an upper or lower respiratory tract infection within four weeks of Visit 1 Patients with a recognised co-existing respiratory disorder other than usual interstitial pneumonia (UIP) (e.g. significant COPD, asthma, sarcoid, lung carcinoma) that in the opinion of the investigator would confound the study outcomes Patients with poorly controlled left ventricular heart failure Serious or uncontrolled medical, surgical or psychiatric disease that in the opinion of the investigator would compromise patient safety or confound the study data (e.g. congestive cardiac failure [CCF], asthma, angina, neurological disease, liver dysfunction and blood dyscrasia) Patients found to have clinically significant anaemia until adequately treated Patients that have a history of alcohol abuse Patients who are currently taking Pirfenidone for IPF or who have received Pirfenidone within the previous 30 days prior to Visit 1


eligible ages (years): 18.0-999.0,  All  Pneumonia Be 18 years of age Having the diagnosis of ventilator-associated pneumonia  Be under 18 years of age


eligible ages (years): 18.0-999.0,  All  Community Acquired Pneumonia Pleuritis Pulmonary Embolism Lung Cancer patient aged 18 years and older patient affected by thoracic pleuritic pain  patient affected by a chronic condition causing thoracic pain patient affected by acute cardiovascular diseases (e.g. acute coronary syndrome)


eligible ages (years): 0.0-21.0,  All  Community Acquired Pneumonia All intubated pediatric patients Age 1 day to 21 years Admitted to the LLUCH PICU with suspected pneumonia for the next 6 months Have received antibiotics for less than 12 hours Have been intubated for less than 24 hours Patients must be English or Spanish speaking for consent purposes  Patients who have received antibiotics for greater than 12 hours Patients who have been intubated for greater than 24 hours Patients who are unable to tolerate non-bronchoscopic bronchoalveolar lavage


eligible ages (years): 18.0-999.0,  All  Pneumonia Streptococcus Pneumoniae Immune Response Patients who participated in the Ovidius or Triple-P study (2004-2009) Diagnosis in these studies with pneumococcal pneumonia or pneumonia due another identified organism Age ≥ 18 years Signing of informed consent  Diagnosis of pneumonia without an identified causative organism Fever at time of vaccination Previous/known allergic reaction to any of the components of the vaccine given Mentally incompetent Previous pneumococcal conjugate vaccination Pneumococcal polysaccharide vaccination within 6 months prior to inclusion Clinical pneumonia within 1 month prior to inclusion


eligible ages (years): 18.0-999.0,  All  Ventilator-Associated Pneumonia Mechanical ventilation for at least 48 hours New or evolving infiltrate on chest radiograph (CXR) or computed tomography (CT), and A minimum of two of the following clinical Body temperature ≥ 38.5° C (101° F) or < 36° C (97° F) White blood cell count > 10,000/ml or < 4,000/ml or > 10% immature cells Partial pressure of oxygen in arterial blood < 60 mmHg or partial pressure of oxygen in arterial blood/ inspired oxygen fraction ratio < 300 Purulent respiratory secretions  Known ongoing pneumonia Patient younger than 18 years old Mechanical ventilation <48 hours Contraindication to bronchoscopy


eligible ages (years): 0.25-4.917,  All  Pneumonia Children admitted with severe pneumonia as defined by the presence of all the following as defined as below months to 59 months old History of cough and/or shortness of breath Unwell for <= 7 days -Increased respiratory rate ( ≥ 50/min if ≤12 months old, ≥ 40/min) or retractions,- Any of the following signs/symptoms are present at examination that would necessitate admission: chest retractions, cyanosis, saturation< 92% on air, poor feeding or lethargy Documented fever (axillary /central temp ≥ 38/38.5°C) within 24 hrs of admission Abnormal CXR with presence of alveolar infiltrates Responds to IV antibiotics by the first 72 hrs and able to go home with oral antibiotics i.e. no more hypoxia and afebrile and reduced respiratory symptoms  Children who (a) are transferred from another hospital (b) refuse blood taking (c) have a doctor diagnosis of asthma or recurrent wheezing illness (d) have a diagnosis of bronchiolitis i.e. wheezing in a child with a CXR with no consolidation (e) not acute illness ( ie >7 days) (f) unable to come for follow-up (g) not community acquired pneumonia e.g. aspiration pneumonia (h)complicated pneumonia with effusion, pneumothorax, clinical suspicion of necrotizing pneumonia (i)PICU admission or use of Non-invasive ventilation (j)significant comorbidities that can increase the risk of having a complicated pneumonia (k) need for use of other antibiotics like anti-staph or macrolides (l)extra-pulmonary infection e.g. meningitis (m)allergy to penicillin (n) unable to tolerate oral antibiotics (o) underlying illness that can predispose to recurrent pneumonia


eligible ages (years): 18.0-999.0,  All  Pneumonia have a positive Febrile Respiratory Illness (FRI) screen on admission to hospital (http://www.health.gov.on.ca/fr/public/programs/emu/sars/reports/dir_122303_acute_care_nonoutbreak.pdf) diagnosed with pneumonia by the admitting physician (Acute exacerbations of chronic obstructive lung disease are considered within the definition of pneumonia for the purposes of this study as they are commonly treated with the same antimicrobial regimens as patients with pneumonia) admitted to a medical ward  hospitalized for ≥ 48 consecutive hours in the preceding 3 months receiving immunosuppressants [defined as ≥ 40 mg prednisone daily (or steroid equivalent) for ≥ 2 weeks preceding hospitalization OR any other immunosuppressant used for systemic illness OR to prevent transplant rejection] neutropenic [defined as a polymorphonuclear count ≤ 0.5 x 109 cells/L] from any cause immunocompromised [defined as having leukemia, lymphoma, HIV with CD4 cell count ≤ 200, splenectomy or on cytotoxic chemotherapy] admitted to high acuity units such as intensive care units require mechanical ventilation, either non-invasive or invasive have a life expectancy of ≤ 3 months (palliative)


eligible ages (years): 18.0-999.0,  All  Pneumonia Community-acquired pneumonia Immunocompetent Age > 18 years  Admitted to an intensive care unit or high intensity unit Requiring invasive or non-invasive ventilation Life expectancy less than 3 months Hospitalization within the previous 3 months for at least 48 consecutive hours Immunocompromised defined as defined as having leukemia, lymphoma, HIV with CD4 count <=200, splenectomy or on cytotoxic chemotherapy Neutropenic [defined as a PMN count<=0.5x109 cells/L] from any cause Receiving immunosuppressants [defined as >=40 mg prednisone daily (or steroid equivalent) for >=2 weeks preceding hospitalization OR any other immunosuppressant used for systemic illness OR to prevent transplant rejection


eligible ages (years): 18.0-999.0,  All  Coughing Cough is the main or only clinical symptom and was persistent for 3-8 weeks Chest X-ray reveals no noticeable pathological changes ≥18 year old, regardless of gender and ethical background Not taking angiotensin-converting enzyme inhibitor Patients must join the programme voluntarily and are able to attend examination and follow-up sessions  Patients diagnosed with rhinallergosis, chronic nasosinusitis or bacterial respiratory tract infections Patients diagnosed with severe reportorial disease of other severe systemic disease Patients who are allergic to any drugs to be tested Patients who are non-cooperative during examination sessions or other steps of the trial Patients who are not able to or refuse to sign consent


eligible ages (years): 18.0-999.0,  All  Cough Cough is the main or only clinical symptom and was persistent for 3-8 weeks Chest X-ray reveals no noticeable pathological changes year old, regardless of gender and ethical background Not taking angiotensin-converting enzyme inhibitor Patients must join the programme voluntarily and are able to attend examination and follow-up sessions  Patients diagnosed with allergic rhinitis, chronic nasosinusitis or bacterial respiratory tract infections Patients diagnosed with severe reportorial disease of other severe systemic disease Patients who are allergic to any drugs to be tested Patients who are non-cooperative during examination sessions or other steps of the trial Patients who are not able to or refuse to sign consent


eligible ages (years): 0.167-4.917,  All  Pneumonia Tachypnea History of cough or difficult breathing < 14 days (observed or reported) AND Respiratory rate ≥ 50 breaths per minute in children 2 to <12 months (on two consecutive readings by independent physicians) OR respiratory rate ≥ 40 breaths per minute in children12 months (on two consecutive readings by independent physicians) AND Written informed consent by a legal guardian  Previously enrolled in study Pedal edema History of hospitalization in last two weeks With severe lower chest wall in-drawing Known asthmatics,TB or other severe illness Antibiotics taken in last 48 hours Bulging fontanel Congenital heart disease Any surgical condition requiring hospitalization Out of catchment area


eligible ages (years): 21.0-59.0,  All  Respiratory Failure Healthy male or female volunteers in the age group  Any acute or chronic cardiopulmonary disorder including a simple common cold


eligible ages (years): 0.083-2.0,  All  Bronchiolitis Patients admitted to the pediatric intensive care unit or pediatric nursing unit. Which they are diagnostic of acute viral bronchiolitis (AVB)  Presence of cyanotic congenital heart disease no longer for comparing the constants Relative or absolute contraindication CPT techniques included in the protocol Patients diagnosed with moderate or severe gastroesophageal reflux since the PSE gastroesophageal reflux can accentuate a previously exist Patients with laryngeal diseases caused because the cough is a technique that is applied directly to the tracheal wall and can affect the larynx Absence of cough reflects and presence of laryngeal stridor is a contraindication to chest physiotherapy in general Systematic presence of gag reflex as the aspiration of secretions and coughing caused nasobucales stimulate this reflex


eligible ages (years): 65.0-999.0,  All  Pneumonia Patients above 65 years old AND at least one infectious sign: T° >38°C or <35°C; C-reactive protein (CRP) >10 mg/L; leucocytes >10,000/mL with >85% polynuclear neutrophils or left deviation AND at least one respiratory sign: cough; purulent sputum; chest pain; localized crackles; recently appeared dyspnea; oxygen saturation (SpO2) <90%; respiratory frequency >20/min AND who will be prescribed antimicrobial therapy for suspicion of low respiratory tract infection AND who will give consent himself or through his support person  Diagnosis of pneumonia in the previous six months AND/OR more than 48h of antimicrobial treatment given before hospitalization AND/OR thoracic CT scan performed before hospitalization or of the patient Each patient will be included only once


eligible ages (years): 14.0-999.0,  All  Community Acquired Pneumonia Patients > or = 14 years of age Patient meets the of community acquired pneumonia Patient meets the of healthcare-associated pneumonia  Patients <14 years of age Patient meets the of hospital acquired pneumonia Known active tuberculosis or current treatment for tuberculosis Non-infectious pulmonary diseases HIV positive


eligible ages (years): 14.0-999.0,  All  Community Acquired Pneumonia Patients > or = 14 years of age Patient meets the of community acquired pneumonia Patient meets the of healthcare-associated pneumonia Informed consent to participate in the study is provided  Patients participating in a clinical trial or other intervention studies Patients <14 years of age Patient meets the of hospital acquired pneumonia Known active tuberculosis or current treatment for tuberculosis Non-infectious pulmonary diseases （e.g. pulmonary embolism, pulmonary edema, pulmonary vasculitis, interstitial pneumonia） HIV positive


eligible ages (years): 18.0-999.0,  All  Community Acquired Pneumonia Be male or female at least 18 years of age Provide written informed consent and be willing and able to adhere to the study-specified procedures and restrictions Have an acute illness (7 days duration) with at least 3 of the following symptoms consistent with a lower respiratory tract infection (new or worsening) Dyspnea New or increased cough Purulent sputum production Chest pain due to pneumonia Have at least 2 of the following vital sign abnormalities Fever (body temperature >38.0°C (100.4°F) measured orally or equivalent temperature from an alternate body site) or hypothermia (body temperature <35.0°C (95.0°F) measured orally or equivalent temperature from an alternate body site) Hypotension (systolic blood pressure <90 mmHg)  Have received more than a single dose of a short-acting oral or IV antibacterial for CABP within 24 hours before randomization Require concomitant systemic antibacterial therapy potentially effective against CABP pathogens Have been hospitalized for 2 or more days within 90 days prior to the onset of symptoms or have resided in a nursing home or long-term healthcare facility within 30 days prior to the onset of symptoms. NOTE: Residence in an independent living facility is permitted Have confirmed or suspected CABP caused by a pathogen known to be resistant to any of the study drugs (e.g., Pseudomonas aeruginosa, any pathogen of the Enterobacteriaceae Family) or attributable to etiologies other than community acquired bacterial pathogens (e.g., ventilator associated pneumonia, hospital acquired bacterial pneumonia, bacterial aspiration pneumonia, Pneumocystis jiroveci pneumonia or other fungal pneumonia, viral or mycobacterial infection of the lung) Have a noninfectious cause of pulmonary infiltrates (e.g., pulmonary embolism, chemical pneumonitis from aspiration, hypersensitivity pneumonia, congestive heart failure, bronchial obstruction, lung cancer, cystic fibrosis) Have confirmed or suspected pleural empyema (does not sterile parapneumonic effusions) Require mechanical ventilation


eligible ages (years): 17.0-70.0,  All  Cough chronic cough group cough lasting ≥ 8 weeks,characterized by irritating dry cough sensitive to fumes，dust,the odorous and cold air with normal chest x-rays. 4.17-70 years old without smoking history. healty controls group: 1.17-70 years old. 2.without smoking hitory or stop smoking for more than 2 years. 3.without chronic cough. 4.without chronic respiratory diseases. 5.without chronic heart, liver, kidney,and autoimmune disease. 6.with normal chest x-rays. 7.with normal pulmonary ventilation function,and histamine challenge test showed negative result  chronic cough group and healty controls group with respiratory tract infection within 8 weeks with chronic respiratory diseases or severe heart, liver, kidney,and autoimmune disease using Angiotensin-Converting Enzyme Inhibitors(ACEI),bronchodilators,glucocorticosteroid,antihistaminics within one week women during pregnancy or lactation patients with malignant tumours


eligible ages (years): 0.5-3.0,  All  Acute Otitis Media Male or female aged < 407 days or less than/equal to 36 months old and meets recurrent acute otitis media Child has received full ( 3 dose ) infant series of Prevnar 13 Parent/guardian willing to bring to all study visits  Any major illness/condition that in investigator opinion would put subject at risk during study Participation in another investigational/interventional trial within 28 days prior or during study. ( Observational study is permitted ) Direct descendant of study site personnel