It is not unusual for an organism not to be identified on the pleural fluid culture and therefore broad-spectrum antibiotic coverage should be instituted when the diagnosis of empyema is made. This can be modified if the culture data identifies Selleckchem Galunisertib an organism. Early VATS combined with early rehabilitation offers excellent results, radically improving the outcome in both the fibrinopurulent, as well as in organizing stages of PE in children, but surgeon should be experienced in the less invasive technique. The method seems to be successful even in very neglected cases, if not patient could benefit

from fibrinolytic therapy. According to order. None declared. “
“Vaccines are among the greatest and most effective public health interventions in

preventing morbidity, mortality and public health costs caused by infectious diseases [1]. Today, incidence rates of vaccine GDC-0068 in vitro preventable disease (VPDs) in the U.S. have declined to an all time low [2]. Despite the undoubted success, the nearly forgotten VPDs in the U.S. are back. From 2001 – 2008, a median of 56 (range: 37–140) measles cases were reported to the CDC annually. During the first 19 weeks of 2011, 118 cases of measles were reported, the highest number reported for this period since 1996. Of the cases, 105 (89%) were imported from other countries and unvaccinated persons accounted for 105 (89%) [3]. There were outbreaks of mumps [4], an invasive HiB disease [5]. The CDC reports on its website that in 2010, 9 143 cases of pertussis were reported in California, the most cases reported since 63 years. Among them were 10 infants who died from the disease. There were outbreaks in Michigan, Ohio and other states [6]. The USA is on the verge of becoming a victim of this

success, because increasing numbers of parents, who apparently love their children, refuse to vaccinate them. Why does it happen? The answer to this question is not easy and straightforward. Robert Chen Cytidine deaminase tried to answer this question showing the graph dubbed – “Natural history of an immunization program” (Fig. 1) [7]. In the first, pre-vaccine period, people feel threatened by the disease, especially if the disease is communicable and hard to treat. They often know victims of the disease, who either died or suffered from the complications. When a vaccine becomes available, people widely and enthusiastically accept it, even despite side effects the vaccine can cause. The best example of this is a national enthusiasm in the USA after developing the polio vaccine in the 1950s. In the second period, when a vaccine causes a massive decrease in VPD cases and deaths, people start to forget the threat, a memory of the victims and social disruptions of the disease fades. With the increased use of a vaccine, the focus is on real and imaginary side effects of vaccination.