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D. MAKING THE DIAGNOSIS OF ACUTE APPENDICITIS: DO MORE
PREOPERATIVE CT SCANS MEAN FEWER NEGATIVE
APPENDECTOMIES? A 10-YEAR STUDY
Courtney A. Coursey, Rendon C. Nelson, Mayur B. Patel, Courtney Cochran
Radiology, February 2010, Vol. 254, pp. 460-468
PURPOSE
To determine the frequency of preoperative computed tomography
(CT) in the evaluation of patients suspected of having appendicitis at one
institution during the past 10 years and to determine whether changes in CT
utilization were associated with changes in the negative appendectomy rate.
DESIGN
A surgical database search.
MATERIALS AND METHODS
925 patients (526 men and 399 women [mean
age - 38 years (range 18–95 years]) who underwent urgent appendectomy between
January 1998 and September 2007. CT, pathology, and surgery reports were
reviewed. By using logistic regression, changes in the proportion of patients
undergoing CT and in the proportion of patients undergoing each year
appendectomy in which the appendix was healthy were evaluated. Subgroup
analyses based on patient age (≤ 45 years or > 45 years) and sex also were
performed.
RESULTS
Prior to urgent appendectomy, 18.5% of patients underwent
preoperative CT in 1998 compared with 93.2% of patients in 2007. The negative
appendectomy rate for women 45 years of age and younger decreased from 42.9%
in 1998% to 7.1% in 2007. However, the timing of the decrease in negative
appendectomy rates for women 45 years and younger could not be proved to be
associated with the increase in CT use.
CONCLUSION
Rising utilization of preoperative CT and advances in technology
coincided with a decrease in the negative appendectomy rate for women 45 years
and younger but not in men of any age or women older than 45 years.
negative appendectomy – отрицательная аппендэктомия (удаление
здорового червеобразного отростка)
timing – синхронизация, согласование по времени, хронометраж
72
Выучите слова и выражения, наиболее часто употребляемые в
рефератах:
1.
anatomical outcomes
анатомический результат
2.
biomarker
биологический маркёр, биомаркёр
3.
bone loss
потеря костной массы
4.
bone marrow
костный мозг
5.
bone mineral density
костная минеральная плотность
6.
calcium supplements
кальциевые добавки
7.
closed reduction method
метод закрытого вправления (закрытой
репозиции)
8.
contiguous bone involvement
вовлечение близлежащих костей
9.
counter-traction
вытяжение в противоположном
направлении
10.
distal radius
дистальный отдел лучевой кости
73
11.
dual energy X-ray absorptiometry
двухэнергетическая рентгеновская
абсорбциометрия
12.
forearm
предплечье
13.
fracture
displaced fracture
перелом
перелом со смещением
14.
hip
бедро
15.
inflammatory back pain (IBP)
воспалительная боль в спине
16.
lumbar spine
поясничный отдел (позвоночника)
17.
manual reduction (Syn.
manipulation)
ручное вправление
18.
metaphyseal equivalent sites
метафизарные эквивалентные участки
19.
osteoporotic fracture
остеопоротический перелом
20.
pelvic abscess
внутритазовый абсцесс
21.
pelvic acute hematogenous
osteomyelitis
внутритазовый острый гематогенный
остеомиелит
22.
proximal femur
проксимальный отдел бедренной кости
23.
sacroiliac joint (SIJ)
крестцово-подвздошное сочленение
24.
sacroiliitis
сакроилеит
25.
spondyloarthropathy
спондилоартропатия
26.
traction
вытяжка
74
Упражнение 1. Переведите предложения на русский язык, обратите
внимание на перевод выделенных слов
1.
Displaced fractures
are usually reduced (вправляются) using
closed
reduction methods
, which are non-surgical and generally comprise
traction
and
manipulation
.
2.
One trial compared a novel
(новый)
non-anaesthetised method of
manual
reduction
involving
counter-traction
versus traditional
manual reduction
under intravenous regional anaesthesia.
3.
We analyzed our experience with MRI
of
pelvic acute hematogenous
osteomyelitis.
4.
Osteomyelitis involved
metaphyseal equivalent sites
in every case, with
single bone involvement in 24
and
contiguous bone involvement
in the
remaining 14.
5.
Bone loss
in patients with
inflammatory back pain
(IBP) suspicious of (c
подозрением на) early undifferentiated
spondyloarthropathy
is poorly
defined (плохо распознается).
6.
In 30 patients with early
IBP
, clinical data were collected and
bone mineral
density
(BMD) assessed using
dual
energy x-ray absorptiometry.
7.
Hip
bone loss
was found to be associated with raised baseline C-reactive
protein levels
(
исходный
уровень С-реактивного белка), baseline MRI
bone marrow
oedema of the
SIJs
and the presence of radiographic
sacroiliitis
after 8 years.
8.
This study examined whether higher intakes
of milk
and other calcium-rich
foods during adult years can reduce the
risk of
osteoporotic fractures
.
9.
These
data do not support the hypothesis that higher consumption
(употребление в пищу)
of
milk or other food sources of calcium by adult
women protects
against
hip
or
forearm
fractures.
10.
This was a 12-year
prospective study among 77 761 women who had never
used
calcium supplements
.
75
Упражнения 2. Прочитайте рефераты медицинских статей. Передайте их
содержание на русском языке по схеме
А. MILK, DIETARY CALCIUM, AND BONE FRACTURES IN WOMEN:
A 12-YEAR PROSPECTIVE STUDY
D. Feskanich, W. C. Willett, M. J. Stampfer and G. A. Colditz
American Journal of Public Health, Vol. 87,Issue 6, pp. 992-997
OBJECTIVES
This study examined whether higher intakes of milk
and other
calcium-rich foods during adult years can reduce the
risk of osteoporotic fractures.
METHODS
This was a 12-year
prospective study among 77 761 women, aged 34
through 59 years
in 1999, who had never used calcium supplements. Dietary
intake
was assessed with a food-frequency questionnaire in 2000, 2004,
and 2006.
Fractures of the proximal femur (n = 133) and distal radius (n = 1046) from low or
moderate trauma were self-reported
on biennial questionnaires.
RESULTS
We found no evidence that
higher intakes of milk or calcium from food
sources reduce fracture
incidence. Women who drank two or more glasses of milk
per day
had relative risks of 1.45 for hip fracture and 1.05 for forearm fracture
when compared with women consuming one glass
or less per week. Likewise,
higher intakes of total dietary
calcium or calcium from dairy foods were not
associated with decreased risk of hip or forearm fracture.
CONCLUSIONS
These
data do not support the hypothesis that higher
consumption of
milk or other food sources of calcium by adult women
protects
against hip or forearm fractures.
food-frequency
questionnaire
–
опросник
частоты
потребления
различных пищевых продуктов
biennial questionnaires – двухлетняя анкета
relative risk – относительный риск
likewise – подобно, так же
B. BONE LOSS IN VERY EARLY INFLAMMATORY BACK PAIN IN
UNDIFFERENTIATED SPONDYLOARTHROPATHY: A 1-YEAR
OBSERVATIONAL STUDY
Haugeberg G, Bennett A.N, McGonagle D, Emery P, Marzo-Ortega H.
Annals of the Rheumatic Diseases, 2010
BACKGROUND
Bone loss in patients with inflammatory back pain (IBP)
suspicious of early undifferentiated spondyloarthropathy is poorly defined.