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41
9.
The triad of
cough, fever
,
and a purified protein derivative
(PPD) (очищенный
белковый продукт) was highly predictive (предсказывающий) of culture-
positive PTB
among children.
10.
A
retrospective
chart
(история болезни)
review
was performed in a family
medicine training center (учебный центр семейной медицины).
11.
Patients who had acute bronchitis were selected from a computerized-record
database
.
12.
We investigated whether
outpatients
with chronic tracheostomy had a high or
low risk for developing
severe respiratory tract infections.
Выучите названия следующих микроорганизмов. Запомните, что
в русском тексте следует хотя бы один раз обязательно упомянуть
полное латинское название микроорганизмов
1.
gram-negative enteric bacteria
(GNEB)
грамотрицательные кишечные
бактерии
2.
Haemophilus influenzae
гемофильная палочка
3.
Helicobacter pylori
Хеликобактер пилори
4.
Moraxella catarrhalis
моракселла катаральная
5.
Mycobacterium tuberculosis (MTB)
туберкулезная бацилла
6.
Pseudomonas aeruginosa
синегнойная палочка
7.
Staphylococcus aureus
золотистый стафилококк
8.
Streptococcus pneumoniae
пневмококк
Упражнение 2. Переведите предложения на русский язык, обратите
внимание на названия микроорганизмов
1.
Aspirates from the hypopharyngeal region of asymptomatic
1-month-old infants
were cultured for
Streptococcus pneumoniae,
Haemophilus influenzae
,
Moraxella catarrhalis,
and
Staphylococcus
aureus
.
42
2.
Staphylococcus aureus, gram-negative enteric bacteria (GNEB), and
Pseudomonas aeruginosa
were the most common colonizing bacteria at these
sites.
3.
Twenty-one percent of the infants were colonized
with
S. pneumoniae,
M. catarrhalis, H. influenzae,
or a combination
of these organisms.
4.
Clinical, epidemiologic, and
laboratory findings were compared between
3 groups of children with a presumptive diagnosis of PTB: those with positive
Mycobacterium tuberculosis
(MTB) cultures, those with negative cultures, and
those who did not meet (не удовлетворяли) clinical diagnostic criteria.
5.
Helicobacter pylori
infection rates in duodenal ulcer (DU) (язва) patients may
be lower than previously estimated.
Упражнение 3. Прочитайте рефераты медицинских статей. Передайте их
содержание на русском языке по схеме
А.
PULMONARY
TUBERCULOSIS (PTB)
IN CHILDREN IN A
DEVELOPING COUNTRY
Guillermo E. Salazar, Tracy L. Schmitz, Rosa Cama et al
Pediatrics, 2001, Vol. 108, Issue 2, pp. 448-453
OBJECTIVE
To determine whether features predictive of definitive PTB could
be identified.
STUDY DESIGN
This was a cross-sectional study of 135 children (mean age:
6.8 years) presenting to the Hospital del Niño in Lima, Peru,
with presumptive
diagnosis of PTB. Clinical, epidemiologic, and
laboratory findings were compared
between 3 groups of children with a presumptive diagnosis of PTB: those with
positive
Mycobacterium tuberculosis (
MTB) cultures, those likely to have
PTB
based on clinical criteria but with negative cultures, and
those who did not meet
clinical diagnostic criteria or have positive
cultures.
RESULTS
A total of 50 (37%) patients were diagnosed with definitive PTB
based on positive sputum culture. Another 55 (47%) patients
were classified as
having probable PTB based on meeting at least
2 of the following criteria: cough
lasting for at least 2 weeks,
typical chest radiograph changes, purified protein
derivative
(PPD) ≥10 mm or family history of tuberculosis.
CONCLUSIONS
The typical presentation of PTB in Peruvian children includes
symptoms of active pulmonary disease similar to those seen in
adults. The triad of
cough lasting ≥2 weeks, fever,
and a PPD ≥10 mm was highly predictive for
culture-positive PTB
among children in this low-income Peruvian population.
43
feature – характерная черта
predictive of – предсказывающий
mean age– средний возраст
meet criteria – удовлетворять критериям
low-income – низкий доход
Peruvian – перуанский
B. WHY ARE ANTIBIOTICS PRESCRIBED FOR PATIENTS WITH
ACUTE BRONCHITIS?
William J. Hueston, Julia E. Hopper, Elizabeth N. Dacus, et al
Journal of the American Board of Family Medicine, Vol. 13, No. 6, 2000
BACKGROUND
Despite the findings in controlled trials that antibiotics provide
limited benefit in the treatment of acute bronchitis, physicians frequently prescribe
antibiotics for acute bronchitis.
Objective
To determine whether certain patient or
provider characteristics could predict antibiotic use for acute bronchitis.
SETTING
A family medicine training center where antibiotic use had already
been substantially reduced due to quality-improvement efforts.
METHODS
Patients who had acute bronchitis diagnosed during an 18-month
period and who had no other condition requiring antibiotics were selected from a
computerized-record database (n = 135). A retrospective chart review was
performed to document patient symptoms, physical findings, provider and patient
characteristics, and treatment.
RESULTS
35 (26%) patients received antibiotics for their acute bronchitis.
Analysis of 20 different symptoms and physical findings showed that symptoms
and signs were poor predictors of antibiotic use. No significant differences were
found based on prescribing habits of individual providers or provider level of
training.
CONCLUSION
In a setting where antibiotic use for acute bronchitis had been
decreased due to quality-improvement effort, it did not appear that providers
selectively used antibiotics for patients with certain symptoms or signs.
despite – несмотря на
quality-improvement efforts – усилия по улучшению качества
family medicine training center – учебный центр семейной медицины
44
level of training – уровень подготовки
chart – история болезни
selectively – избирательно
C. CHILDHOOD ASTHMA AFTER BACTERIAL COLONIZATION OF
THE AIRWAY IN NEONATES
Hans Bisgaard, M.D., D.M.Sc., Mette Northman Hermansen, M.D. et al
New England Journal of Medicine, Vol. 357, 2007, pp. 1487-1495
OBJECTIVE
We conducted a study to investigate a possible association between
bacterial colonization of the hypopharynx in asymptomatic neonates
and later
development of recurrent wheeze, asthma, and allergy
during the first 5 years of
life.
METHODS
The subjects were 321 neonates
at 1 month of age who were born to
mothers
with asthma. Aspirates from the hypopharyngeal region were cultured for
Streptococcus pneumoniae,
Haemophilus influenzae
,
Moraxella catarrhalis,
and
Staphylococcus
aureus
. Wheeze was monitored prospectively on diary cards during
the first 5 years of life. Lung function
was measured and asthma was diagnosed at
5 years of age.
RESULTS
21% of the infants were colonized
with
S. pneumoniae, M. catarrhalis,
H. influenzae,
or a combination
of these organisms. Colonization with one or more
of these organisms,
but not colonization with
S. aureus,
was significantly
associated
with persistent wheeze, acute severe exacerbation of wheeze, and
hospitalization for
wheeze.
CONCLUSIONS
Neonates colonized in the hypopharyngeal region
with
S.
pneumoniae, H. influenzae,
or
M. catarrhalis,
or with
a combination of these
organisms, are at increased risk for
recurrent wheeze and asthma early in life.
neonate – новорожденный
diary cards – дневники пациентов
exacerbation – обострение болезни
45
D. RESPIRATORY TRACT COLONIZATION AND INFECTION IN
PATIENTS WITH CHRONIC TRACHEOSTOMY. A ONE-YEAR STUDY
IN PATIENTS LIVING AT HOME
R. Harlid, G. Andersson, C. Frostell et al
Am. J. Respir. Crit. Care Med., Volume 154, No. 1, 07 1996, pp. 124-129
BACKGROUND
The high rate of complications, especially respiratory tract
infection
(RTI), was reported in patients with chronic tracheostomy (CT) However,
previous studies of CT have
concerned mainly hospitalized patients.
OBJECTIVE
We investigated whether
outpatients
with CT had a high or low risk
for developing
severe RTIs.
METHODS
We have followed the bacterial
colonization patterns of the upper and
lower respiratory tract and recorded
all RTIs in 39 outpatients with CT during a 12-
month period. Patients were
colonized with one or more potential pathogens at the
stomal site and in
the trachea in 95% and 83%, respectively.
RESULTS
Staphylococcus aureus, gram-negative enteric bacteria (GNEB), and
Pseudomonas aeruginosa were the most common colonizing bacteria at these
sites.
70% of bronchial-protected brush cultures were negative,
despite simultaneous
heavy colonization of the stomal site or the trachea.
Only 18 of 39 (46%) patients
were treated with antibiotics because of RTIs
during the study year. Of these, only
5 episodes of pneumonia were registered.
CONCLUSION
Outpatients
with chronic tracheostomy had a low risk for
developing
severe RTIs, despite massive airway colonization with potentially
pathogenic bacteria.
concern – касаться, относиться
stomal – относящийся к стоме
bronchial-protected brush cultures – посевы культур микроорганизмов,
полученных с помощью защищенной бронхиальной щёточки