C) Pathological findings in the central nervous system of aids patients on antiretroviral therapУ: retrospective study of 1597 autopsies

Vago, Luca; Bonetto, Sara; Nebuloni, Manuela et al

AIDS, Vol. 6, Issue 14, 2002, pp. 1925-1928

Objective To evaluate the prevalence of HIV-related central nervous system (CNS) lesions (HIV-encephalitis and/or HIV-leukoencephalopathy: HIV-E/L) with and without concomitant opportunistic diseases in a large autopsy series, and to correlate it with the changes in antiretroviral treatment.

Methods We reviewed 1597 autopsies of HIV-positive patients performed between 1984 and 2000, and divided into four time periods on the basis of the therapeutic regimens: 1984-1987, no therapy; 1988-1994, monotherapy (zidovudine); 1995-1996, dual combination therapy with nucleoside reverse transcriptase inhibitors (NRTI); and 1997-2000, triple combination therapy including two NRTI and at least one protease inhibitor or non-NRTI.

Results The CNS of 1210 patients (76%) was affected by opportunistic diseases, HIV-related lesions or both. The prevalence of HIV-related lesions in the four periods was respectively 54%, 32%, 18% and 15%. During the last period, however, differences in HIV-E/L between treated and untreated patients were not statistically significant.

Conclusions These neuropathological data confirm the efficacy of antiretroviral treatment in reducing the frequency of HIV-related CNS lesions in AIDS patients.

• HIV-positive – ВИЧ инфицированный, ВИЧ-положительный

• nucleoside reverse transcriptase inhibitors – нуклеозидный ингибитор обратной транскриптазы

• protease inhibitor – ингибитор протеазы

• non-NRTI – ненуклеозидный ингибитор обратной транскриптазы

D) Treatment of Traumatic Brain Injury with Moderate Hypothermia

Donald W. Marion, M.D., Louis E. Penrod, M.D., Sheryl F. Kelsey, Ph.D. et al

New England Journal of Medicine, 1997

Background Traumatic brain injury causes several metabolic processes that can exacerbate the injury.

Objective To determine whether hypothermia may limit some of these harmful metabolic responses.

Methods In a randomized, controlled trial, we compared the effects of moderate hypothermia and normothermia in 82 patients with severe closed head injuries (a score of 3 to 7 on the Glasgow Coma Scale). The patients assigned to hypothermia were cooled to 33°C a mean of 10 hours after injury, kept at 32 to 33°C for 24 hours, and then rewarmed. A specialist in physical medicine and rehabilitation evaluated the patients 3, 6, and 12 months later with the use of the Glasgow Outcome Scale.

Results At 12 months, 62 percent of the patients in the hypothermia group and 38 percent of those in the normothermia group had good outcomes (moderate, mild, or no disabilities). Hypothermia did not improve the outcomes in the patients with coma scores of 3 or 4 on admission. Among the patients with scores of 5 to 7, hypothermia was associated with significantly improved outcomes at 3 and 6 months, although not at 12 months.

Conclusions Treatment with moderate hypothermia for 24 hours in patients with severe traumatic brain injury and coma scores of 5 to 7 on admission hastened neurologic recovery and may have improved the outcome.

• hypothermia – искусственное понижение температуры тела с лечебными целями

• normothermia – нормотермия (температура окружающей среды, не вызывающая повышение или угнетение активности клеток организма)

• Glasgow Coma Scale – шкала комы Глазго

• assign – направлять

• limit – ограничивать, лимитировать

Выучите слова и выражения, наиболее часто употребляемые в рефератах:

antibody titer	титр антител
aspiration pneumonia	аспирационная пневмония
bacteremia	бактериемия (наличие бактерий в циркулирующей крови)
bacterial counts	определение количества бактерий
beneficial	благотворный, полезный
benefit	польза, благо; извлекать пользу, выгоду
blood culture	гемокультура
coexistent	сосуществующий
chest radiograph (Syn. X-ray fim)	рентгеновский снимок грудной клетки
colony-forming unit	колониеобразующая единица
consolidation	консолидация, уплотнение
contamination rate	загрязненность
contaminate	загрязнять, инфицировать, заражать
enhance	увеличивать, усиливать
focal lobar consolidation	очаговое лобарное уплотнение
HIV seropositivity	серопозитивная реакция на ВИЧ
humoral immunity	гуморальный иммунитет
immune related disease	иммуно-обусловленное заболевание
immune response	иммунная реакция, иммунный ответ
isolate	изолят, штамм, культура (микрофлоры)
multicentric disease	многоочаговая болезнь
multifocal and focal bronchopneumonia pattern	картина многоочаговой и очаговой бронхопневмонии
nosocomial	госпитальный, внутрибольничный, нозокомиальный (об инфекции)
radiographic appearance	рентгенологическое изображение
radiographic pattern	рентгенологическая картина
sputum cultures	посев мокроты
strain	штамм

Упражнение 1. Переведите предложения на русский язык, обратите внимание на перевод выделенных слов.