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 醫學英語閲讀:致命的軍團桿菌

Legionnaires' disease is a serious and sometimes fatal form of pneumonia. Legionnaires' disease is caused by infection with Legionella bacteria which are found naturally in the environment and thrive in warm water and warm damp places. Man-made water systems sometimes provide environments that let Legionella bacteria increase to large numbers. These man-made systems include showers, spa pools, fountains, and air conditioning cooling towers. People usually get Legionnaires' disease by breathing in mists that come from a water source contaminated with Legionella bacteria.

An estimated 8,000 to 18,000 people get Legionnaires' disease in the United States each year. Some people can be infected with Legionella bacteria and have mild symptoms or no illness at all. Patients with Legionnaires' disease usually have fever, chills, and a cough, which may be dry or may produce sputum. Some patients also have muscle aches, headache, tiredness, loss of appetite, and, occasionally, diarrhea. From the time of infection with Legionella bacteria, it takes 2-10 days for symptoms to appear. In most cases, symptoms begin after 5-6 days. Legionnaires' disease is treated with antibiotics, such as erythromycin. The earlier that treatment is begun, the better the outcome.

The first known outbreak of Legionnaires' disease was in Philadelphia, USA, in 1976. A total of 221 people contracted the disease and 34 died. Most of those that died were Legionnaires and that's how the disease got its name. The second largest outbreak was at the Stafford hospital in England in 1985; a total of 101 people contracted the disease and 28 died.

軍團病是一種非常嚴重的、有時可以致命的肺炎。軍團病是由軍團桿菌引起,這種細菌產生在自然環境中,在温水裏及潮熱的地方蔓延。人工供水系統有時也能為軍團桿菌的大量繁殖提供生存環境。這些系統包括淋浴器、礦泉池、噴泉以及空調設備的冷卻水塔。人們通常是由於呼吸了被軍團桿菌污染的水源散發的水霧而傳染上軍團病的。

據估計,在美國每年都有國每年都有8000~18000人感染上軍團病。有些軍團病感染者所表現出來的症狀比較温和,甚至根本就沒有得病的跡象。軍團病患者通常有發燒、畏寒及乾咳或咳痰等表現。部分患者還有肌肉疼痛、頭痛、疲勞、食慾不振及偶爾腹瀉等症狀。這種病的潛伏期約為的潛天。許多病例表明,出現症狀需要狀需要5~6天的時間。軍團病可以用紅黴素等抗生素進行治療,越早治療效果越好。

軍團病已知的首次爆發是在發是1976年美國費城,221人感染疾病,其中死亡34人。由於大多的死者都是軍團成員,因此稱為軍團病。該病的第二次大爆發是1985年在英國的斯塔福德醫院。這次101個被感染者中有28人死亡。

 醫學英語閲讀:循證醫學

Evidence based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research, By individual clinical expertise we mean the proficiency and judgment that individual clinicians acquire through clinical experience and clinical practice. By best available external clinical evidence we mean clinically relevant research, often from the basic sciences of medicine, but especially from patient centered clinical research into the accuracy and precision of diagnostic tests (including the clinical examination), the power of prognostic markers, and the efficacy and safety of therapeutic, rehabilitative, and preventive regimens, External clinical evidence both invalidates previously accepted diagnostic tests and treatments and replaces them with new ones that are more powerful, more accurate, more efficacious, and safer.

循證醫學是一種明確、謹慎、合理運用最佳依據以決定個體患者的醫學方法。循證醫學實踐意味着綜合個人臨牀專業知識與系統研究中可得的最佳外部臨牀依據。所謂個人臨牀專長是指臨牀醫師本人從臨牀經驗與臨牀實踐中所獲得的熟練程度與判斷力。而最佳外部臨牀依據是指臨牀相關研究,一般來自基礎醫學研究,尤其是針對患者的臨牀研究轉化為準確的診斷試驗(包括臨牀檢查)、預後標誌效應、治療、康復及預防療法的效果與安全性。外部臨牀依據旨在廢除過去既定的診斷試驗與療法,並代之以更有力、更準確、更有效、更安全的新方法。

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