You are on page 1of 3

Keith Wesley C.

Ybut, BSN-3 M-W 2:30-4:00 PM


Assignment in Humanities November 15, 2017

Reaction:

HIGH STRUNG has a very strong plot set in a very imaginative world of dance that includes
ballet, contemporary and street dancing. In classical art forms each specific field has one or two
areas that have a more prestigious status. In dance it is ballet, and in the orchestra it is the violin.
These two have a reputation of being highly difficult to master, being rigid in both technique and
discipline. When these two classical arts step outside their rigid structure they can create something
new and inspiring. Although its never overtly sexual like many other dance movies, it does lightly
imply romance. HIGH STRUNG is very powerful. They show that there is no possible to partner
the two, both musical art and dancing art it make uniqueness performance. And it make eye
catching to the viewers and other artist. The ending of the movie is superb and heartwarming.
Management of community-acquired pneumonia in older adults
Abstract
Community-acquired pneumonia (CAP) is an increasing problem among the elderly. Multiple
factors related to ageing, such as comorbidities, nutritional status and swallowing dysfunction
have been implicated in the increased incidence of CAP in the older population. Moreover,
mortality in patients with CAP rises dramatically with increasing age. Streptococcus
pneumoniaeis still the most common pathogen among the elderly, although CAP may also be
caused by drug-resistant microorganisms and aspiration pneumonia. Furthermore, in the elderly
CAP has a different clinical presentation, often lacking the typical acute symptoms observed in
younger adults, due to the lower local and systemic inflammatory response. Several independent
prognostic factors for mortality in the elderly have been identified, including factors related to
pneumonia severity, inadequate response to infection, and low functional status. CAP scores and
biomarkers have lower prognostic value in the elderly, and so there is a need to find new scales
or to set new cut-off points for current scores in this population. Adherence to the current
guidelines for CAP has a significant beneficial impact on clinical outcomes in elderly patients.
Particular attention should also be paid to nutritional status, fluid administration, functional
status, and comorbidity stabilizing therapy in this group of frail patients. This article presents an
up-to-date review of the main aspects of CAP in elderly patients, including epidemiology,
causative organisms, clinical features, and prognosis, and assesses key points for best practices
for the management of the disease.

References:
Abisheganaden J., Ding Y., Chong W., Heng B., Lim T. (2012) Predicting mortality among older adults
hospitalized for community-acquired pneumonia: an enhanced confusion, urea, respiratory rate and blood
pressure score compared with pneumonia severity index. Respirology 17: 969975.
Etiology and treatment of community-
acquired pneumonia in ambulatory children
Abstract:
Objectives. To determine the etiology of community-acquired pneumonia in ambulatory children and
to compare responses to treatment with azithromycin, amoxicillin-clavulanate or erythromycin estolate.

Methods. Ambulatory patients with pneumonia were identified at the Children's Medical Center of
Dallas, TX. Children age 6 months to 16 years with radiographic and clinical evidence of pneumonia were
enrolled and randomized to receive either azithromycin suspension for 5 days or a 10-day course of
amoxicillin-clavulanate for those <5 years or erythromycin estolate suspension for those 5 years. Blood
culture was obtained in all patients and we obtained nasopharyngeal and pharyngeal swabs for culture
and polymerase chain reaction (PCR) testing for Chlamydia pneumoniae and Mycoplasma
pneumoniae and nasopharyngeal swabs for viral direct fluorescent antibody and culture. Acute and
convalescent serum specimens were tested for antibodies to C. pneumoniae, M.
pneumoniae and Streptococcus pneumoniae. Patients were evaluated 10 to 37 days later when
repeat specimens for serology, PCR and culture were obtained. For comparative purposes healthy
children attending the well-child clinic had nasopharyngeal and pharyngeal swabs obtained for PCR and
culture for C. pneumoniae and M. pneumoniae.

Results. Between February, 1996, and December, 1997, we enrolled 174 patients, 168 of whom
fulfilled protocol criteria for evaluation. There were 55% males and 63% were <5 years of age. All blood
cultures were sterile and there was no correlation between the white blood cell and differential counts
and etiology of pneumonia. Etiologic agents were identified in 73 (43%) of 168 patients. Infection was
attributed to M. pneumoniae in 7% (12 of 168), C. pneumoniae in 6% (10 of 168), S. pneumoniae in
27% (35 of 129) and viruses in 20% (31 of 157). None of the swab specimens from 75 healthy control
children was positive for C. pneumoniae or M. pneumoniae. Clinical response to therapy was similar
for the three antibiotic regimens evaluated, including those with infection attributed to bacterial agents.

Conclusion. Although a possible microbial etiology was identified in 43% of the evaluable patients,
clinical findings and results of blood cultures, chest radiographs and white blood cell and differential
counts did not distinguish patients with a defined etiology from those without a known cause for
pneumonia. There were no differences in the clinical responses of patients to the antimicrobial regimens
studied.

http://journals.lww.com/pidj/Abstract/1999/02000/Etiology_and_treatment_of_community_acquired.4.as
px

You might also like