Maîtrise des risques liés à la production des fluides de dialyse dans une unité de télédialyse

Objective

The “Centre Hospitalier Francois Dunan” is located on an isolated island and ensures patients care in hemodialysis thanks to telemedicine support. Many research studies have demonstrated the importance of hemodialysis fluids composition to reduce morbidity in patients on chronic hemodialysis. The aim of this study was to identify the risks inherent in the production of dialysis fluids in a particular context, in order to set up an improvement action plan to improve risk control on the production of dialysis fluids.

High-Pressure Water Swelling Sealant Injection Injury to the Hand: a Case Report and Review of the Literature

High-pressure injection injuries (HPII) caused by water swelling sealant are rare at present. The patient generally has small-sized skin lesions, and the misleadingly benign presentation may cause delayed treatment at the early stage of management. In addition, radiographic examination may be underestimated. Subsequently, the inadequate surgical intervention may cause tissue necrosis and poor prognosis. Furthermore, the early recognition of water swelling sealant injected into tissue and emergent surgical intervention are the key to successful management for the patient with HPII caused by injecting water swelling sealant to tissue.     

How current risk assessment and risk management methods for drinking water in The Netherlands cover the WHO water safety plan approach

In the Netherlands, safe and sufficient drinking water is provided to the general population by ten drinking water companies. To guarantee safe drinking water the World Health Organization (WHO) developed a Water Safety Plan (WSP), a Risk Assessment and a Risk Management (RA/RM) framework. The objective of the study was to identify legally required RA approaches, to document application of RA/RM activities at Dutch drinking water companies and to determine to what extent these RA/RM activities as a whole cover all the elements of the WHO WSP approach. This study could be of interest to both managers of large water utilities and decision makers.The assessment was performed by means of a policy review and interviews with two to four staff members involved in RA/RM from all ten Dutch drinking water companies combined with a joint workshop. The drinking water companies are well aware of the potential hazards and risks that can influence the drinking water quality. To guarantee the supply of safe and sufficient drinking water, the Dutch drinking water sector uses six different legally required RA/RM approaches. This study shows that by using the six legally required RA/RM approaches, all WSP steps are covered. WSP entails a generic risk assessment for identifying all hazards and hazardous events from source to tap, whereas the six legally required RA/RM each focus on specific risks at an advanced level. Each risk assessment provides information on specific hazards and hazardous events covering a part of the water supply chain. These legal requirements are complemented with additional RA/RM activities at sector and water company level such as codes of practices and standard operating procedures. The outcomes of all RA/RM approaches combined provide information from source to tap. When using multiple RA/RM approaches, it is crucial to share and combine information derived from the different activities.     

Low doses of the 5-HT1A agonist 8-hydroxy-2-(di-n-propylamino)-tetralin (8-OH DPAT) increase ethanol intake

Previous work has reported that the 5-hydroxytryptamine (5-HT)_1A agonist, 8-hydroxy 2-(di-n-propylamino)tetralin (8-OH DPAT), reduces ethanol intake by rats. However, as 8-OH DPAT reduces 5-HT neurotransmission, these findings are inconsistent with the proposed inhibitory role of central 5-HT neurons on ethanol intake. We examined the effect of 8-OH DPAT on ethanol, water and food intake in rats maintained on a limited access schedule using a lower dose range (6–250 µg/kg) and by assessing concomitant changes in behaviour. Low doses of 8-OH DPAT enhanced ethanol intake even when food and water were offered as alternatives. Suppression in ethanol intake was observed at higher doses where elements of the 5-HT syndrome were apparent. Similar observations were made in both fluid and non-fluid deprived water drinking rats, suggesting the latter effect is non-selective. Therefore 8-OH DPAT may both increase or decrease ethanol consumption in the rat depending on the dose used.     

蛭弧菌与微生物污染的相互关系探讨

本文在实验室条件下动态观察了蛭弧菌含量与微生物污染的相互关系。结果表明：蛭弧菌含量的增加滞后于水体污染，而污染过后蛭弧菌则可在较长时间内维持较高水平，这一特性在水污染指示中的可能作用值得进一步探讨。     

高原康胶囊对大批快速进入高原者血浆醛固酮、血管紧张素II及水负荷的影响及意义

目的 :了解高原康胶囊对快速进入高原者血浆醛固酮 (Aldosterone ,ALD)、血管紧张素II(AngiotensinII ,AII)及水负荷的影响及意义。方法 :将 80名由平原快速进入高原的新兵随机分为实验组 4 0名 ,对照组 4 0名 ,实验组于平原登机前开始给予口服高原康胶囊 ,连服 3日 ,对照组给予安慰剂 ,两组均于进入高原的前 1天及进入高原的第 3天午给予水负荷实验 ,并对饮水前血浆ALD、AII及饮水后 15 0min内各时间段的尿量及两组进入高原后 7天内急性高原病 (Acutehighal titudediseaes ,AHAD)的发病率进行对照比较。结果 :对照组进入高原后与平原相比血浆ALD、AII显著升高 ,水负荷实验 6 1min～ 15 0min各时间段的尿量及相应时间的总尿量与平原时相应各时间段的尿量及相应时间的总尿量相比则显著减少 (P <0 0 5～ 0 0 0 1) ,而实验组则无显著变化 (P >0 0 5 ) ;进入高原后实验组与对照组相比水负荷实验 6 1min～ 90min的尿量及 12 0min、15 0min的尿总量则显著多于对照组 (P <0 0 5 ) ;血浆ALD、AII及AHAD发病率则显著低于对照组 (P <0 0 5～ 0 0 0 1)。结论 :高原康胶囊能显著降低快速进入高原者的血浆ALD、AII ,通过对水负荷调节的影响减少机体的钠水潴留 ,从而防止快速进入高原者AHAD的发生 ,可用于大批快     

Effects of chelating agents on the rheological property of cervical mucus

As an ongoing effort to elucidate the mechanisms involved in the calcium-dependent fertility regulation process, the viscoelastic properties of the mucus obtained from lamb cervix and human semen, as well as their water and total protein contents after exposure to EDTA, a chelating agent, or Nonoxynol-9 (N-9), a spermicidal agent, were examined. The viscosity was measured using a Cone Plate Digital Viscometer, while the water and total protein contents were determined by the lyophilization process and the Lowry method, respectively. The significant changes in the rheological properties of mucus, such as its viscosity and the water content, upon exposure to EDTA were demonstrated. The viscosity of cervical mucus and human semen were significantly increased by EDTA treatment (as compared to the controls): lamb cervical mucus (2.9 ± 0.3 vs. 2.2 ± 0.3 cps) and human semen (5.0 ± 0.3 vs. 4.3 ± 0.3 cps), respectively. The hydration rate was decreased by EDTA treatment as compared with the control (93.6 ± 0.7 vs. 96.8 ± 0.8%). Among tested samples, the reduction in the percentage of sperm penetration through the cervical mucus was the highest in the mucus containing EDTA, which had the lowest water content (93.6 ± 0.7%), indicating that there is a positive relationship between the hydration rate of the cervical mucus and its ability to permit the penetration of spermatozoa. This result indicates that spermicidal activity exerted by high concentrations of EDTA is in part due to its effect on the rheological properties of cervical mucus or semen.     

血液透析水处理设备的现状与研发

血液透析水处理设备的进步与发展,直接影响到患者的生存质量。进入21世纪通过国际学术交流与合作,一些诸如双极反渗、直供式、热消毒等新的思维和理念,促进了血液透析水处理设备研制与开发。     

巢湖水藻类毒性及对饮用水水质影响

目的了解巢湖含藻水源水和藻类毒性对饮用水水质的影响。方法于1999年在距巢湖水厂岸边1.5km(A点:废弃水源)和3.0km(B点:现用水源)处取水样进行巢湖的浮游藻类调查,取B点湖水及其处理后的饮用水检测微囊藻毒素(MC)含量,并进行水质分析及Ames试验、微核试验和单细胞凝胶电泳(SCGE)试验。结果A和B点水样全年共检出浮游藻类83种,分属于8门49属,年均藻量(每升水样藻细胞数)B点(8205.67×104个/L)比A点(7024.24×104个/L)高16.8%。巢湖16份水样中有12份检出了MC,2份超标;合肥和巢湖市5个水厂原水及饮用水中未检出MC(不含四水厂)。合肥四水厂MC含量较低的原水,经过运输贮存后,清水池一次出厂水MC含量超标,经混凝、加氯和活性炭等处理后,二次出厂水未检出MC;原水中总氮等6项指标不同程度地超过GB3838-2002地表水环境质量标准Ⅴ类标准,经处理后的饮用水符合卫生标准;Ames试验与微核试验提示原水有可疑致突变性,经混凝处理不能消除,加氯后致突变性仍存在。SCGE试验表明原水有机浓集物存在DNA损伤效应。结论现用巢湖水源浮游藻类的污染重于废弃水源,湖水与四水厂清水池一次出厂水中的MC均存在超标现象,原水和饮用水存在可疑致突变性。     

Impaired water metabolism and cerebral oedema following experimental subarachnoid haemorrhage in rats1

The acute phase of subarachnoid haemorrhage (SAH) is frequently associated with an impaired water metabolism and a disposition to cerebral oedema. For study of the pathogenesis of brain oedema following SAH, an experimental model of SAH was created in the rat The diuretic curves after water loading, the brain water and electrolyte contents and the plasma and cerebrospinal fluid arginine vasopressin (AVP) levels were examined in rats with SAH. Following a water load, a significant water retention and increases in brain water and sodium contents were observed after subarachnoid bleeding. Plasma and cerebrospinal fluid AVP levels were also elevated following SAH. It can be concluded that AVP plays important roles in the development of antidiuresis after water loading and in the disturbance of the brain water and electrolyte balance following experimental SAH.