Babesiosis Acquired through Blood Transfusion, California, USA

Babesiosis was reported in a California resident who received a transfusion of blood products collected in the disease-endemic northeastern region of the United States. Babesiosis should be considered year-round in the diagnosis of febrile and afebrile patients with abnormal blood cell counts who have received blood products from disease-endemic areas.     

Does changing the heart mean changing personality? A retrospective inquiry on 47 heart transplant patients

Heart transplantation is not simply a question of replacing an organ that no longer functions. The heart is often seen as source of love, emotions, and focus of personality traits. To gain insight into the problem of whether transplant patients themselves feel a change in personality after having received a donor heart, 47 patients who were transplanted over a period of 2 years in Vienna, Austria, were asked for an interview. Three groups of patients could be identified: 79% stated that their personality had not changed at all postoperatively. In this group, patients showed masslve defense and denial reactions, mainly by rapidly changing the subject or making the question ridiculous. Fifteen per cent stated that their personality had indeed changed, but not because of the donor organ, but due to the life-threatening event. Six per cent (three patients) reported a distinct change of personality due to their new hearts. These incorporation fantasies forced them to change feelings and reactions and accept those of the donor. Verbatim statements of these heart transplant recipients show that there seem to be severe problems regarding graft incorporation, which are based on the age-old idea of the heart as a centre that houses feelings and forms the personality.     

Fatal disseminated Acanthamoeba lenticulata infection in a heart transplant patient

We report a fatal case of disseminated acanthamebiasis caused by Acanthamoeba lenticulata (genotype T5) in a 39-year-old heart transplant recipient. The diagnosis was based on skin histopathologic results and confirmed by isolation of the ameba from involved skin and molecular analysis of a partial 18S rRNA gene sequence (DF3).     

Compliance with the medical regimen and partner's quality of life after heart transplantation

The authors investigated 40 heart transplant recipients and their partners to determine both the partner's quality of life upon transplantation and the experiences of both patient and partner with compliance with the medical regimen. Data on sleep disturbances, social isolation, emotional reactions, depression, anxiety, partner's apprehension, social support and compliance (regarding behaviour and emotional experience) were obtained approximately 21 months after transplantation. Compared to related study groups, partners did not experience more problems in sleep, social isolation, emotional reactions, depression and anxiety. Patients overestimated the apprehension of their partners significantly (p<0.0001). Generally speaking, with the exception of three items relating to eating fish, canned food and forgetfulness in medicine intake, patients and partners agreed with respect to actual compliance behaviour. Lowest compliance concerned regular physical exercise: 28%. Both patient and partner insisted that they had scarcely any emotional problem with the regimen. Further systematic research is needed to bring to light factors that affect compliance as well as adequate methods to bring about an improvement therein.     

影响心脏移植术后患者环孢素A血药浓度的因素分析

目的:探讨心脏移植术3个月后,影响患者环孢素A(CsA)血药浓度的因素。方法:某医院先后采用双腔静脉法进行了10例同种异体心脏移植,术后均采用CsA口服联合免疫抑制治疗。采用多元线性回归回顾性分析同一患者在不同时期的CsA剂量、膳食结构、体重变化、肝功能、合用影响CsA代谢的药物对CsA血药浓度的影响。结果:同一患者在不同时期内CsA剂量、患者饮食结构和合用药物对CsA血药浓度的影响较大。结论:心脏移植患者术后应讲究平衡饮食,不要随便更改饮食结构。合用其他药物应咨询心脏或免疫科医生并检测CsA浓度。     

采用自体血回输与血库血输入对输卵管妊娠破裂手术后疗效及感染的对比研究

目的 对比采用自体血回输与血库血输入对输卵管妊娠破裂手术的疗效及感染.方法 考察并对比输卵管妊娠破裂手术后,31例血库血输入和38例自体血回输的术后疗效和感染情况.结果 与血库血输入组比,自体血回输组输血前的C-反应蛋白(CPR)、中性粒细胞,差异无统计学意义;血库血输入组输血前CPR为(2.64±1.08)mg/L,与输血后1h、术后1、2d的CPR(15.50±5.60)、(2.64±1.08)、(93.80±16.40)mg/L比较,差异均有统计学意义(均P＜0.05);自体血回输组输血前的CPR为(3.00±1.05)mg/L,与输血后1h、术后1、2d的CPR(12.50±2.40)、(84.60±21.20)、(70.10±30.40)mg/L比较,差异均有统计学意义(均P＜0.05),血库血输入组术后2d的CPR与术后1d比,有降低趋势,但差异无统计学意义,术后2d自体血回输组的CPR显著降低,差异有统计学意义(P＜0.05);与血库血输组比,自体血回输组输血后1h、术后1d和2d的CPR较低;与输血前比,血库血输入组和自体血回输组输血后1h、术后1、2d的中性粒细胞显著增高,差异均有统计学意义(均P＜0.05);与术后1d比,自体血回输组术后2d的中性粒细胞显著降低;与血库血输入组比,自体血回输组的输血后1h、术后1d和术后2d的中性粒细胞显著较低;与输血前比,血库血输入组和自体血回输组输血后1h、术后1d的血红蛋白显著降低,差异均有统计学意义(均P＜0.05);与术后1d比,血库血输入组术后2d的血红蛋白有增高趋势;与术后1d比,血库血输入组术后2d的血红蛋白增高至输血前水准,差异均无统计学意义.结论 自体血回输有利于患者恢复,降低了患者住院期间的感染风险,自体血回输值得推广.     

Lack of Macrolide Resistance in Chlamydia trachomatis after Mass Azithromycin Distributions for Trachoma

We investigated antimicrobial drug resistance in ocular Chlamydia trachomatis 18 months after 4 biannual communitywide distributions of antimicrobial drugs in a region of Ethiopia where ocular strains of C. trachomatis are highly endemic. We found no significant differences in susceptibilities to azithromycin and doxycycline in 6 posttreatment and 4 pretreatment samples.     

心脏移植手术中巡回护士的配合

总结3例同种异体心脏移植手术中巡回护士护理配合,主要包括:手术前的充分准备,手术中的密切配合,严格的无菌观念,术中用药的正确管理等,都是手术成功的保障.3例手术过程顺利,手术成功.     

心脏移植患者的围手术期3例护理

目的:总结3例心脏移植患者的护理体会.方法:对3例心脏移植患者实行全程、整体化护理,包括术前准备、术后病情的观察、抗感染、抗免疫的护理.结果:3例患者手术取得成功,术后来发生右心衰、排异反应和感染等并发症,均顺利康复出院.结论:心脏移植围术期完善的护理为手术的成功提供了可靠的保证.     

Molecular evidence of Pneumocystis transmission in pediatric transplant unit

We describe an outbreak of Pneumocystis jirovecii pneumonia in a pediatric renal transplant unit, likely attributable to patient-to-patient transmission. Single-strand conformation polymorphism molecular typing showed that 3 affected patients had acquired the same 2 strains of Pneumocystis, which suggests interhuman infection. An infant with mitochondriopathy was the probable index patient.     

Psychosocial problems of donor heart recipients adversely affecting quality of life

Heart transplantation has become an accepted therapy for patients suffering from terminal heart disease for whom neither standard forms of medication nor the usual surgery are of any benefit. Although results regarding postoperative quantity and quality of life are encouraging, it must not be overlooked that the patient and his family face, and have to overcome, profound psychosocial problems. The main stressors were identified in interviews with 47 heart transplant patients. The main preoperative problems were: the way of being informed about the diagnosis, the waiting period for transplantation, anguishing doubts about the decision to have a transplant, being a body without heart (zombie), guilt and shame regarding the donor, the reactions of others. Postoperatively the patients have to cope with: re-entering social systems, reactions of friends, neighbours and colleagues, rejection episodes, death of a fellow patient, the need to redesign family life. All the problems reported by the patients interviewed are discussed regarding their psychosocial implications, and hints are given on how to minimize them.     

搏动性心室辅助装置Excor治疗儿童终末期心衰

目的:评价应用气动外置式搏动性心室辅助装置(VAD)Excor(Berlin Heart AG)治疗儿童终末期心功能衰竭(ESHF)的可行性。方法:1990年至2003年 12月共55例儿童ESHF患者接受Excor心室辅助治疗。结果:6例(10．91％)心功能恢复后撤离辅助装置, 23例(41．82％)过渡到心脏移植,26例(47．27％)死亡。平均辅助时间(28．0±8．1)天,最长辅助天数421天。结论:Excor作为中、长期搏动式VAD,可辅助ESHF儿童患者向心脏移植或心功能恢复过渡。     

美托洛尔治疗风湿性心脏病慢性心力衰竭效果研究

目的 探讨美托洛尔对风湿性心脏病慢性心力衰竭患者血压水平及心功能的影响.方法 选取本院2016年3月-2018年4月收治的70例风湿性心脏病慢性心力衰竭患者,随机分为对照组与观察组,各35例.对照组采用常规治疗,在对照组基础上,观察组予以美托洛尔治疗.比较两组临床疗效、血压水平、心功能.结果 对照组治疗总效率为65.7...     

具有血氧监测功能的智能心率控制输血仪的研制与临床应用

目的:研制一种具有血氧监测功能且根据心率的变化智能控制输血速度的输血仪.方法:输血仪由单片机系统、心率血氧传感器、滴速检测装置、滴速控制器及报警装置等组成,通过心率血氧传感器感受心率和血氧变化,经单片机处理后,将信号传递给滴速控制器,以达到对滴速的控制和对血氧的监测;通过滴速检测装置感知血流的速度,并控制其通断,输血结...     

Vaccine-derived varicella zoster infection in a kidney transplant recipient after zoster vaccine live administration

A 49-year-old kidney transplant recipient, presented with a skin rash, and interstitial infiltrates three weeks after receiving a live attenuated varicella-zoster vaccine. Varicella-zoster Oka-vaccine strain was detected in plasma by polymerase chain reaction and sequencing analysis targeting open reading frame 62 (ORF 62). She was treated successfully with intravenous acyclovir. Our case report supports the current contraindication of live attenuated varicella-zoster vaccine in the solid-organ transplant recipients. Recombinant subunit varicella-zoster vaccine may be the vaccine of choice in these patients; nevertheless, further information is required to establish its safety, efficacy, and optimal timing.     

Psychosocial,neuropsychological and neurological status in a sample of heart transplant recipients

The sample for this psychosocial follow-up study was formed using the 71 surviving patients from a total of 100 who underwent heart transplantation up until March 1990 at Kiel University Hospital. Forty of these could be investigated comprehensively. The neurological investigation comprised EEG and auditory and visually evoked potentials. The psychological investigation started with several neuropsychological tests; additionally all patients were interviewed and they completed questionnaires concerning anxiety, depression, ways of coping, personality characteristics and life satisfaction. Within the entire sample, there were few indications for specific psychological impairment. The psychosocial status of the patients was not significantly related to the time which had elapsed since they underwent transplantation. There were few associations between neuropsychological and psychosocial data, and several indicators of early postoperative complications which are described in the literature (e.g., length of stay in the intensive care unit). Clinically relevant subgroups (formed on the basis of neuropsychological test results, anxiety and depression) did not differ in terms of these indicators. Nevertheless, a considerable proportion of the patients (25%) were characterized by having a higher level of affective and neuropsychological impairment. Although based upon retrospective investigations, the results of this follow-up generally correlate with those gained from Anglo-American countries. In interpreting the results one needs to consider the possible influence of premorbid personality characteristics as well as denial which may be typical for patients undergoing heart transplantation.     

心肌细胞坏死与慢性充血性心力衰竭

目的 研究心肌细胞坏死在慢性充血性心力衰竭(CHF)病程中的作用及其可能机制。方法 测定128例CHF患血清心肌特异性肌钙蛋白I成分(cTnI)及肌酸激酶同工酶MB成分(CK—MB)含量，并以56例健康人作对照。同时，检测CHF患血浆中肾素活性、血管紧张素Ⅱ及醛固酮含量。结果 CHF患血清cTnI含量显高于正常人；CHF患血清cTnI含量与其血浆血管紧张素Ⅱ含量呈正相关，与其左室射血分数呈负相关；在CHF患中：①血清cTnI含量升高亚组临床心功能状况更差；②cTnI升高亚组超声心动图心功能指标更差；③cTnI升高亚组住院期间死亡率更高。结论 CHF患有间歇性心肌细胞坏死，肾素-血管紧张素系统参与此过程。     

Psychrobacter arenosus Bacteremia after Blood Transfusion,France

We report a case of transfusion-associated bacteremia caused by Psychrobacter arenosus. This psychrotolerant bacterium was previously isolated in 2004 from coastal sea ice and sediments in the Sea of Japan, but not from humans. P. arenosus should be considered a psychrotolerant bacterial species that can cause transfusion-transmitted bacterial infections.     

Unusual transmission of Plasmodium falciparum, Bordeaux, France, 2009

Plasmodium falciparum malaria is usually transmitted by mosquitoes. We report 2 cases in France transmitted by other modes: occupational blood exposure and blood transfusion. Even where malaria is not endemic, it should be considered as a cause of unexplained acute fever.