病毒性肝炎会引起肝癌吗

七十年代后期,从事流行病学研究的国外学者发现,除了甲型肝炎和乙型肝炎之外,还有非甲非乙型肝炎。迄今为止,医学界将病毒性肝炎分为甲、乙、丙、丁、戊等五型。过去所指的非甲非乙型肝炎,实际上包括丙型肝炎和戊型肝炎。戊型肝炎通过粪——口途径传播,其临床表现与甲型肝炎相似,只引起一次性感染,无慢性化病例。而丙型肝炎通过输血等肠道外途径传播。其临床过程与乙型肝炎相似,但更易慢性化,除引起一次性感染外,还可导致慢性肝炎、肝硬化和肝癌。近些年来,肿瘤流行病学调查资料证明,甲型和戊型肝炎与肝癌关系甚小;乙型肝炎病毒     

甲型肝炎和戊型肝炎的临床特点

病毒性肝炎是由多种肝炎病毒引起的以肝脏受累为主的全身性疾病。按病原分类 ,目前已经确定的病毒性肝炎共有5型。其中乙、丙、丁型主要通过血液和体液传播 ,可以表现为急性、慢性及重型肝炎 ,并可发展为肝硬化和肝细胞癌。甲、戊型肝炎主要通过粪 口途径传播 ,主要表现为急性肝炎。本文仅就甲、戊型病毒性肝炎的流行病学特征、临床表现及治疗等做以简介。1流行病学特征甲、戊型肝炎的流行病学特征相似。传染源为急性肝炎患者和亚临床型患者 ,目前尚未发现病毒携带者。潜伏期和急性期粪便排毒量最多 ,传染性最强。主要通过粪 口途径传播 ,…     

急性散发性戊型肝炎肝功能检测

戊型肝炎日常以散发为主,绝大部分患者起病急,临床表现多为急性肝炎,而实验室检查是本病诊断和治疗的主要基础。本组49例急性散发性戊型肝炎患者,根据临床表现和实验检测,急性黄疸型戊型肝炎40例,急性无黄疸型戊肝炎9例;单一戊肝病毒感染39例,戊肝病毒又     

病毒性肝炎的预后评价

病毒型肝炎临床上可分为甲型、乙型、丙型、丁型、戊型五种。每年至少有30万人死于肝炎后肝硬化或肝癌,已经成为严重危害我国人民健康的“国害”。人们不禁会问:不同类型的肝炎预后有什么差别?是不是每种肝炎都可转为慢性?是否慢性肝病患者最终都要走“慢性肝炎——肝硬化——肝癌”三步曲?影响肝炎患者预后的因素主要有哪些? 肝炎病毒的类型 目前认为,甲型和戊型肝炎病毒只能引起急性肝炎,不会转为慢性;乙型、丙型和丁型肝炎病毒所致的急性肝炎均有慢性化倾向,其中丙     

戊型肝炎疫苗研究最新进展

戊型肝炎是由戊型肝炎病毒(HEV)引起的急性自限性疾病,一般不发展成慢性,但最新研究表明,在器官移植等免疫抑制人群中存在持续性HEV感染[1].HEV主要经粪口途径传播,也可经输血和母婴传播[2].HEV只有一个血清型,但其基因型主要有1～4型,基因1型和2型只感染人,而3型和4型既可感染人,也可感染多种动物.     

加强病毒性肝炎传染源的管理是控制病毒性肝炎的重要措施

病毒性肝炎是一组传染病。我国是高发区,占传染病的首位,就乙型肝炎来说,1979～1980年全国病毒性肝炎流行病学调查结果,经放射免疫测定为10.3％。我国有1亿以上无症状HBsAg携带者。病毒性肝炎可造成肝坏死。乙丙丁型肝炎易慢性化,发展成肝硬化,20％癌变,严重危胁人们的健康。对于它的防治及卫生管理急需提到日常防疫工作的重要日程。1 掌握病源学及流行病学管理人员要掌握病源学分类。目前已发现甲乙丙丁戊型肝炎。从流行病学和预防方面分两类:一类经粪—口传播,如甲型和戊型,有季节性,有时可引起暴发流行,不易慢性化。另一类主要经血液传播,如乙丙丁型,无季节性,多为散发,常变慢性。甲戊型肝炎在一次流行后80％的易感人群可被感染,     

肝炎患者的家庭护理

肝炎有多种,最常见的是病毒性肝炎.根据病原体不同,病毒性肝炎又分甲、乙、丙、丁和戊型肝炎5种.甲肝和戊肝经消化道传播;乙肝、丙肝和丁肝传播途径复杂,主要经血液体液途径、母婴垂直传播和性接触传播.甲肝和戊肝只有急性患者;乙肝、丙肝和丁肝既有急性患者,也有慢性患者,慢性患者更多见.俗话说,病靠三分治,七分养.对肝炎患者而言,家庭护理非常重要,是养好病的关键.肝炎的家庭护理包括:     

不同人群TT病毒的检测及部分核苷酸序列分析

目的：了解不同人群TTV感染状况及基因型别。方法：采用TTV（N22）区核苷酸序列设计引物，建立半巢式（nPCR）方法，对健康人群、不同型别肝炎病人、非甲-非戊型肝炎、肝硬化患者等7组人群血清进行啊VDNA检测，并对部分阳性标本进行序列测定和分析。结果：TTV在非甲-非戊型肝炎、肝硬化患者、丙型肝炎、急性甲型肝炎、急性乙型肝炎、慢性乙型肝炎和健康人群中感染率分别为75．00％（15／20）、75．00％（27／36）、61．90％（13／21）、58．06％（18／31）、52．78％（38／72）、45．61％（26／57）和38．89％（28／72）。肝硬化患者及非甲-非戊型肝炎感染率明显高于健康人群（P〈0．01），也明显高于急、慢性乙型肝炎患者（P〈0．05）。5个阳性株序列分析结果显示：4株属于G1基因型，1株属于G2基因型。结论：TTV在河北地区肝病患者中有较高的感染率，TTV感染与不明原因ALT升高有一定的关系，基因型以G1型为主。     

难以区别的慢性迁延性肝炎和慢性活动性肝炎

我在专家门诊时,常常可以遇到有一些慢性肝炎病人,困惑不解的问:什么是慢性迁延性肝炎?什么是慢性活动性肝炎?我跑了多家医院说法不一,如何正确认识?慢性肝炎可以由病毒、药物、酒精、遗传等因素引起。我国慢性肝炎的主要病因是病毒。其中乙型肝炎最易形成慢性肝炎;甲肝、戊肝不会形成慢性肝炎;丙肝和丁肝双重感染时,部分患者可形成慢性肝炎。慢性肝炎可分为慢性迁延性肝炎和慢性活动性肝炎两型。这两型从临床表现上常难以区别。但疾病的转归不同:前者较好,后者较差,易进展为肝硬化。慢性迁延性肝炎患者约63%有急性肝炎病史,病程迁延半年以…     

谈谈重型肝炎

重型肝炎是指病毒性肝炎临床分型中的重型。按1990年5月上海第六次全国病毒性肝炎会议拟定的《病毒性肝炎防治方案》中诊断标准,重型肝炎分三个型:急性重型、亚急性重型及慢性重型。急性重型是指急性黄疸型肝炎起病后10天以内迅速出现肝性脑病而排除其他病因者,患者肝脏进行性缩小,黄疸逐日加深,肝功能严重损害;亚急性重型是指急性黄疸型肝炎起病10天以上8周以内出现上述症状体征者;慢性重型是指临床表现同亚急性重型肝炎,但既往有慢性活将病感染分可过变临床肝脏细胞的病     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.     

Assessing occupational and environmental exposure

Exposure assessment is a poorly understood component of the science of epidemiology. The relationship between exposure to chemicals and ill-health outcomes is often calculated using crude exposure measures such as ever/never exposed or duration. When investigating subtle effects, exposures need to be characterized much more fully in terms of intensity, frequency, duration and route. While occupational exposures tend to be much greater than those experienced from the wider environment there is a need to remember that, for many chemicals, exposure can occur occupationally, environmentally and through consumer use of products containing the material of interest. Inhalation exposure has generally been the traditional focus for most epidemiological investigations but there is now growing awareness of the importance of the dermal and ingested routes of contact and internalization. Quantification of the exposure also needs to be related to a biological mechanism of action and exposure metrics need to be selected accordingly. Occupational exposures can generally be measured using simple well-validated techniques. Environmental exposures require much more sensitive instruments and are more difficult to assess. Exposure modelling, particularly for the environmental fate of chemicals has undergone many recent developments and Monte Carlo techniques can be used to characterize model uncertainty and variability. This approach to exposure assessment can now be used in the setting of the wider environment and will enable a far better understanding of the relationship between exposure and disease.     

Mercury toxicity due to the smelting of placer gold recovered by mercury amalgam

A 19-year-old man developed tremor in both hands and fatigue after starting work at a placer gold mine where he was exposed to mercury-gold amalgam. Examination revealed an intention tremor, dysdiadochokinesis and mild rigidity. The 24-h urinary mercury concentration reached a peak of 715 nmol/l (143 ug/l) shortly before the clinical examination, after which he was removed from working in the gold room [Mercury No. Adverse Effect Level: 250 nmol/l (50 ug/l)]. On review 7 weeks later his tremor had almost resolved and the dysdiadochokinesis and rigidity had gone. The 24-h urinary mercury concentration had fallen to 160 nmol/l (32 ug/l). The principal exposure to mercury was considered to be the smelting of retorted gold with previously unrecognized residual mercury in it. The peak air concentration of mercury vapour during gold smelting was 0.533 mg/m3 (Mercury Vapour ACGIH TLV: 0.05 mg/m3 TWA). Several engineering and procedural controls were instituted. This episode occurred at another mine site, unrelated to Mount Isa Mines Limited.     

How Adults with Acquired Brain Damage Perceive Computer Training as a Rehabilitation Tool: A Focus-group Study

The aim of this study was to explore and describe how adult outpatients with acquired brain damage and referred to occupational therapy perceive computer training with the RehaCom programs, in order to evaluate the method of treatment as a tool in the rehabilitation of persons with cognitive disorders. By using focus-group discussions as a qualitative method of research when analysing the result, five themes with corresponding categories emerged, describing a development of understanding and learning about capacities. Themes describing how the participants could apply strategies to overcome shortcomings in daily occupations and the therapeutic role of the occupational therapist were identified as well. The result shows that a computer training program such as RehaCom can be used as an educational tool, for example, to guide a person who is trying to adopt compensatory strategies to avoid overload by taking pauses. It was found that anything the participants learned was also applicable to occupational performance in daily life.