肾移植术后早期感染类型分析

目的 总结肾移植术后早期感染的类型、原因及死亡率,以提高其生存率.方法 对1102例肾移植术后发生感染的298例住院患者临床资料进行回顾性分析,总结感染类型、病原体、预后等.结果 肾移植术后早期感染率为27.04％,其中肺部269例,泌尿系统15例,消化道9例,切口3例,颅内及全身各1例;应用抗胸腺细胞球蛋白(ATG)后感染率达59.35％;病原体以革兰阴性菌为主占64.77％,革兰阳性菌占19.80％,真菌占6.71％,卡氏肺孢子虫占4.03％,病毒占3.02％;感染率中男女无差异,男性发生感染后死亡及切除移植肾比例较高.结论 肾移植术后早期感染患者有一定的规律,应合理应用免疫抑制剂,加强肺部感染的早期诊断和全身支持治疗,尤其是男性患者.     

女性性病500例检测结果分析

目的 为了明确女性性传播疾病(STD)患者的病原体构成。方法 采用单克隆抗体免疫荧光法及培养、涂片对500例女性性病患者进行解脲支原体(UU)、衣原体(CT)、淋球菌(GC)、人乳头瘤病毒(HPV)、单纯疱疹病毒Ⅱ型(HSV—Ⅱ)5种常见病原体检测。结果 检出率最高的为UU，占29％，CT、GC、HPV、HSV—Ⅱ分别占24．6％、15％、7％、11．2％。2种或2种以上的病原体混合感染占13．2％。结论 对久治不愈的STD患者，更应重视多种病原体的检测，应广泛开展健康教育，加强个人对STD的预防行为。     

肾移植术后并发重症肺炎27例临床分析

目的探讨肾移植术后并发重症肺炎的临床特点及救治措施。方法对27例肾移植术后并发重症肺炎的临床资料进行回顾性分析。结果肾移植术后并发重症肺炎具有发病早、进展迅速、多种病原体混合感染等特点。22例（81．5％）患者救治成功，死亡5例。结论对于肾移植术后并发重症肺炎的患者应密切观察，积极救治。合理使用广谱抗菌素、呼吸支持及联合治疗措施是救治成功的关键。     

肾移植术后肺部感染的病原体分析与诊治

目的 探讨肾移植术后肺部感染的病原体诊断,提高患者生存率.方法 回顾性地分析2003年8月-2008年8月43例肾移植术后肺部感染患者临床资料.结果 肾移植术后肺部感染的病原体主要有真菌(44.2%)、病毒(30.2%)、结核分枝杆菌(9.3%)和其他细菌(9.3%);出现时间一般在术后<6个月;曲霉菌属及卡氏肺囊虫性肺炎病死率高,分别为28.6%和16.7%.结论 早期诊断及经验性治疗尤为重要,发病早期无特殊急重情况不建议联合治疗.     

急性下呼吸道感染患者支气管肺泡灌洗液非典型病原体与病毒检测

目的探讨急性下呼吸道感染患者非典型病原体与病毒感染情况。方法采集71例社区获得性肺炎和21例急性气管一支气管炎患者支气管肺泡灌洗液（BALF），采用多重PCR技术与Luminex xMAP多重分析技术平台相结合，以荧光微球为载体检测非典型病原体与多种病毒。结果10种（14个亚型）病原体阳性检出率为50．00％，其中病毒阳性检出率为33．69％，以流感病毒A为主，其占病毒阳性检出的67．74％f非典型病原体阳性检出率为16．30％，以肺炎支原体（MP）为多，其占非典型病原体阳性检出的73．33％IMP、病毒和细菌混合感染率为13．04％。结论多重荧光微球检测技术具有高通量、敏感性高、特异性强、检测速度快、价格便宜的优点，可实用于临床病原微生物的快速检测；流感病毒A和肺炎支原体是本地区社区获得性肺炎和急性气管-支气管炎重要的病原体，并有相互混合感染或与细菌混合感染，临床应予重视。     

5915例成人呼吸道感染患者常见呼吸道病原体IgM检测结果分析

目的 了解金华地区成人呼吸道感染的9种常见呼吸道病原体IgM的阳性检出率,分析阳性率在不同性别、年龄、季节的差异,为临床诊疗提供病原学依据。方法 对就诊的5 915例出现呼吸道感染症状的成人患者的9种常见呼吸道病原体IgM抗体检测结果进行回顾性分析。结果 5 915例成人呼吸道感染患者9种呼吸道病原体IgM抗体检测总阳性检出率为28.2%;其中肺炎支原体(MP)阳性检出率最高(18.31%),其次为B型流感病毒(BIV)(10.5%)。男性呼吸道病原体IgM检测总阳性检出率高于女性,>60岁年龄组单一阳性与混合阳性高于其他年龄组,差异均有统计学意义(P<0.05)。柯萨奇B组病毒(CoxB)、人副流感病毒(HPIV)的检出率,夏季高于其他季节;MP检出率秋季低于其他季节;BIV的检出率,春、冬季节高于夏、秋季节;差异均有统计学意义(均P<0.05)。结论 成人呼吸道感染患者9种呼吸道病原体IgM抗体检测中MP阳性检出率最高,BIV次之,呼吸道病原体的感染分布与性别、年龄、季节等有关。     

62例性病性尿道炎并发前列腺炎的临床分析

目的：探讨性病尿道炎与前列腺炎病因学特点。方法：常规镜检结合聚合酶链反应(PCR)方法对患者前列腺液(EPS)进行检测。结果：62例EPS共检测到病原体37例，阳性率59．7％，其中淋球菌2l例(34．0％)，解脲支原体(UU)19例(30．6％)，沙眼衣原体(CT)15例(24．2％)，复合感染17例(27．4％)，结论：性病性尿道炎症可并发前列腺炎，前列腺液病原体的检测对前列腺炎的治疗具有重要的临床意义。     

嘉兴市6402份呼吸道病原体IgM抗体检测结果分析

目的分析嘉兴市呼吸道病原体IgM抗体检出情况,为呼吸道感染的预防及诊治提供参考依据。方法收集2020年—2021年嘉兴市某医院呼吸道感染患者血清6402份,用间接免疫荧光法检测血清中嗜肺军团菌(LP)、肺炎支原体(MP)、肺炎衣原体(CPn)、呼吸道合胞病毒(RSV)、腺病毒(ADV)、甲型流感病毒(INFA)、乙型流感病毒(INFB)、副流感病毒(PIV)IgM抗体,分析各项病原体的检出率、合并感染情况、时间及年龄分布。结果6402份血清样本中,病原体特异性IgM抗体阳性样本1956份,总检出率为30.55%,检出最多的为INFB(15.85%)、MP(11.89%)和INFA(10.17%);其中,有1291份为单一病原体感染,665份为多种病原体合并感染,以INFA合并INFB检出最多;年龄分布上,0岁～12岁年龄组的检出率明显高于另外2个年龄组;时间分布上,1月、10月—12月,总检出率明显高于其他月份。结论2020年—2021年嘉兴市呼吸道感染病原体以INFB、MP和INFA为主,具有一定年龄和时间分布特点。     

支气管哮喘急性发作期的病原学分析

目的分析支气管哮喘急性发作期的病原菌分布特点,为临床合理应用抗菌药物提供参考。方法选择2007年7月-2011年12月医院治疗的136例支气管哮喘急性发作期患者为研究对象,采集患者的痰液、血液进行病原学检测,观察病原体分布特点。结果 136例支气管哮喘急性发作期患者中检出支原体属30株,检出率为22.1%,检出衣原体属33株,检出率为24.3%,两者比较差异无统计学意义;检出合胞病毒19株,检出率为14.0%,明显高于其他病毒的检出率,差异有统计学意义(P<0.05);检出卡他莫拉菌36株,检出率为26.5%,与其他细菌的检出率比较,差异有统计学意义(P<0.05)。结论支气管哮喘急性发作与病原体感染关系密切,其中病毒感染呼吸道合胞病毒的检出率最高,非典型微生物感染支原体属与衣原体属的检出率差异不大,细菌感染卡他莫拉菌的检出率最高,临床上可根据病原体分布特点进行合理用药。     

肾移植患者术后肺部感染的临床特征分析

目的探讨肾移植术后患者肺部感染的临床特点和治疗方法。方法回顾性分析2010年10月-2015年12月医院收治的肾移植术后合并肺部感染患者130例的临床资料,分析患者肺部感染的临床特点及治疗方法。结果研究期间共诊治肾移植术后患者肺部感染130例次。肺部感染发生时间多发生于术后6个月76.92%(100/130);主要临床症状为发热83.85%(109/130)、咳嗽55.38%(72/130)、咳痰46.15%(60/130)和呼吸困难37.69%(49/130)。影像学表现主要为斑片状密度增高影40.00%(52/130)。在130例次感染中,有65例患者检测病原体阳性,病原体以混合感染为主占46.15%(30/65)。结论肾移植术后肺部感染多发于术后半年后,患者多因发热、咳嗽、呼吸困难就诊,混合感染多见,针对病原菌应用抗菌药物及对症支持治疗是治疗成功的关键。     

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.