水体中克雷伯菌属的分布及其在水源性急性肠道感染中的价值

俄罗斯不同气候地区不同功能水体中克雷伯菌属广泛分布。克雷伯菌属可见于遭受生物、化学污染的集中供水的地表水源,无防护的地下蓄水层,缺乏有效清洁、消毒系统的饮用水。研究表明,水体中的克雷伯菌属具有致病性和毒性,对现代药物和消毒剂(氯、紫外线)具有抗性,很容易穿透进入地下蓄水层。克雷伯菌属细菌有很强的致病性(粘附力、侵袭力、磷酸酯酶、卵磷脂酶、脱氧核糖核酸酶、溶血活性),含有致病性遗传标记cnf-1。克雷伯菌属(100 CFU/dm³)可引起急性肠道感染。在不检测总大肠菌群的情况下,检测水体尤其是饮用水中的克雷伯菌属,可以评估所用水的流行病学危险。     

Disseminated intravascular coagulation associated with toxic epidermal necrolysis (Lyell''s syndrome)

Evidence of disseminated intravascular coagulation was recorded in eight patients with toxic epidermal necrolysis (TEN)--Lyell's syndrome. Patients were treated with low doses of heparin in combination with the usual treatment of TEN, i.e. maintenance of fluid and electrolyte balance, systemic corticosteroids, antibiotics and aseptic dressings, in the Intensive Care Unit environment. It is suggested that the alteration of haemostasis and inter-related biological systems, such as activation of components of complement, kinins and immunoglobulins, may affect the outcome of TEN.     

Cardiac Resynchronization in a Child with Dilated Cardiomyopathy and Borderline QRS Duration: Speckle Tracking Guided Lead Placement

Cardiac resynchronization therapy (CRT) is proved to prevent heart transplantation in some patients with dilated cardiomyopathy and mechanical dyssynchrony. We report of the benefit of CRT accomplished by atrial synchronized single-site left ventricular pacing in an 8-year-old boy with idiopathic dilated cardiomyopathy, normal atrioventricular conduction, borderline QRS complex duration (120 ms), and marked mechanical left ventricular dyssynchrony proved by echocardiographic speckle tracking.     

Sterile water injection for labour pain: a systematic review and meta-analysis of randomised controlled trials

Background  Up to one-third of labouring women will experience painful 'back labour'. Sterile water injected lateral to the lumbosacral spine is a simple and well-researched approach to this pain.
Objective  To determine if sterile water injection for low back pain compared to placebo or alternative therapy increased or decreased the rate of Caesarean section.
Search strategy  We performed a literature search with no language restriction in four databases: the Cochrane library, EMBASE (1980–2009), Ovid Medline (1950–2009) and CINAHL (1982–2009).
Selection criteria  We included all randomised controlled trials (RCTs) of sterile water injection for labour pain that included outcomes of interest and original data.
Data collection and analysis  We compared Caesarean section rates among women who received sterile water injection in labour with those who received either placebo treatment or another non-pharmacological treatment modality. Other outcomes included pain scores, use of regional analgesia and women's assessment of treatment. We used Revman 5 for the meta-analysis. Data were entered by one reviewer and independently cross-checked. Pooled outcomes were reported as Relative Risk (RR) or Weighted Mean Difference using Mantel–Haenszel fixed-effects model except when the I ² value >50% indicated significant heterogeneity in which case random-effects model was used.
Main results  We included eight RCTs. The Caesarean section rate was 4.6% in the sterile water injection group and 9.9% in the comparison group ( n  =   828) (RR 0.51, 95% CI: 0.30, 0.87).
Conclusion  We believe that a large RCT should be mounted to validate our findings regarding the impact of sterile water injections on mode of delivery.     

MOTOR RESTLESSNESS

Motor restlessness, characterised by an irresistible urge to move about, can be a manifestation of many underlying disorders. Unfortunately, it is often poorly recognised and underdiagnosed in clinical practice, possibly because patients do not seek medical attention, or their complaints were thought to be secondary to anxiety. While the two major conditions to consider are restless legs syndrome and neuroleptic-induced akathisia, there are many other differential diagnoses. We provide a concise review of the clinical features and diagnostic pitfalls of these conditions. A proper detailed clinical history and examination can often help clinch the diagnosis, as most of these conditions have their unique clinical features.     

Dioxins and the Ah receptor

Despite continuing controversies related to public policy, information on the molecular biology of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) has advanced significantly over the past decade. Current understanding of the biological mechanisms of TCDD action is based upon the interactions of TCDD with a genetically expressed cytosolic macromolecule that functions as a receptor in many cells across many species. The Ah receptor recognizes TCDD and structurally similar molecules and serves as the transducing step whereby TCDD alters gene expression through the association of the TCDD:receptor complex with specific TCDD-responsive elements on the genome. Understanding these molecular events and their relevance to the organ-level manifestations of TCDD toxicity may be critical to formulating scientifically based assessments of the risk of TCDD exposure.