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1.
Melioidosis. Forgotten, but not gone! 总被引:3,自引:0,他引:3
Melioidosis, infection by the soil bacterium Pseudomonas pseudomallei, has the potential for prolonged latency with recrudescence into an acute, often fulminating, and fatal infection. Although the organism is never found in North America, infection is endemic in areas of southeast Asia, and populations of service personnel exposed during the Vietnam war and southeast Asian immigrants are at risk of severe recrudescent disease. Diagnosis, however, has been missed or delayed because of lack of familiarity with this disease. We present a case of recrudescent melioidosis that illustrates the difficulties encountered in diagnosis and treatment. This case involves a 76-year-old Vietnam veteran who presented with melioidosis of the bone 18 years after exposure to the organism and 10 years after a missed diagnosis of latent pulmonary disease. This case illustrates the protean nature of latent infection and the difficulty of selecting successful antibiotic therapy. 相似文献
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H Koponen U Stenb?ck E Mattila K Reinikainen H Soininen P J Riekkinen 《Neuropsychopharmacology》1989,25(7):938-944
Cerebrospinal fluid beta-endorphin-like immunoreactivity (CSF BLI) was determined for 69 patients who met DSM-III criteria for delirium and for 8 controls. The CSF BLI was significantly lower in the delirious patient group than in the controls (12.5 +/- 3.0 pg/ml versus 15.0 +/- 3.4 pg/ml, p less than 0.05). CSF BLI had no correlation with age or neuroleptic drug dosage, but did have a significant positive correlation with cognitive functioning as evaluated by the Mini-Mental State. Our findings suggest a role for beta-endorphinergic dysfunction in the development of delirium. 相似文献
3.
BACKGROUND: Acute otitis media (AOM) is a major health problem in young children. There is a general conception that AOM is a bacterial disease but with the availability of sensitive diagnostic methods, it has gradually become evident that viruses play an important role in the pathogenesis of AOM. Paired blood samples are seldom taken from infants although valuable information could be obtained by serological methods. During the recent Finnish Otitis Media (FinOM) Cohort Study, in addition to nasopharyngeal aspirates (NPA) and middle ear fluids (MEF), paired acute and convalescent serum samples were collected from children with AOM. OBJECTIVES: To establish the diagnostic value of serological methods in etiological and epidemiological studies of AOM. STUDY DESIGN: A complete set of NPA, MEF, and paired sera was collected during 447 events of AOM experienced by 179 children between 2 months and 2 years of age. Antigens of respiratory syncytial virus (RSV), adenoviruses, influenza A and B, and parainfluenza types 1-3 in NPAs and MEFs were detected by time-resolved fluoroimmunoassay (TR-FIA), and antibody titers were determined by complement fixation test (CFT) or by enzyme immunoassay. RESULTS: A total of 163 virus-positive events were identified. Of those, only 34 were positive by TR-FIA and by serology. From 48 events a positive result was obtained only by TR-FIA and from 81 only by serology. CONCLUSION: Although serological methods are usually of little use in clinical practice, epidemiological studies clearly gain value if serology is included. The number of virus-positive findings dramatically increased by including serological tests in the diagnostic work-up of these AOM events. 相似文献
4.
Dr. P.- L. Kalliomäki O. Korhonen T. Mattsson V. Sortti V. Vaaranen K. Kalliomäki M. Koponen 《International archives of occupational and environmental health》1979,43(2):85-91
Summary Ten iron foundry workers representing typical foundry occupations were examined. The amount of lung contamination was estimated after the workers' thoracic area had been magnetized and the remanent magnetic field measured. Chest radiographs were classified according to the siderotic, silicotic, and nonspecific changes found; and the changes were then divided into four categories.The preliminary results of the electron micrographs indicated that the size and shape of the pollutants varied greatly according to the type of foundry site. In addition, the estimated amount of lung contaminants in the subjects varied between 30 and 600 mg. A good correlation (r=0.86) was obtained between radiological siderotic and silicotic changes, and the correlation between both of these radiological findings and the measured average permanent magnetic field was rather good (r=0.60). There was no correlation between the estimated exposure (neither length nor magnitude) and the amount of retained lung contaminants, and therefore a balance between retention and clearance seemed to have been achieved. These results indicate that the magnetic measuring method can be used to evaluate the amount of lung contaminants retained by foundry workers. 相似文献
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In line with current policies and service developments related to palliative care, more people are dying at home. This situation has provoked discussions about the importance of non-medical issues related to death. The process of dying is often long, with many phases, and the social aspect is a major part of it. Our focus in this article is on dying as a social process. Social relationships are significant and play a meaningful role in enhancing the well-being of older adults approaching the end of life. Meaningful social relationships tend to change over time; however, and the process of dying may exacerbate such changes in and challenge these relationships. The aim of our study was to examine how social relationships are experienced and (re)constructed among older adults (70–83 years old) during the process of dying, in a Finnish context. We were interested in the nature and type of these relationships, and in the possible new forms of expression that may emerge during this process. Our empirical data were based on interviews with seven older adults who were close to death. The analysis revealed processes of exclusion from existing relations. At the same time, we observed new and unexpected relations being initiated, which sometimes became meaningful and supportive. The results highlighted the role of expectations and importance of analysing exclusion from a life-course perspective. 相似文献
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Anne S. Koponen Juha E. Peltonen Marja K. Päivinen Jyrki M. Aho Harriet J. Hägglund Arja L. Uusitalo Harri J. Lindholm Heikki O. Tikkanen 《European journal of applied physiology》2013,113(5):1181-1188
Blood O2 carrying capacity affects aerobic capacity (VO2max). Patients with type 1 diabetes have a risk for anaemia along with renal impairment, and they often have low VO2max. We investigated whether total haemoglobin mass (tHb-mass) and blood volume (BV) differ in men with type 1 diabetes (T1D, n = 12) presently without complications and in healthy men (CON, n = 23) (age-, anthropometry-, physical activity-matched), to seek an explanation for low VO2max. We determined tHb-mass, BV, haemoglobin concentration ([Hb]), and VO2max in T1D and CON. With similar (mean ± SD) [Hb] (144 vs. 145 g l?1), T1D had lower tHb-mass (10.1 ± 1.4 vs. 11.0 ± 1.1 g kg?1, P < 0.05), BV (76.8 ± 9.5 vs. 83.5 ± 8.3 ml kg?1, P < 0.05) and VO2max (35.4 ± 4.8 vs. 44.9 ± 7.5 ml kg?1 min?1, P < 0.001) than CON. VO2max correlated with tHb-mass and BV both in T1D (r = 0.71, P < 0.01 and 0.67, P < 0.05, respectively) and CON (r = 0.54, P < 0.01 and 0.66, P < 0.001, respectively), but not with [Hb]. Linear regression slopes were shallower in T1D than CON both between VO2max and tHb-mass (2.4 and 3.6 ml kg?1 min?1 vs. g kg?1, respectively) and VO2max and BV (0.3 and 0.6 ml kg?1 min?1 vs. g kg?1, respectively), indicating that T1D were unable to reach similar VO2max than CON at a given tHb-mass and BV. In conclusion, low tHb-mass and BV partly explained low VO2max in T1D and may provide early and more sensitive markers of blood O2 carrying capacity than [Hb] alone. 相似文献
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