神经
词汇介绍
拓展阅读
解析
alcohol 英 [ˈælkəhɒl] 美 [ˈælkəhɔːl]
释 义 n. 酒精,乙醇 [ 复数 alcohols ]
例 句 When under the influence of alcohol, I behave badly. 在酒精的影响下时,我有不好的行为。
withdrawal 英 [wɪðˈdrɔːəl; wɪθˈdrɔːəl] 美 [wɪðˈdrɔːəl,wɪθˈdrɔːəl]
释 义 n. 撤退,收回;提款;取消;退股 [ 复数 withdrawals ]
例 句 Atomicity requires that both withdrawal and deposit should happen in one go, or neither mustoccur. 原子性要求提款和存款必须同时发生,或者二者都不发生。
syndrome 英 [ˈsɪndrəʊm] 美 [ˈsɪndroʊm]
释 义 n. [临床] 综合征;综合症状;并发症状;校验子;并发位
例 句 To study the effect of rhubarb in treating patients with systemic inflammation reaction syndrome and its mechanism. 目的:研究大黄对全身炎症反应综合征患儿的治疗作用及其作用机制。
概述
概述
酒精戒断综合征,是指酒精依赖者突然停止饮酒或骤然减少饮酒量时出现的一组症状。即在末次酒后6~28小时内开始出现的如焦虑、颤抖、心动过速、厌食、恶心、反射亢进、失眠、恶梦、出汗、高热、定向力障碍、呕吐、癫痫发作、谵妄等一系列典型的症候群。通常发生于因其他疾病而强行戒酒或由于发生与酒精有关的其他疾病而自愿放弃饮酒的患者中。戒酒综合征的出现,标志着个体对酒已产生了躯体依赖。
分类
一般将AWS分为三类,第一类为自主性的活动过多,此症状在末次饮酒后的数小时内表现出来,其中以颤抖、出汗、恶心、呕吐、焦虑最为常见;第二类在第一类的基础上出现神经兴奋症状,主要是癫痫发作,一般在戒酒后12~48小时内出现;第三类在第一类的基础上出现谵妄,此症状仅在极少数患者中发生,主要表现为视、听幻觉、思维混乱、定向力障碍、意识模糊、注意力不集中等,如果不及时治疗,患者将死于呼吸及循环衰竭。
临床特征
正如名称所示,有震颤及谵妄两方面。患者定向力丧失,并伴有各种各样生动的幻觉,以幻视为主。震颤多为粗大震颤,尤其多见于手指、面部、舌头等部位。震颤谵妄易于在患者出现感染、外伤或其他应激情况时发生。此症多为突然发病,前驱期出现发热、脉快、白细胞增多、呼吸深大、厌食、恶心、周身无力及脱水表现。继之出现谵妄,震颤常伴有共济失调及反射亢进,据认为这主要与额叶-脑桥小脑通路的病变有关。检查可发现颅内压增高,且脑脊液中免疫球蛋白升高,约有一半病例出现一过性的中度的白蛋白尿。患者也可出现癫痫样抽搐发作,据认为这与维生素B6缺乏有关。
影响戒酒综合征的因素
①个体饮酒方式如习惯的饮酒速度与酒量,总的说来,血乙醇浓度越高,维持时间越长,戒酒后症状越重;
②饮酒类型饮用高浓度酒者比饮用低浓度酒者戒酒症状重;
③年龄愈大戒酒症状愈重;
④既往戒酒症状既往发作的戒酒症状发作次数越多,症状越重,则本次的戒酒症状出现的几率越高,且较为严重;
⑤机体状况愈差,戒酒症状愈重;
⑥精神状态个体是否伴有精神障碍,对戒酒症状也有一定影响。
Francisella tularensis Transmission by Solid Organ Transplantation, 2017复制标题
土茯苓通过实体器官移植传播,2017
发表时间:2019-04-01
影响指数:7.2
作者: Christina A Nelson
期刊:Emerging Infect Dis
In July 2017, fever and sepsis developed in 3 recipients of solid organs (1 heart and 2 kidneys) from a common donor in the United States; 1 of the kidney recipients died. Tularemia was suspected only after blood cultures from the surviving kidney recipient grew Francisella species. The organ donor, a middle-aged man from the southwestern United States, had been hospitalized for acute alcohol withdrawal syndrome, pneumonia, and multiorgan failure. F. tularensis subsp. tularensis (clade A2) was cultured from archived spleen tissue from the donor and blood from both kidney recipients. Whole-genome multilocus sequence typing indicated that the isolated strains were indistinguishable. The heart recipient remained seronegative with negative blood cultures but had been receiving antimicrobial drugs for a medical device infection before transplant. Two lagomorph carcasses collected near the donor's residence were positive by PCR for F. tularensis subsp. tularensis (clade A2). This investigation documents F. tularensis transmission by solid organ transplantation.
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