广东潮汕地区3785例泌尿生殖道感染患者支原体分布及药敏分析

目的:了解广东潮汕地区泌尿生殖道感染的支原体分布及其对常用抗菌药物的耐药性。方法:收集2016年1月—2016年12月泌尿生殖道感染患者标本3 785份,使用支原体试剂盒进行培养鉴定及药敏试验。结果:3 785份标本中检出支原体阳性1 117份,阳性率为29.5%,其中解脲支原体(Uu)、人型支原体(Mh)和两者共同感染的阳性率分别为24.4%、0.5%和4.6%。药敏分析结果显示,Uu对交沙霉素、克拉霉素和美满霉素的敏感率较高,分别为96.3%、94.4%和93.4%;Mh对交沙霉素、强力霉素和美满霉素较敏感,敏感率分别为100%、94.4%和94.4%,对Uu+Mh共同感染敏感率较高的抗菌药物分别为强力霉素(89.7%)、美满霉素(89.1%)和交沙霉素(86.2%)。结论:Uu是广东潮汕地区泌尿生殖道支原体感染的主要病原菌,在治疗支原体感染时,应优先考虑交沙霉素、克拉霉素和美满霉素等敏感率较高的抗菌药物。     

非淋菌性尿道炎患者支原体培养及药敏分析

目的了解非淋菌性泌尿生殖道感染患者解脲脲原体(UU)和人型支原体(MH)感染及耐药情况,以指导临床合理用药。方法采用支原体培养、鉴定、药敏一体化试剂盒对850例非淋菌性尿道炎(NGU)患者进行支原体培养及药敏试验。结果850例中支原体阳性275例,阳性率为32.35%,其中UU阳性210例(24.76%),MH阳性19例(2.24%),混合感染46例(5.4%)。对支原体敏感性最高的是强力霉素(86.18%),其次依次为交沙霉素(82.18%)、美满霉素(81.46%)、罗红霉素(70.18%)、氧氟沙星(65.09%)、阿奇霉素(60.00%)、克林霉素(58.91%)。结论支原体在体外对多种抗菌药物耐药现象严重,治疗宜首选强力霉素、交沙霉素、美满霉素。     

1080例女性泌尿生殖道支原体感染状况及药敏分析

目的:探讨惠州地区女性泌尿生殖道支原体感染及药物敏感情况。方法:采用支原体培养及药敏试剂盒检测1080例女性泌尿生殖道的解脲支原体(Uu)和人型支原体(Mh),并对9种抗生素的药敏试验进行分析。结果:392例检测出支原体,阳性率36.30%,其中Uu 338例(31.30%),Mh 26例(2.41%),Uu合并Mh 28例(2.59%)。药敏结果表明:Uu对强力霉素、美满霉素、交沙霉素、克拉霉素较为敏感,Mh及Uu合并Mh对强力霉素、美满霉素较为敏感。Mh及Uu合并Mh对多种药物有较高的耐药性。结论:惠州地区女性泌尿生殖道支原体感染以Uu为主,强力霉素、美满霉素等是惠州地区女性泌尿生殖道支原体感染的首选药物,支原体耐药性的动态监测是指导临床治疗的重要依据。     

阴道分泌物支原体检测及耐药性分析

目的:了解和探讨成年女性阴道分泌物支原体感染情况及对各类抗菌药物的耐药性,以指导临床合理治疗。方法:对2012年6月至2013年6月期间在我院就诊的589例女性患者的阴道分泌物进行支原体检测及药敏试验,药敏试验抗菌药包括:美满霉素(MIN)、强力霉素(DOX)、交沙霉素(JOS)、阿奇霉素(AZI)、克拉霉素(CLA)、罗红霉素(ROX)、红霉素(ERY)、琥乙红霉素(ECC)、甲砜霉素(THI)、环丙沙星(CPF)、左氧氟沙星(CRA)、加替沙星(GAT),观察和分析支原体检测及药敏试验结果。结果:589份阴道分泌物标本中,390例检出支原体,支原体感染率为66.21%,其中Uu占所有感染病例的67.95%,Uu+Mh占29.49%,Mh占2.56%。药敏试验结果显示:Uu、Mh、Uu+Mh三种类型的感染对强力霉素、美满霉素及交沙霉素表现了较低的耐药性,对氟喹诺酮类抗菌药物表现了较高的耐药性,甚至达50%以上;对加替沙星的耐药率均维持在20%左右;单一Uu感染对大环内酯类抗菌药耐药性多维持在20%以下,而Mh、Uu+Mh对大环内酯类耐药性维持在50%左右;单一Uu感染对强力霉素、美满霉素及交沙霉素耐药率为0,而Mh、Uu+Mh对上述三药表现了10%左右的耐药率。结论:女性生殖道支原体感染已相当普遍且比较严重,不同的感染类型对临床常用抗菌药物可表现出不同的耐药性,临床上应加强支原体培养及药敏试验,以指导合理应用抗菌药,同时应加强对重点人群的监测,预防或降低支原体感染的发生。     

1825例STD患者泌尿生殖道支原体感染STD分析

目的了解近年STD门诊患者支原体感染情况及对12种抗生素的敏感性,为临床治疗提供参考依据。方法采用支原体培养、鉴定、计数药敏一体化试剂盒对1825例STD门诊患者进行支原体培养,并对阳性标本进行12种抗生素药敏试验。结果1825例中支原体阳性712例,感染率为39.01%。解脲支原体(UU)、人型支原体(MH)及UU+MH混合感染的阳性率分别为82.02%(584例),1.83%(13例)及16.15%(115例)。UU对12种抗生素敏感性最高的是美满霉素、交沙霉素、强力霉素(均在85.0%以上);耐药性最高的为环丙沙星,其次是司帕沙星。MH对12种抗生素敏感性最高的是美满霉素、交沙霉素、强力霉素(均为100%);耐药性最高的为阿奇霉素、环丙沙星。结论目前治疗泌尿生殖道支原体感染的首选抗生素为美满霉素、交沙霉素、强力霉素。     

性病门诊非淋菌性泌尿生殖道感染965例支原体检测及耐药性分析

目的探讨性病门诊就诊非淋菌性泌尿生殖道感染者(NGU)的支原体感染及耐药情况。方法采用支原体诊断试剂盒对965例拟诊为NGU的患者的分泌物进行培养、鉴定以及抗生素药物敏感试验。结果 965例患者中支原体培养阳性436例(45.18%),其中解脲支原体(UU)阳性333例(34.51%),人型支原体(MH)阳性28例(2.90%),UU合并MH阳性75例(7.77%)。女性支原体阳性率高于男性(P0.01),UU感染率高于MH(P0.01)。UU对美满霉素、强力霉素、克拉霉素、交沙霉素以及阿奇霉素较为敏感,UU合并MH以及MH感染均对美满霉素及强力霉素敏感。结论本组NGU感染以UU为主,美满霉素及强力霉素为首选药物。     

性病门诊就诊者1408例泌尿生殖道支原体培养及药敏分析

目的了解遵义地区性病门诊非淋菌性泌尿生殖道感染患者中支原体感染及耐药性状况,指导临床合理用药。方法采用支原体(解脲脲原体/人型支原体,UU/Mh)诊断试剂盒对1408例性病门诊患者的尿道、宫颈分泌物标本进行支原体培养、鉴定及药敏试验。结果 1408例患者标本中支原体阳性555例,阳性率39.42%,其中UU阳性384例(27.27%),Mh阳性27例(1.92%),UU合并Mh混合感染144例(10.23%);UU感染明显高于Mh感染(P<0.01)。药敏试验显示12种常用的抗菌药物中交沙霉素、美满霉素、强力霉素对UU及Mh的敏感性极高,但合并二者感染的敏感性下降,耐药性升高。结论遵义地区泌尿生殖道支原体感染主要以UU发病率最高,显著高于Mh。UU和Mh对交沙霉素、美满霉素和强力霉素的耐药率低,是治疗支原体感染的首选药物。     

非淋菌性尿道(宫颈)炎患者泌尿生殖道解脲脲原体及人型支原体的检出率与药敏分析

目的了解解脲脲原体及人型支原体感染与药敏情况,为临床支原体感染病原学诊断和治疗提供依据。方法采用支原体诊断试剂盒对拟诊为NGU的患者进行支原体培养、鉴定和药物敏感试验。结果456例泌尿生殖道感染支原体培养阳性(45.24%),其中UU阳性324例(32.14%),MH阳性36例(3.57%),UU+MH 96例(9.52%);UU阳性率明显高于MH(P<0.01),女性支原体阳性率高于男性(P<0.05)。药敏试验显示UU、MH以及UU+MH对抗生素的敏感性不同,但对交沙霉素、强力霉素、美满霉素、阿齐霉素均显示出较高的敏感性。结论重视STD门诊支原体的培养与药敏检测,对指导临床用药、控制其传播、防止耐药性产生具有重要的意义。     

非淋菌性尿道（宫颈）炎患者支原体的检检测和药敏分析

目的:了解丹东地区性病门诊支原体感染的状况和药物敏感情况。方法:应用试剂盒对Uu和Mh进行检测,并对9种抗菌药物的药敏检测进行分析。结果:669例怀疑有泌尿生殖道感染患者中,221例检出支原体,其中Uu198例,Mh5例,Uu Mh18例。患者药敏分析对交沙霉素、强力霉素、美满霉素敏感性均很高;对克林霉素、氧氟沙星、左氧氟沙星、罗红霉素、阿奇霉素敏感性较低。结论:在支原体感染患者治疗前应做药敏检测,以指导临床应用敏感的抗菌药物,减少耐药株产生。     

泌尿生殖道支原体感染临床耐药性分析

目的　分析解脲脲原体(UU)和人型支原体(MH)在非淋菌性尿道炎 (宫颈炎 )患者中的感染情况及耐药现状。方法　采用珠海浪峰公司生产的支原体培养鉴定药敏试剂盒进行培养及药敏试验。结果　184例支原体培养阳性标本中,UU阳性 139例(75. 5% ),MH阳性 15例(8. 2% ),UU+MH阳性 30例 (16. 3% )。对红霉素、四环素和阿奇霉素耐药率分别为 87. 5%, 83. 7%, 58. 2%;对强力霉素、美满霉素、交沙霉素的耐药率分别为 6. 0%, 7. 1%, 15. 2%。结论　UU感染是支原体感染的主要病原体;临床治疗应首选强力霉素、美满霉素、交沙霉素。     

New fillers for the new man

ABSTRACT:  Two new collagen-based lidocaine-containing dermal fillers, ArteSense™/ArteFill™ (Artes Medical, San Diego, CA) and Evolence® (Colbar LifeScience Ltd., Herzliya, Israel), have proved to be of particular interest to men, many of whom seek a long-lasting or permanent correction. ArteFill™ has been available in the United States since 2006, and it is expected that Evolence® will reach the American market in 2008. The properties of the two products will be described, and experience based on the administration of many hundreds of syringes of both products by a Canadian dermatologist will be detailed here, with tips and precautions to optimize patient outcomes.     

Outcomes and adverse effects of ablative vs nonablative lasers for skin resurfacing: A systematic review of 1093 patients

It is generally believed that ablative laser therapies result in prolonged healing and greater adverse events when compared with nonablative lasers for skin resurfacing. To evaluate the efficacy of ablative laser use for skin resurfacing and adverse events as a consequence of treatment in comparison to other modalities, a PRISMA‐compliant systematic review (Systematic Review Registration Number: 204016) of twelve electronic databases was conducted for the terms “ablative laser” and “skin resurfacing” from March 2002 until July 2020. Studies included meta‐analyses, randomized control trials, cohort studies, and case reports to facilitate evaluation of the data. All articles were evaluated for bias. The search strategy produced 34 studies. Of 1093 patients included in the studies of interest, adverse events were reported in a total of 106 patients (9.7%). Higher rates of adverse events were described in nonablative therapies (12.2% ± 2.19%, 31 events) when compared with ablative therapy (8.28% ± 2.46%, 81 events). 147 patients (13.4%) reported no side effects, 68 (6.22%) reported expected, transient self‐resolving events, and five (0.046%) presented with hypertrophic scarring. Excluding transient events, ablative lasers had fewer complications overall when compared with nonablative lasers (2.56% ± 2.19% vs 7.48% ± 3.29%). This systematic review suggests ablative laser use for skin resurfacing is a safe and effective modality to treat a range of pathologies from photodamage and acne scars to hidradenitis suppurativa and posttraumatic scarring from basal cell carcinoma excision. Further studies are needed, but these results suggest that ablative lasers are a superior, safe, and effective modality to treat damaged skin.     

Multiple New-Onset Subcutaneous Nodules of the Upper Extremity Digits: Giant Cell Tumor of Tendon Sheath and Lipoma

A black woman with the concurrent onset of two subcutaneous nodules located on the digits of her upper extremities is described. Initially, a single systemic disorder was considered; yet, the lesions differed in morphology and consistency. Microscopic examination of the nodules showed a giant cell tumor of tendon sheath and a lipoma. Although Occam's “razor” suggests that multiple lesions in the same person are more likely to represent variable manifestations of a single disorder than several different diseases in that individual, the simultaneously appearing lesions in this patient represented two different conditions.     

Genetic alterations in RAS‐regulated pathway in acral lentiginous melanoma

Studies integrating clinicopathological and genetic features have revealed distinct patterns of genomic aberrations in Melanoma. Distributions of BRAF or NRAS mutations and gains of several oncogenes differ among melanoma subgroups, while 9p21 deletions are found in all melanoma subtypes. In the study, status of genes involved in cell cycle progression and apoptosis was evaluated in a panel of 17 frozen primary acral melanomas. NRAS mutations were found in 17% of the tumors. In contrast, BRAF mutations were not found. Gains of AURKA gene (20q13.3) were detected in 37.5% of samples, gains of CCND1 gene (11q13) or TERT gene (5p15.33) in 31.2% and gains of NRAS gene (1p13.2) in 25%. Alterations in 9p21 were identified in 69% of tumors. Gains of 11q13 and 20q13 were mutually exclusive, and 1p13.2 gain was associated with 5p15.33. Our findings showed that alterations in RAS‐related pathways are present in 87.5% of acral lentiginous melanomas.     

Medición del impacto psicológico en pacientes con psoriasis en tratamiento sistémico

Background and objectives

The negative impact of psoriasis on patient quality of life can be as important as the physical consequences of the disease. We could assume that clearance of the disease would also lead to an improvement in its psychosocial impact. The present study assesses the psychological state of patients with psoriasis receiving systemic treatment in a psoriasis unit, especially those with mild or no disease involvement.