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  • 简介:【摘要】目的:对基层医院开展白内障超声乳化手术1006眼的回顾性分析总结。方法:选入样本803例白内障患者(1006眼),选入样本时间为2018年1月至2020年12月,回顾性分析1006眼的白内障超声乳化手术,随访患者预后。结果:术后有796例患者视力为0.6~1.0,184例患者视力为0.3~0.6,26例患者视力为0.1~0.3;术后对患者进行3个月随访,术中发生后囊膜破裂有28眼,发生率为2.78%(28/1006);术后发生角膜水肿有70眼,玻璃体腔掉核1例,环形撕囊失败有10例,转化成小切口ECC E 5只眼,色素膜炎有3例等。结论:超声乳化手术在基层医院开展的安全性较高,术者有熟练的小切口ECCE经验,只要做好术前准备、术中精细操作及围手术期的感管理,就能保证手术的成功率,可在基层医院推广。

  • 标签: 基层医院 白内障超声乳化手术 并发症
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  • 简介:AbstractThe novel coronavirus disease 2019 (COVID-19) is the third coronavirus outbreak in the last two decades. Emerging and re-emerging infections like COVID-19 pose serious challenges of the paucity of information and lack of specific cure or vaccines. This leaves utilisation of existing scientific data on related viral infections and repurposing relevant aetiologic and supportive therapies as the best control approach while novel strategies are developed and trialled. Many promising antiviral agents including lopinavir, ritonavir, remdesivir, umifenovir, darunavir, and oseltamivir have been repurposed and are currently trialled for the care for COVID-19 patients. Adjunct therapies for the management of symptoms and to provide support especially in severe and critically ill patients have also been identified. This review provides an appraisal of the current evidence for the rational use of frontline therapeutics in the management of COVID-19. It also includes updates regarding COVID-19 immunotherapy and vaccine development.

  • 标签: SAR-CoV-2 COVID-19 Respiratory Drug repurposing Antiviral Supportive therapy Immunotherapy
  • 简介:AbstractBackground:The pandemic of the coronavirus disease 2019 (COVID-19) has caused substantial disruptions to health services in the low and middle-income countries with a high burden of other diseases, such as malaria in sub-Saharan Africa. The aim of this study is to assess the impact of COVID-19 pandemic on malaria transmission potential in malaria-endemic countries in Africa.Methods:We present a data-driven method to quantify the extent to which the COVID-19 pandemic, as well as various non-pharmaceutical interventions (NPIs), could lead to the change of malaria transmission potential in 2020. First, we adopt a particle Markov Chain Monte Carlo method to estimate epidemiological parameters in each country by fitting the time series of the cumulative number of reported COVID-19 cases. Then, we simulate the epidemic dynamics of COVID-19 under two groups of NPIs: (1) contact restriction and social distancing, and (2) early identification and isolation of cases. Based on the simulated epidemic curves, we quantify the impact of COVID-19 epidemic and NPIs on the distribution of insecticide-treated nets (ITNs). Finally, by treating the total number of ITNs available in each country in 2020, we evaluate the negative effects of COVID-19 pandemic on malaria transmission potential based on the notion of vectorial capacity.Results:We conduct case studies in four malaria-endemic countries, Ethiopia, Nigeria, Tanzania, and Zambia, in Africa. The epidemiological parameters (i.e., the basic reproduction number R0 and the duration of infection DI) of COVID-19 in each country are estimated as follows: Ethiopia (R0 = 1.57, DI = 5.32), Nigeria (R0 = 2.18, DI = 6.58), Tanzania (R0 = 2.47, DI = 6.01), and Zambia (R0 = 2.12, DI = 6.96). Based on the estimated epidemiological parameters, the epidemic curves simulated under various NPIs indicated that the earlier the interventions are implemented, the better the epidemic is controlled. Moreover, the effect of combined NPIs is better than contact restriction and social distancing only. By treating the total number of ITNs available in each country in 2020 as a baseline, our results show that even with stringent NPIs, malaria transmission potential will remain higher than expected in the second half of 2020.Conclusions:By quantifying the impact of various NPI response to the COVID-19 pandemic on malaria transmission potential, this study provides a way to jointly address the syndemic between COVID-19 and malaria in malariaendemic countries in Africa. The results suggest that the early intervention of COVID-19 can effectively reduce the scale of the epidemic and mitigate its impact on malaria transmission potential.

  • 标签: COVID-19 pandemic Non-pharmaceutical interventions Particle Markov chain Monte Carlo Insecticide-treated nets Vectorial capacity Malaria transmission potential
  • 简介:【摘要】 介绍1例原钙黏蛋白19(PCDH19)基因相关癫痫的综合护理方法。PCDH19基因相关癫痫目前在国内报道尚少,严密的病情监测、丛集性发作期间正确处理、安全防护、康复训练及健康指导等护理措施对原钙黏蛋白19(PCDH19)基因相关癫痫丛集性发作的控

  • 标签: PCDH19基因 癫痫 丛集性发作 护理
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  • 简介:AbstractThe pandemic of coronavirus disease 2019 (COVID-19) has already evoked massive influence. The global pandemic has been ravaging the whole world for a year, with the number of confirmed human infection cases over 150 million and a death toll exceeding 3 million. Although the genomic sequence of the cognate pathogen SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) has been quickly determined, there are still many unknown aspects, including the virus origin and evolution trend, and the effectiveness of current vaccines and drugs against the mutating virus. This review summarizes current knowledge and advances about COVID-19, including virus origin, transmission and infection, with the aim to improve the understanding of COVID-19 and provide a new perspective for future studies.

  • 标签: COVID-19 SARS-CoV-2 Virus origin Transmission Virus infection
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  • 简介:AbstractWith the number of Coronavirus Disease 2019 (COVID-19) cases soaring worldwide and limited vaccine availability for the general population in most countries, the monoclonal antibody (mAb) remains a viable therapeutic option to treat COVID-19 disease and its complications, especially in the elderly individuals. More than 50 monoclonal antibody-related clinical trials are being conducted in different countries around the world, with few of them nearing the completion of the third and fourth phase clinical trial. In view of recent emergency use authorization (EUA) from the FDA (Food and Drug Administration) of casirivimab and imdevimab, it is of importance that mAbs, already used to treat diseases such as Ebola and respiratory syncytial virus (RSV) infection, are discussed in scientific communities. This brief review discusses the mechanism of action and updates to clinical trials of different monoclonal antibodies used to treat COVID-19, with special attention paid to SARS-CoV-2 immune response in host cells, target viral structures, and justification of developing mAbs following the approval and administration of potential effective vaccine among vulnerable populations in different countries.

  • 标签: SARS-CoV-2 Coronavirus Monoclonal antibody mAb Antibody therapy
  • 简介:AbstractThe ongoing coronavirus disease 2019 (COVID-19) pandemic has put a strain on health systems globally. Although Africa is the least affected region to date, it has the weakest health systems and an exponential rise in cases as has been observed in other regions, is bound to overwhelm its health systems. Early detection and isolation of suspected and confirmed COVID-19 cases are pivotal to the prevention and control of the pandemic. The World Health Organization (WHO) recommends that all laboratory-confirmed cases should be isolated and treated in a health care facility; however, where this is not possible due to the health system capacity, patients can be isolated in re-purposed facilities or at home. An already very apparent future challenge for Africa is facility-based isolation of COVID-19 cases, given the already limited health infrastructure and health workforce, and the risk of nosocomial transmission. Use of repurposed facilities requires additional resources, including health workers. Home isolation, on the other hand, would be a challenge given the poor housing, overcrowding, inadequate access to water and sanitation, and stigma related to infectious disease that is prevalent in many African societies. Conflict settings on the continent pose an additional challenge to the prevention and control of COVID-19 with the resultant population displacements in overcrowded camps where access to social services is limited. These unique cultural, social, economic and developmental differences on the continent, call for a tailored approach to COVID-19 case management strategies. This article proposes three broad case management strategies based on the transmission scenarios defined by WHO, and the criteria and package of care for each option, for consideration by policy makers and governments in African countries. Moving forward, African countries should generate local evidence to guide the development of realistic home-grown strategies, protocol and equipment for the management of COVID-19 cases on the continent.

  • 标签: COVID-19 Case management Strategies Africa
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  • 简介:摘要目的系统分析2019新型冠状病毒肺炎(COVID-19)患者的凝血特征。方法计算机检索PubMed、Scopus、Web of Science、EMbase、中国知网数据库,搜集报道COVID-19凝血特征相关的文献,检索时限均为2020年1月1日至5月1日。由2名研究员独立筛选文献、提取数据并评价纳入研究的偏倚风险后,采用Stata12.0软件对不同疾病分型COVID-19患者的血小板计数、D-二聚体、凝血酶原时间(PT)、活化的部分凝血活酶时间(APTT)、纤维蛋白原(FIB)进行Meta分析。结果共纳入39个回顾性研究,共计6 994例COVID-19患者。Meta分析结果显示:(1)与重症患者相比,轻症患者的血小板计数较高[加权均值差(WMD)=20.11,95%CI 11.53~28.69,P<0.001],APTT(WMD=1.30,95%CI 0.31~2.30,P=0.01)更长,D-二聚体(WMD=-0.41,95%CI-0.58~-0.24,P<0.001)、FIB(WMD=-0.58,95%CI-0.76~-0.39,P<0.001)较低,凝血酶原时间(PT)(WMD=-0.51,95%CI-0.92~-0.10,P<0.001)更短;危重患者血小板计数较低(WMD=-14.75,95%CI-29.73~-0.23,P=0.044),D-二聚体较高(WMD=1.06,95%CI 0.65~1.47,P<0.001)。(2)与存活组相比,死亡组患者血小板计数较低(WMD=-36.40,95%CI-63.23~-9.58,P=0.008),D-二聚体较高(WMD=6.86,95%CI4.15~9.57,P<0.001),PT(WMD=1.37,95%CI0.73~2.02,P<0.001)更长。结论凝血功能紊乱在重症、危重症和死亡的COVID-19患者中较常见。血小板计数、D-二聚体和PT值与病情严重程度相关,可作为住院期间病情恶化的早期预警指标。

  • 标签: COVID-19 2019-nCoV 活化的部分凝血活酶时间 D-二聚体 凝血酶原时间 Meta分析
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  • 简介:AbstractAdenotonsillectomy is one of the most common surgical procedures performed by otolaryngologists. It is vital that surgeons are aware of the risks in performing this surgery especially during the COVID-19 pandemic and in children with hematologic disorders. In this review we describe common hematologic disorders often noted in pediatric patients undergoing this procedure, as well as proper screening and management of these patients. In addition, we also address the impact of the COVID-19 pandemic and some measures to help mitigate the risks of this procedure during this time.

  • 标签: Adenotonsillectomy Tonsillectomy Tonsillectomy and adenoidectomy Bleeding disorders Sleep apnea Covid-19 Sickle cell disease Pediatrics Recurrent tonsillitis
  • 简介:摘要新型冠状病毒(severe acute respiratory syndrome coronavirus-2,SARS-CoV-2)感染引起的新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)在世界范围内广泛流行,造成了前所未有的公共卫生灾难,找到有效的药物和治疗方案显得尤为迫切。本文综述了干扰素(IFN)与COVID-19相关的最新研究进展,并重点分析了IFN-λ(III型IFN)抗SARS-CoV-2感染的理论基础,提示IFN-λ具有预防和治疗COVID-19的潜力,同时本文也列举了使用IFN-λ治疗COVID-19存在的潜在风险。

  • 标签: COVID-19 IFN-λ 防治