➥ 本文研究27名COVID-19呼吸器插管病人,約3/1感染侵襲性肺曲霉病(IPA),與流感患者的感染IPA的盛行率類似。因CT及支氣管肺泡灌洗(BAL)在重症患者難以執行,真菌學數據的蒐集對診斷IPA極為重要。本研究結果支持對重症COVID-19患者的曲霉菌感染標記物進行系統篩檢。(「財團法人國家衛生研究院」莊淑鈞博士 摘要整理 ➥http://forum.nhri.org.tw/covid19/virus/j_translate/j1105/)
📋 Prevalence of putative invasive pulmonary aspergillosis in critically ill patients with COVID-19 (2020/05/20)+中文摘要轉譯
■ Author:
Alexandre Alanio, Sarah Dellière, Sofiane Fodil, et al.
■ Link:
(The Lancet) https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30237-X/fulltext
🔔豐富的學術文獻資料都在【論壇COVID-19學術專區】
■ http://forum.nhri.org.tw/covid19/
#2019COVID19Academic
衛生福利部
疾病管制署 - 1922防疫達人
疾病管制署
國家衛生研究院-論壇
invasive中文 在 國家衛生研究院-論壇 Facebook 的最佳貼文
➥【重點摘要】:
■ 門診:
1. 限制門診,至需要緊急處理的患者或諮詢者,或正在接受治療的患者。
2. 限制醫護人員的人數,以降低全部感染的風險。
3. 考慮限制照護人員至確實需要照顧的病人。
4. 當病患確實有需要時,如有身體或心理上的限制,限制陪病人員一名。
5. 延後所有的追蹤檢查,若資源許可,則轉至遠距問診,直至疫情穩定。
6. 考慮遠距問診,以允許恰當、安全、及快速的分流。
7. 考慮延後所有不必要的介入措施。
■ 對子宮頸癌病人:
1. Pre-invasive疾病:根據ASCCP建議,low-grade篩檢可延後6-12個月,high-grade篩檢應在三個月內檢查。
2. 早期子宮頸癌:若情況允許,可依計畫進行手術。但若手術吃緊,則考慮以下步驟:以CT scan或PET/CT影像,確認疾病期別,延後高風險手術6-8週,或至疫情緩解。對於低風險疾病,在可行的情況下,可考慮簡單的手術。若已可看到腫瘤,則可考慮化療。
3. 中晚期疾病:考慮低分次放射治療已減少患者到醫院治療的次數。對需要每天到醫院的放療患者,除非需要檢查,考慮遠距醫療。
■ 子宮內膜癌:
1. 低風險患者:對grade 1患者可考慮非手術治療,如賀爾蒙療法。
2. 高風險患者:對grade 2 or 3患者,可行的話,應考慮子宮切除術及雙側輸卵管切除術,並依風險進行術後管理。在COVID-19的威脅下,進行腹腔鏡應考慮開腹手術的風險。
3. 晚期疾病:晚期病人應考慮進行切片確診,並作全身性的治療。
■ 卵巢癌:
1. 在疑似早期疾病時,應考慮年齡、家族史、及理學檢查。
2. 在晚期疾病患者,應考慮進行切片確診,並進行化療直至疫情緩解。
3. 對已開始化療的患者,考慮延長治療由3個cycle至6個cycle,但是這些患者仍須考慮手術室的資源,及延長化療時間可能增加感染風險。
4. 對已完成化療的患者,可考慮停止治療。
5. 對需長途旅行已接受治療之患者,考慮至當地腫瘤科接受治療,或考慮接受遠距治療。
6. 對復發患者,應根據臨床判斷已決定是否開始新的化療。
■ 治療計畫:
1. 當地患者:可進行影像學及實驗室檢查,並同意醫師以電話討論後續處置。
2. 遠地患者:考慮在當地進行影像及實驗室檢查並將病歷資料寄給醫師已討論後續處置。
3. 國際患者:考慮延後國際患者的問診。
■ 臨床試驗:
1. 間的互動。
2. 除了有治癒機會、較現行治療有延長或挽救生命機會、或目前沒有標準治療選擇的試驗,其他試驗應限制收案。
3. 對已在試驗中的患者,應持續治療。;但以視訊方式進行毒性評估並以郵件方式寄送藥物。
4. 若試驗患者感染COVID-19,應將患者自試驗排除並進行治療。
5. 所有研究人員應留在家裡,並減少研究人員出現在醫院對病患進行追蹤研究。
■ 學術活動:
1. 藉由視訊方式持續進行學術活動。
2. 持續以視訊會議學習並探索改善照護病患的方式。
■ 安寧照護:
1. 了解病患生活品質的需求、病患生命末期的期待、照顧計畫、疼痛及症狀護理、及照顧者支持仍是醫療團隊的首要目標。
2. 跨領域合作以盡速確保支持及安寧照顧的需求。
3. 對門診及住院患者考慮遠距醫療以減低患者及醫護人員感染風險。
4. 對支持及安寧患者而言,家人的參與是最重要的。
(「財團法人國家衛生研究院」莊淑鈞博士 摘要整理)
📋 COVID-19 Global pandemic: Options for management of gynecological cancers(2020/03/30)+中文摘要轉譯
➥Author:Pedro T Ramirez, Luis Chiva, Ane Gerda Z Eriksson, et al.
➥Link: BMJ
https://ijgc.bmj.com/content/early/2020/03/27/ijgc-2020-001419.full
#2019COVID19Academic
衛生福利部
疾病管制署 - 1922防疫達人
疾病管制署
國家衛生研究院-論壇
invasive中文 在 良醫生 Dr Ares Facebook 的最佳解答
送別好友。
泰哥人品、學識、醫德,都令人手屈一指。
君子,完美。
【敬悼蕭永泰醫生】蕭永泰醫生,香港中文大學(中大)醫學院校友,於2019年9月29日辭世。中大醫學院對蕭醫生的離開深表哀悼,並向蕭醫生的家人致以深切慰問。
蕭醫生是傑出的外科醫生,多年來積極貢獻本地醫學界,當中尤對微創手術的發展建樹良多。
蕭醫生於1989年畢業於香港中文大學醫學院,在學時成績優異,屢獲殊榮,並於畢業試的專業考試中以總成績首名摘取「城市獅子會金章獎」。
蕭醫生一生以「做個好醫生」為目標。畢業後,他即投身杏林,以外科為終身事業,在業界德高望重,深受同業和社會各界的表彰及稱許,並於多個專業團體中擔任重要公職。
蕭醫生對母校關懷備至,多年來一直全心全力協助中大醫學院發展,給予很多高瞻遠足的意見,慷慨捐助,對加強舊生與醫學院之間的聯繫貢獻至深。他是中大醫學院舊生會的創會功臣,自舊生會成立至今一直擔任幹事,並於2011至2014年成為該會長。蕭醫生於出任會長期間,積極籌備醫科畢業生師友計劃,而計劃最終於2016年推行,為中大醫學院學生及新畢業醫生提供持續的支援。該計劃為醫科生提供一系列充實的輔導及網絡支持,讓他們從進入大學伊始(甚至進入迎新營之前),以致隨後的每一個學習階段,都能得所需的幫助。
蕭醫生對醫學界、教育界,以致社會各階層均貢獻良多,於2018年獲頒中大榮譽院士銜, 是首位醫學院畢業生得此榮譽;亦是首屆香港中文大學傑出醫科校友獎(卓越成就)的得主。
中大醫學院院長陳家亮教授對蕭醫生的離開表達沉痛哀慟:「蕭醫生畢生貢獻醫學界,積極回饋母校,扶掖後進,不遺餘力。他一生以『做個好醫生』為目標,豎立典範;多年來對醫學院的關切及支持更是不能言喻。即使患病後他仍如常出席各項活動,以行動表達對醫學院、教職員、學生及校友最大的支持。他的離世不論對醫學界及大學等均為重大損失。我們將永遠懷念他在醫學上展現的專業、對病人的關愛、對學生的和藹親切,以及對醫學院和校友的無私支持。我謹代表醫學院上下向蕭醫生的家人致以最誠摯的慰問。」
【Mourning Dr SIU】With profound sadness, we announce the passing of Dr SIU Wing-tai on 29 September 2019. Dr Siu was a graduate of the Faculty of Medicine of The Chinese University of Hong Kong (CU Medicine) and was a distinguished surgeon who had contributed greatly to the development of minimally invasive surgical skills.
Dr Siu’s story as a brilliant medical practitioner began when he graduated from the medical faculty in 1989. Even as a medical student, he gained prominence by winning many awards and honours, including the City Lions Club Gold Medal Award for the best overall performance in professional examinations in his graduating year.
Dr Siu was known to his colleagues, patients and staff as a compassionate and caring physician. As he had always humbly said, he “just wanted to be a good doctor”.
Dr Siu served on many societies and associations, either as a board member or president. But his love for his alma mater is unparalleled. He wholeheartedly supported the Faculty development by offering invaluable advice and through generous donations.
He made significant contributions to strengthening the bonds between the alumni and Faculty. He was directly involved in the establishment of The Chinese University of Hong Kong Medical Alumni Association and was a Council Member of the Association since its foundation, and its President between 2011 and 2014. He was instrumental in establishing the Faculty’s signature Medical Alumni Buddy Programme in 2016. The programme is aimed at providing a mentoring and support network for medical students and young practitioners, as well as helping to cement the relationship between alumni and the Faculty. In 2018, he became the first winner of the CUHK Distinguished Medical Alumni Award for Global Achievement.
Dr Siu took extreme pride in his work as a surgeon and imparted whatever wisdom he could to his peers and younger doctors. His distinction as a surgeon brought him respect from his peers and the community and earned him numerous accolades.
In appreciation and recognition of his work, he was conferred Honorary Fellowship by The Chinese University of Hong Kong in 2018, becoming the first CUHK medical graduate to receive such an honour.
Professor Francis KL Chan, Dean of Medicine, expressed his great sorrow at the passing of Dr Siu. “Dr Siu is a highly respected person who has dedicated himself to caring patients, giving back to his alma mater, and shaping the future generations of medical students. He has indeed achieved his ambition as being ‘a good doctor’.” Even in his illness, he attended Faculty events as much as he could to show his full support to the staff, students and alumni. Dr Siu’s passing is a great loss to the medical profession, CUHK and society. He will be dearly missed by his peers, his patients, and all of us from the Faculty. He will always be remembered for his selfless devotion to serving the community, and for his unfailing support to the Faculty. On behalf of the teachers, students and alumni of CU Medicine, may I offer our deepest condolences to Dr Siu's family.”
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