埃博拉出血热的研究近况

埃博拉出血热(Ebola hemorrhagic fever,EHF)是由丝状病毒科(Filoviridae)丝状病毒属的埃博拉病毒(Ebola virus,EBOV)引起的一种急性出血性传染病。主要通过患者的血液和排泄物传播,临床主要表现为急性起病、发热、肌痛、出血、皮疹、肝功能和肾功能损害。     

Learning from Ebola Virus: How to Prevent Future Epidemics

The recent Ebola virus disease (EVD) epidemic in Guinea, Liberia and Sierra Leone demonstrated that the World Health Organization (WHO) is incapable to control outbreaks of infectious diseases in less developed regions of the world. This essay analyses the causes for the failure of the international response and proposes four measures to improve resilience, early detection and response to future outbreaks of infectious diseases.     

Fluid restriction in the management of decompensated heart failure: no impact on time to clinical stability

BackgroundTo examine the clinical effect of fluid restriction in patients admitted to the hospital with class IV heart failure (HF).Methods and ResultsThis is a single-blind randomized controlled study. Time to clinical stability was compared between the fluid restricted (FR: n = 34) and free fluid (FF: n = 33) groups respectively showing no significant difference (8.3 ± 6.3 days versus 7.0 ± 6.0 days, P = .17). There was no significant difference between groups in time to discontinuation of intravenous diuretic therapy (FR: 2.7 ± 4.5 days, FF: 3.2 ± 5.6 days, P = .70). Changes from baseline to achievement of clinical stability in serum urea (P = .23), serum creatinine (P = .14), BNP (P = .42), and sodium (P = .14) did not differ between the FF and FR groups. Baseline serum sodium levels did not predict the time to clinical stability (β = −0.11, 95% CI: −0.60, 0.23).ConclusionsFluid restriction is not an evidence-based therapy although it is occasionally applied in the management of HF. These results suggest that FR is not of any clinical benefit in patients with acute decompensated HF and this hypothesis should be tested in a larger randomized controlled study.