伦理学与SARS：多伦多的教训

SARS的流行说明传染病在世界范围内流行是件多么容易的事，为了更好地应对下一次流行病，我们不仅要解决医学方面的问题，也同样需要解决伦理学方面的问题。     

综合性医院SARS流行阶段放射科应急隔离影像信息管理系统的建设与实践

目的:结合SARS流行阶段综合性医院放射科应急隔离影像信息管理系统的建设,阐明本系统的软硬件环境特点,总结本系统建设与使用的经验与实践效果,探讨应急信息系统优点与存在的问题.方法:采用双机热备服务器,院内设立独立的网段,文本信息采用TCP/IP协议传输,胸片图像采用DICOM图像传输与浏览技术,分别在被隔离的SARS门诊、摄片区以及放射科诊断区放置工作站.记录系统安装前后的全院医务人员感染情况.结果:应急隔离放射科影像信息管理系统的应用使疑似SARS的病例诊断过程远离非SARS隔离区,启用系统前后,院内医务人员的感染率有明显下降的趋势.结论:应急隔离系统的建设有效地控制了SARS在医院内的传播途径;网络基础建设,软环境准备(包括科室人员前期计算机使用培训),网络维护与管理制度的建设是应急系统建设与顺利使用的关键.     

Fever attribution in the SARS outbreak

Fever as a somatised symptom is not commonly described. We report a patient who complained of recurrent unexplained "fevers" during the severe acute respiratory syndrome (SARS) outbreak in Singapore. The presentation, while likely to be peculiar to the outbreak, posed challenges and difficulties to the primary care doctors. Investigations did little to allay her anxiety. Instead, appreciating the psychosocial backdrop and how the SARS outbreak affects patient and doctor may be useful.     

The Little India riot: experience of an emergency department in Singapore

INTRODUCTION

Singapore experienced its second riot in 40 years on 8 December 2013, in the area known as Little India. A retrospective review of 36 casualties treated at the emergency department was conducted to evaluate injury patterns.

METHODS

Characteristics including the rate of arrival, injury severity, type and location, and disposition of the casualties were analysed.

RESULTS

The injuries were predominantly mild (97.2%), with the most common injuries involving the head (50.0%) and limbs (38.9%). 97.2% of the casualties were managed as outpatient cases.

CONCLUSION

The majority of the injuries in this incident were mild and could be managed as outpatient cases. Important lessons were learnt from the incident about the utilisation of manpower and safety of staff in the emergency department.     

门、急诊管理在防治SARS中作用的探讨

目的 探讨加强门诊部、急救中心管理在防治SARS工作中所起的作用。方法通过安排专职医护人员在门诊部、急救中心大厅门口进行分诊、导诊;建立发热病人“关隘式”筛查的哨口;由专门的导医将筛查出的发热患者转送至发热门诊;门诊部、急救中心按乙类区域进行消毒;医务人员采取普通防护措施;开展多种形式的卫生宣教活动。普及防治SARS的知识。结果初步筛查出发热病人3662例,及时转送至发热门诊。未出现发热病人的漏诊、误诊情况。门诊部、急救中心的医护人员没有出现院内交叉感染。结论门诊部、急救中心应认真配合对发热病人的“关隘式”筛查制度和工作流程,保证各项预防措施落实到位,才能及时发现发热病人,避免院内交叉感染。     

公共卫生领域中的数据挖掘

以公共卫生领域数据为分析对象,探索公共卫生多源数据采集、整理、数据仓库构建、数据挖掘及可视化展示的总体思路与技术框架,以期使数据挖掘技术更好地服务于公共卫生领域,提高相关决策的科学性。     

Six months in an Irish emergency department: the experience of a senior house officer

Introduction  Emergency Medicine (EM) is a challenging specialty to work within and forms part of a number of training programs. The Emergency Medicine experience at non-consultant hospital doctor (NCHD) level in Ireland has not been reported. Methods  We retrospectively audited one NCHDs 6-month experience in Emergency Medicine at Cork University Hospital to document the potential experience gained from this rotation. Results  We found a broad experience and exposure to a variety of medical conditions, especially orthopaedic presentations (39% of patients seen). Conclusion  Emergency Medicine provides a potential broad experience for a senior house officer and may be of benefit to various training schemes.     

后SARS时代公共卫生政策的伦理思考

2003年春天中国发生的SARS流行暴露出我们在卫生改革中政策导向上的失误。我国在向市场经济转化过程中，忽视了公共卫生对国家安全的重要性，导致政府对公共卫生投入不足，重治轻防，缺乏紧急事件的应对措施，是这次SARS大范围流传的深层次原因。我们必须从为最广大人民群众的根本利益出发，调整卫生政策，重新构建我国的公共卫生体系。     

充分发挥高等学校公共卫生学院在SARS防治中的作用

公共卫生问题的解决,需要政府、社会和民众的共同参与,而公共卫生学专家的任务是提供技术支持和教育民众．总结了在云南省防治SARS的斗争中,昆明医学院公共卫生学院配合政府和社会有关部门积极应对SARS疫情,撰写各种防控方案、实施健康教育、对医学生进行公共卫生知识教育等工作的经验,论述了高校公共卫生学院在突发公共卫生事件中的地位和作用,并提出必须重视公共卫生教育．