疫情报告“滑坡”及宏观调控探讨

疫情报告“滑坡”及宏观调控探讨浙江省卫生防疾站（３１０００９）李还浙江省的法定传染病报告管理网络覆盖全省，多年来一直处于常规运行状态，工作稳定，资料完整。１９９３年出现了一些“滑坡”迹象，通过原因分析，从宏观上采取措施，使部分管理上失控得到扭转，巩固...     

“De Mandibulae Dysarthria” – Thinking Outside the Box

Background

Urgent decisions in the Emergency Department allow for only a short history and physical examination.

Objectives

To highlight the risks associated with a strict application of protocols, especially in the emergency setting.

Case Report

An unusual case of acute dysarthria is presented.

Conclusion

Even in the emergency setting, thorough history-taking and physical examination remain fundamental, and it is necessary to “think outside the box.”     

“You Wanna Do What?!” Modern Indications for Nasogastric Intubation

Through the years, patients have asked their physicians why they needed nasogastric inbutation (NGI), a painful test. Some recent studies have also questioned the utility of NGI for several indications, enabling physicians to use judgment in offering it to patients. This article reviews the use of NGI for its traditional indications: gastrointestinal bleeding, presenting with or without hematemesis; gastric decompression; and the administration of treatment. It concludes with suggestions for limiting the pain of the procedure for patients who need it.     

一起罕见“恶臭假单胞菌”引起的幼儿园食物中毒

2006年9月22日11∶30,昆明市某区幼儿园数十名儿童发生不明原因呕吐、腹泻。市、区疾病预防控制中心(CDC)专业人员和卫生监督部门即赶赴现场进行流行病学调查。经采集幼儿园内凉、熟食品、水及现症患者肛拭,结果在2份酸奶和2份肛拭中检出恶臭假单胞菌。     

“护理应急管理”在新型冠状病毒肺炎突发公共卫生事件中的应用

通过积极动员、可持续的梯队建设和培训演练完成团队建设。制定COVID-19应急制度,建立应急预案、病区管理、多级质控完成突发公共卫生事件定点医院护理部应急队护理人员工作纲领、质量控制管理体系。通过磁性管理,人文关怀做好一线护理人员的心理支持。将科学管理应用到应对COVID-19的应急护理管理中,提高护理应急队伍的反应速度,提升队员应对能力,从而更好地应对各种突发公共卫生事件。     

Is there a “gold” standard treatment for patients with isolated myeloid sarcoma?

Isolated myeloid sarcoma is an extramedullary tumor of immature myeloid cells defined by the absence of leukemia history, myelodisplastic syndrome, or myeloproliferative neoplasma with a negative bone marrow biopsy. Myeloid sarcoma is a very rare condition, and few cases have been reported. We reviewed data of 12 patients with isolated myeloid sarcoma managed at a single center to determine the possible prognostic factors affecting patient survival, such as age, sex, type, localization, and treatment options. Patients were mostly men (n = 8), with a median age of 39 years. Patients were initially treated with chemotherapy (n = 7) or surgery (n = 5). In three patients, hematopoietic stem cell transplantation was performed. During the follow-up period, nine patients died. The median overall survival was 13 months, while event-free survival was 8 months. Regarding initial treatment strategy, no significant difference in overall survival was observed. Both chemotherapy and hematopoietic stem cell transplantation independently improved event-free survival. In addition, patients who received chemotherapy combined with hematopoietic stem cell transplantation had significantly longer event-free survival than those treated with chemotherapy alone. Age < 40 years together with chemotherapy/hematopoietic stem cell transplantation significant affected event-free survival. Based on our results, the treatment of myeloid sarcoma requires a systemic rather than a localized approach with surgery or radiotherapy. While prospective evaluations are needed, chemotherapy with allogenic hematopoietic stem cell transplantation should be considered as the optimal therapy for isolated myeloid sarcoma.     

Does a more “physiological” infant manikin design effect chest compression quality and create a potential for thoracic over-compression during simulated infant CPR?

Poor survivability following infant cardiac arrest has been attributed to poor quality chest compressions. Current infant CPR manikins, used to teach and revise chest compression technique, appear to limit maximum compression depths (CDmax) to 40 mm. This study evaluates the effect of a more “physiological” CDmax on chest compression quality and assesses whether proposed injury risk thresholds are exceeded by thoracic over-compression.     

浙江省景宁县“外来媳”人群艾滋病病毒感染状况及艾滋病相关知识调查

目的　了解浙江省景宁县外来媳人群艾滋病病毒（HIV）感染状况及艾滋病知识知晓情况。方法　对1990年以后由外省嫁到景宁县的外来媳 （包括法定婚姻、事实婚姻）采血检测抗-HIV并进行问卷调查。结果　检测930名外来媳，抗 HIV阳性2例,感染率为0.22%，参加问卷调查的880名外来媳大部分来自艾滋病流行相对严重的云南和贵州省，小学及以下文化程度占78.86%，艾滋病知识总知晓率仅为54.56%。 结论　景宁县外来媳人群存在着一定的HIV感染流行，是景宁县艾滋病防治的重点人群之一。     

“Medically Cleared”: How Well are Patients with Psychiatric Presentations Examined by Emergency Physicians?

Significant numbers of patients present to Emergency Departments (ED) with psychiatric complaints, and alternative or concomitant medical diagnoses are commonly present. The literature reveals that physical examinations on these patients in the ED are often incomplete. The purpose of this study was to assess the completeness of examinations for “medical clearance” in our ED. We conducted a retrospective chart review of consecutive adult patients presenting to our ED over 1 year, using patients with a disposition diagnosis of “schizophrenia” as our subject group. The ED physician and nursing records were analyzed for 17 quantitative and qualitative variables, and these were stratified for age. Complete physical examinations were regularly lacking. Complete vital signs (VS) were documented in only 52% of cases, whereas no VS were recorded in 6% of patients. Older patients were more likely to receive full examinations, but this was not universal. Patients with psychiatric presentations should undergo a complete physical examination, including a full set of VS, before disposition from the ED.