简介:〖 摘要 〗 目的 探讨临床容易误诊为颈椎病的病种和原因。 方法 分析我院 19 例误诊为颈椎病的病例资料。 结果 本组最后确诊为腕管综合征的 6 例,肘管综合征的 4 例,多灶性运动神经病的 1 例,运动神经原病 2 例,吉兰 -- 巴雷综合征 1 例,肺癌骨转移 1 例,心肌梗塞 1 例,蛛网膜下腔少量出血 1 例,下肢静脉血栓 1 例,强直性脊柱炎 1 例。所有病例开始均误诊为颈椎病,其中 6 例腕管综合征, 4 例肘管综合征, 1 例多灶性运动神经病, 2 例运动神经元病最后通过肌电图检查得以明确诊断, 1 例吉兰 -- 巴雷综合征通过肌电图和腰椎穿刺得以明确诊断, 1 例肺癌骨转移通过上级医院核素扫描得以诊断, 1 例颈肩痛者通过常规心电图诊断为心肌梗塞, 1 例短暂性晕厥,双下肢无力者通过脑 CT 和腰椎穿刺证实为蛛网膜下腔出血, 1 例通过下肢血管彩超证实为下肢静脉血栓, 1 例通过查 HBLA-27 得以诊断为强直性脊柱炎。 结论 颈椎病是临床极为常见的疾病,且颈椎 CT 或颈椎磁共振诊断颈椎病的阳性率极高,故临床很多貌似颈椎病的病例很容易误诊,临床医生需提高警惕。
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.
简介:AbstractThe World Health Organization characterized coronavirus disease (COVID-19) as a pandemic on March 11, 2020. Peritoneal dialysis patients have a weakened immune system that is associated with a high morbidity of infection. Thus, COVID-19 prevention measures and management for patients on peritoneal dialysis are urgent and critical. Based on published research on COVID-19 and previous clinical practices for similar coronavirus outbreaks, we aimed to make recommendations to manage patients undergoing peritoneal dialysis.
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.