2020-03-04 最新期刊文獻

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今日最引人注意的是一篇文獻是由知名的史丹佛大學王智弘副教授發表在JAMA，文中詳解台灣如何利用大數據、新科技和主動檢疫的方式來面對COVID-19的威脅(40，新聞報導)。總計本日共新增58篇期刊文獻。

關於COVID-19的文獻，每天都以數十篇速度增加，義大利學者整理了一篇針對COVID-19的臨床實證、專家建議和待解決問題的清單，內容包括六呎以內的近距離接觸就會增加傳染風險、八成確診患者為輕症、將近兩成患者會變成急重症、只有在照護疑似或確診病患時才需要戴口罩等資訊(3)。

在診斷部分，武漢發現確診病患可能無症狀，但CT影像已經顯示異常，可做為早期篩檢另一重要依據(23)。中國130例個案中發現，CT影像特點主要以胸膜下及小葉核心為主，重症者會發展成雙肺瀰漫，且有胸膜平行徵狀(43)。

在治療方面，對於重症患者、有合併症或經常使用類固醇藥物的患者應謹慎使用類固醇藥物，劑量需低且使用時間要短(37)。埃及學者研究發現Sofosbuvir，IDX-184，Ribavirin和Remidisvir應可抵抗人類冠狀病毒疾病(14)。北京中醫學者建議可利用中藥針劑來治療急重症患者(42)。

在疫情控制方面，洗手，戴口罩和運動等保護措施可以有效地防止人們被感染，但浙江學者發現有將近4成民眾戴口罩方式錯誤，包括鼻子暴露在空氣中，或長時間沒有更換口罩等(49)。加拿大學者以SARS經驗推算，建議醫院應計畫增加重症床數或將普通病房轉為重症病房使用(4)。美國學者認為疫苗開發或生產仍須12-18個月時間(1)。法國學者建議公司應建立應急計畫，包括防止歧視、遠距辦公和醫療監測、照護及心理支持等措施(15)。英國則因應COVID-19，可能要求退休的醫師重回工作岡位(30)。


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