關於 case reports in surgery ，我們在網路上蒐集到這些相關的討論、資訊與評價

問：沒什麼動力做研究寫 paper，現在只是為了應付醫院的要求而硬擠出來，要怎麼硬是找到興趣？硬是找到回饋？（婦產部 住院醫師 / 主治醫師）（神經外科 住院醫師）
　
答：（蔡依橙 / #醫學論文與寫作工作坊）
　
■ Letter to the Editor
　
可以從 letter to the editor 入手，挑挑別人的毛病，言之有物，作為初學者的起步，原論文作者也會諒解的 XD。
　
這種文體會有個別期刊的限制，通常是要在出刊一定時間以內投稿（例如：一個月），否則不受理。開始準備動筆前，記得先把 instruction for authors 看清楚。
　
　
■ Case Report
　
最近 case report 行情比較差，但有許多「沒有 impact factor 但卻專門收 case report 的雜誌出現」，像是：
　
- BMJ Case Reports
- Case Reports in Obstetrics and Gynecology
- International Journal of Surgery Case Reports
- Radiology Case Reports
　
雖然多數要付錢才能刊登，但白紙黑字查得到，網路上也將長久存在，我覺得也是個好開始。
　
就像我們寫部落格，一開始也是寫免錢的，沒稿費，我們還是會做。就像我們做簡報，一開始也是在免費的場子練習，後來才取得「有演講費」的演講邀請。
　
學術界的規矩就是刊登沒稿費，所以初學者標準下調，自己付點錢也是可以接受。
　
您可以評估看看，找個「你覺得 50 年後可能還會存在」的期刊投看看，最好 PubMed 有 index，那就沒問題！像是 BMJ Case Reports 就有，雖然他不是 open access，而是有自己的獨特商業模式，費用跟細節，就給您自己做功課啦。
　
　
🎯 作為研究新手，新思惟課程協助您......
　
√ 投稿期刊選擇策略。
√ 多元文體與學術參與。　
√ 入門稿件寫作與準備要訣。
√ 不再害怕統計，讓你親手畫出數據圖。
√ 還是寫不出來？過來人時間安排建議。
　　
眾多校友從 0 到 1 突破困境，校友們平均每月 40 篇論文發表，最高單月 55 篇！2020 許自己一個有論文的未來，年初投資自己，年底 PubMed 有你！　　
　
　
🎯 一天弄懂「寫論文」、「統計」及「投稿」。
　
➠ 【席次倒數】6 / 13（六）醫學論文與寫作工作坊
➠ https://mepa2014.innovarad.tw/event/

【義大利醫療崩潰】Silvia Stringhini是一個瑞士的社會和生物流行病學專家，研究社會不平等的生物學後果。生活在世界各地。

他張貼了一篇位於義大利貝爾加莫的醫生Daniele Macchini自述英文翻譯，透過當地醫生第一手的目擊資料，讓我們可以了解醫療崩潰的災難現場是什麼樣的情況。

https://twitter.com/silviast9/status/1236933818654896129

I may be repeating myself, but I want to fight this sense of security that I see outside of the epicenters, as if nothing was going to happen "here". The media in Europe are reassuring, politicians are reassuring, while there's little to be reassured of. #COVID19

我可能是在自言自語，但是我想要對抗我身處風暴中心之外看到的這種安全感，就好像「這裏」什麼都沒有發生一樣。歐洲的媒體在安撫人心，政客們在安撫人心，儘管沒有什麼可以讓人安心的。#COVID19

This is the English translation of a post of another ICU physician in Bergamo, Dr. Daniele Macchini. Read until the end. After much thought about whether and what to write about what is happening to us, I felt that silence was not responsible.

這是貝爾加莫的另一位ICU醫生Daniele Macchini的文章英文翻譯。讀到最後在深思是否該寫些什麼以及該寫些什麼發生在我們身上之後，我覺得沉默是不負責任的。

I will therefore try to convey to people far from our reality what we are living in Bergamo in these days of Covid-19 pandemic. I understand the need not to create panic, but when the message of the dangerousness of what is happening does not reach people I shudder.

因此，我將設法向遠離我們面臨的現實的人們傳達我們在這些Covid-19大流行的日子裏在貝爾加莫所生活的情況。我明白不需要製造恐慌，但當事情的危險性沒有傳達給人們時，我會不寒而慄。

I myself watched with some amazement the reorganization of the entire hospital in the past week, when our current enemy was still in the shadows: the wards slowly "emptied", elective activitieswere interrupted, intensive care were freed up to create as many beds as possible.

過去一週，當我們當前的敵人還在暗處的時候，我自己有些驚愕地看到了整個醫院的重組:病房慢慢地“清空”，可選擇性的活動被中斷，重症監護被解放出來，以創造儘可能多的床位。

All this rapid transformation brought an atmosphere of silence and surreal emptiness to the corridors of the hospital that we did not yet understand, waiting for a war that was yet to begin and that many (including me) were not so sure would ever come with such ferocity.

所有這些迅速的轉變給醫院的走廊帶來了一種我們還不瞭解的寂靜和超現實的空虛氣氛，等待着一場即將開始的戰爭，而許多人(包括我在內)都不確定戰爭是否會如此兇猛地到來。

I still remember my night call a week ago when I was waiting for the results of a swab. When I think about it, my anxiety over one possible case seems almost ridiculous and unjustified, now that I've seen what's happening. Well, the situation now is dramatic to say the least.

我還記得一週前我在等棉籤化驗結果時的夜間電話。當我想到這件事的時候，我對一件可能發生的病例的焦慮幾乎是荒謬和不合理的，但現在我已經看清發生了什麼事。至少可以這麼說，現在的形勢是急轉直下的。

The war has literally exploded and battles are uninterrupted day and night. But now that need for beds has arrived in all its drama. One after the other the departments that had been emptied fill up at an impressive pace.

戰爭確實爆發了，戰鬥不分晝夜地進行着。但現在，對床位的需求出現了戲劇性的變化。一個接一個被清空的科室以驚人的速度被填滿。

The boards with the names of the patients, of different colours depending on the operating unit, are now all red and instead of surgery you see the diagnosis, which is always the damned same: bilateral interstitial pneumonia.

寫着病人名字的板子，不同顏色的板子取決於作業單位，現在都是紅色的，你看到的診斷結果，總是該死的一樣:雙側間質性肺炎。

Now, explain to me which flu virus causes such a rapid drama. [post continues comparing covid19 to flu, link below]. And while there are still people who boast of not being afraid by ignoring directions, protesting because their normal routine is"temporarily" put in crisis,

現在，給我解釋一下是哪種流感病毒導致了這樣一場突如其來的大戲。[後繼續比較covid19與流感，鏈接如下]。儘管仍有一些人不顧指示，吹噓自己不害怕，但他們會抗議，因爲他們的正常生活“暫時”陷入危機，

the epidemiological disaster is taking place. And there are no more surgeons, urologists, orthopedists, we are only doctors who suddenly become part of a single team to face this tsunami that has overwhelmed us.

流行病學災難正在發生。這裡無所謂外科醫生，泌尿科醫生，骨科醫生，我們只是突然成爲一個團隊的一部分來面對這場席捲我們的海嘯的醫生。

Cases are multiplying, we arrive at a rate of 15-20 admissions per day all for the same reason. The results of the swabs now come one after the other: positive, positive, positive. Suddenly the E.R. is collapsing.

病例在成倍增長，我們每天有15-20人因同樣的原因入院。抽檢的結果一個接一個地出現:陽性、陽性、陽性。突然間，急診室崩潰了。

Reasons for the access always the same: fever and breathing difficulties, fever and cough, respiratory failure. Radiology reports always the same: bilateral interstitial pneumonia, bilateral interstitial pneumonia, bilateral interstitial pneumonia. All to be hospitalized.

使用急診的原因總是一樣的:發燒和呼吸困難，發燒和咳嗽，呼吸衰竭。放射學報告總是相同的:雙側間質性肺炎，雙側間質性肺炎，雙側間質性肺炎。所有人都要住院。

Someone already to be intubated and go to intensive care. For others it's too late... Every ventilator becomes like gold: those in operating theatres that have now suspended their non-urgent activity become intensive care places that did not exist before.

已經有人需要插管，需要去重症監護。而對其他人來說，一切都太遲了……每一個呼吸器都變成了黃金:那些在手術室裏的，現在已經暫停了他們的非緊急活動，變成了以前不存在的重症監護場所。

The staff is exhausted. I saw the tiredness on faces that didn't know what it was despite the already exhausting workloads they had. I saw a solidarity of all of us, who never failed to go to our internist colleagues to ask "what can I do for you now?"

團隊成員都筋疲力盡了。我看到了臉上的疲倦，儘管他們的工作已經很累了，但他們卻不知道在與什麼作戰。我看到我們所有人都團結在一起，每個人都會去問內科同事“我現在能爲你做些什麼?”

Doctors who move beds and transfer patients, who administer therapies instead of nurses. Nurses with tears in their eyes because we can't save everyone, and the vital parameters of several patients at the same time reveal an already marked destiny.

移動病床和轉移病人的醫生，他們代替護士進行治療。護士眼中含着淚水，因爲我們無法拯救每一個人，幾個病人的生命參數同時透露出一個早已註定的命運。

There are no more shifts, no more hours. Social life is suspended for us. We no longer see our families for fear of infecting them. Some of us have already become infected despite the protocols.

沒有更多的輪班，沒有更多的時間。我們的社交生活暫停了。因爲害怕感染，我們再也見不到家人了。我們中的一些人已經被感染了。

Some of our colleagues who are infected also have infected relatives and some of their relatives are already struggling between life and death. So be patient, you can't go to the theatre, museums or the gym. Try to have pity on the myriad of old people you could exterminate.

我們的一些被感染的同事也有被感染的親戚，他們的一些親戚已經在生死之間掙扎。所以要有耐心，你不能去劇院、博物館或健身房。試着憐憫那些因為你的不僅慎而可能消滅的無數老人吧。

We just try to make ourselves useful. You should do the same: we influence the life and death of a few dozen people. You with yours, many more. Please share this message. We must spread the word to prevent what is happening here from happening all over Italy."

我們只是想讓自己變得有用。你也應該這麼做:我們影響了幾十個人的生死。你和你們，還有更多人。請分享這條信息。我們必須傳播這個消息，防止這裏發生的事情在整個義大利發生

I finish by saying that I really don't understand this war on panic. The only reason I see is mask shortages, but there's no mask on sale anymore. We don't have a lot of studies, but is it panic really worse than neglect and carelessness during an epidemic of this sort?

最後我想說的是，我真的不理解這場恐慌戰爭。我看到的唯一原因是口罩不足，但現在已經沒有口罩出售了。我們沒有太多的研究，但在這種流行病中，恐慌真的比忽視和粗心更糟糕嗎?

https://t.co/zDC7de6wtI?amp=1 全文(義大利語)

原文：
https://www.ptt.cc/bbs/Gossiping/M.1583764796.A.DE6.html

ปัญหาการเกิดมะเร็งหลังการเสริมหน้าอกด้วยซิลิโคนผิวทราย ตอนนี้เป็นประเด็นที่วงการแพทย์และสื่อมวลชนต่างประเทศให้ความสนใจและกดดันหน่วยงานที่รับผิดชอบให้มีการแถลงข้อเท็จจริงและมาตรการการจัดการกับปัญหานี้ ซึ่งคงไม่ต่างจากที่บ้านเรากำลังกดดันให้หน่วยงานของรัฐจัดการกับปัญหาของฝุ่นpm2.5สักเท่าไร และที่คล้ายกันไปกว่านั้นคือในช่วงแรก ก็ยังไม่มีใครตอบคำถามได้ชัดเจนเพราะข้อมูลไม่เพียงพอ แต่ ณ วันนี้ มีคนไข้ที่พบว่าเป็นมะเร็งชนิดนี้ที่เสริมหน้าอกด้วยไปแล้วถึง400กว่ารายทั่วโลก เรื่องนี้จึง...
Continue ReadingThe problem of cancer after breast augmentation with sand skin silicone is now an issue that medical and foreign press pay attention and pressure on responsible agencies to make a statement of facts and measures to deal with this issue which would not be different from home. We are pressuring. How many of the cuddle state agencies deal with pm2. 5 dust problems and more similar is that in the beginning, no one answered clearly because of information is not enough information. But today, there are patients who found this type of cancer that have breast augmentation. With over 400 people around the world, this is no longer a small thing.

This cancer is a lymphoma called anaplastic large cell lymphoma that is very little, but it is interested. Because most of these patients have been supplementation, it has been supplemental, it makes a thorough study which has started collecting for ten years. At First, I didn't find much and I thought it might be more coincidence. But when medical reports keep getting more, this type of cancer and breast augmentation is not a coincidence, and now it's concluded that there is a relationship with breast augmentation. With Silicone Sand skin for sure

For those who have breast augmentation with silicone, smooth skin can feel comfortable because they don't find this type of cancer.

From Finding out, this makes people scared and when the press comes to play this news, the more it freaks society, because the patient who are wasting time to check without knowing what it is. It's been a long time to know that lymphoma has wasted months.

The beginning of this disease is not quite found, but now more reports are believed that because of this type of cancer took almost ten years, and sand skin silicone has been popular for over ten years. It makes it has been reported in the beginning. How much?

There is nothing much in the beginning but chest swelling. It makes the back to heal the breast inflammation. It's been a long time to check. It's been a long time to check. It's been a long time and in the past, I don't even know what At First, I sent this type of cancer detection in the room. I was confused. What disease should I detect?

But now all the evidence is clear. Although the chance of this disease is very little, ten thousand breast augmentation patients may only find one person, but should not be careless

In France, a big company's Sand Silicone Sales license was cancelled. and later this company returned its own sand skin products from all European markets. in conclusion, it is no longer sold in Europe and French official. Meeting with Breast Augmentation Silicone Production company this February to discuss and set measures to rule the people.

In The United States, the us Fda has been pressured by both patients and press because they saw Europe not to sell. US FDA, which is an official medical equipment and medicine, held a meeting to determine measures this march.

While waiting for specialist to talk, the medical group has preliminary advice that if you want to have breast augmentation now, you should use silicone smooth skin because it's safe. There is no cancer report. If any doctor wants to use silicone, Lymphoma and always let the patient st.

For those who have had breast augmentation, sand skin, don't be alarmed because there are very few chances of cancer. and if it is, it can be cured if it is found in the first phase, which often see the doctor with chest symptoms.

In Thailand, doctors see all companies still promote selling sand skin silicone. They don't explain the problems of cancer. Not know. Not know. and think that silicone sand skin is the best. The relevant agencies don't see what to be shocked. Maybe because I haven't found this type of cancer in Thailand yet.

When no one warns the doctor, I would like to warn you. If anyone is interested in finding out more information, search the word bia alcl will find out that there are many pages, but the content is like what the doctor wrote. So who wants to have breast augmentation, learn to find out I can't be fooled by anyone!

Doctor's page primarily focus on educating.
#เพจหมอไม่ได้โฆษณาอะไรไม่มีโปรโมชั่นใดๆทั้งสิ้น
#คนไข้อ่านแล้วจะไปรักษากับใครก็ได้ไม่จำเป็นต้องมาหาหมอ

In Case of surgery problem
You can inbox or send line via line @ ID: @Dr.Surawejrama
#หมอจะพยายามตอบทุกคำถามแค่เป็นแนวทางนะครับ
#หมอไม่ได้ตอบคำถามในโพสหรือcomment
#หมอไม่ได้ตอบทุกวันบางทีห้าหกวันถึงเช็คคำถาม

Or if you want to check it out, you can come at
1. Hospital Come every monday. Regular clinic at government time 9.00-15.00 pm or special clinic. Part time. Monday 16.30-18.30 pm or Saturday 9-11.30 PM (except public holidays). Surgery Department, 2th floor, king tephon medical center building. Cuddle of them
Call 02-2003186 (call only for government time)
#But it's very difficult to call and there is only one number.
#ตอนนี้ที่รามาไม่ให้ใบนัดล่วงหน้าแล้วเพราะคิวยาวเป็นปี
#I really want to check. I wish walkin come. Doctor will try to check it out.

2. Hospital Rama 9 Doctor check out every Sunday 10.30-16.30 PM CALL 02-202-9999 or 1270 (get case, call only. No walkin)Translated