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目前顯示的是 2011的文章

即便是用IGRA, 有時也要等大於三個月才能決定TB contact

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接觸TB後,TST大抵上2-12週轉陽,IGRA大抵上6-10週,但IGRA可以長到3個月以上 TB Tests Can Have a Lengthy Window Period Two studies suggest that interferon- release assay conversion sometimes occurs more than 3 months after exposure to active tuberculosis. Increasingly, interferon- release assays (IGRAs) are being used for diagnosing latent tuberculosis (TB). Although the tuberculin skin test (TST) traditionally used for this purpose converts to positive within 2 to 12 weeks after an individual is exposed to someone with active TB, the interval for IGRA conversion has remained unclear. Current guidelines recommend repeating an initially negative IGRA after 6 to 10 weeks, but this recommendation is not based on controlled studies. Two recent investigations address this issue. Anibarro and colleagues conducted a longitudinal prospective analysis among contacts of TB patients in Spain. The 152 contacts received a TST and an IGRA at first visit; for individuals with negative or conflicting results, t

provoked VTE,吃coumadin吃三個月即可

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porvoked VTE ->吃3個月即可 最近有一位病人,CVA長期臥床 約一年前hip fracture, 三個月後DVT(provoked VTE) 在長庚吃coumadin吃到現在 -> 應該不用吃了 Summary and Comment Minimizing Recurrence of VTE Initial presentation of venous thromboembolism and duration of previous anticoagulation were associated with risk for recurrence. How does clinical presentation of venous thromboembolism (VTE) and duration of anticoagulation affect risk for recurrent VTE after anticoagulation is stopped? In this pooled analysis of data from seven randomized trials that involved 2925 participants, investigators addressed this question. Twenty percent of the patients had isolated distal deep venous thrombosis (DVT), 52% had proximal DVT, and 29% had pulmonary embolism (PE). VTE was provoked by a temporary risk factor (e.g., immobilization) in 40%. During mean follow-up of 1.4 years, 312 episodes of recurrent VTE occurred. Risk for recurrent VTE in patients with isolated distal DVT was about half that of patients with proximal DVT

TG無用論,不用吃fenofibrate了,除非> 500mg/dl

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不用管TG levels,除非高到>500 好好吃東西,好好運動,比吃藥重要!! Don't Miss the New AHA Recommendations on Triglycerides A new scientific statement raises the threshold for pharmacologic treatment of hypertriglyceridemia. The following was published as a "Voices" blog on CardioExchange , an online forum for cardiology news and discussion. The blog prompted a lively conversation, which you can access and join by registering for CardioExchange. I've been surprised at the lack of fanfare surrounding the American Heart Association's recently published scientific statement on triglycerides and cardiovascular disease (CVD). The attention it did receive focused on the lower fasting triglyceride level that is now considered optimal: <100 mg/dL. In my opinion, the real headline was the committee's important statements in support of less drug treatment — in particular, the recommendation for a substantial increase in the triglyceride level that should trigger consideratio