Dengue hemorrhagic fever 的 skin rash
這個網誌中的熱門文章
看到monoarthritis, 是gout 嗎?
身為一個披著CM外皮的一般科醫師 常常在門診碰到好像gout又不是gout的病人也是很合理的 雖然病人指天發誓他是gout 我們難道就信他了嗎? 全台灣有多少gout是抽關節液診斷的? 這篇文章好!! 可是，要到8分以上還有點難度耶。 Monoarticular Arthritis: Which Patients to Treat for Gout? A new clinical score supports decision making. Researchers at an academic rheumatology department in the Netherlands prospectively developed a diagnostic rule for gout using data from 381 consecutive patients with monoarticular arthritis who were referred by family physicians. Within 24 hours of visits to family practitioners, patients underwent joint aspiration, examination of synovial fluid for monosodium urate (MSU) crystals, physical examination, and laboratory testing. Researchers, who were blinded to the family practitioners' diagnoses of gout or nongouty arthritis, analyzed predefined potentially diagnostic variables in logistic regression models; variables that were significantly associated with presence of MSU crystals were weighted and used to develop a clinical prediction model. The best-fit model...
即便是用IGRA, 有時也要等大於三個月才能決定TB contact
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...
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