atypical mycobacterium infection ppt

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孟加拉的MDRTB tx trial, 使用gatifloxacin > ofloxacin

台灣的regimen不太一樣 基本上能不用fluroquinolone就不會用 Treatment of Multidrug-Resistant Tuberculosis In an observational study, a gatifloxacin-containing regimen for at least 9 months had the highest cure rate. Multidrug-resistant tuberculosis (MDRTB) is defined as infection caused by an organism resistant to both isoniazid and rifampin. Currently recommended treatment regimens are long, often poorly tolerated, and difficult to monitor. Treatment standardization has been recommended for MDRTB in low-income areas, which generally have low levels of resistance to second-line drugs. As part of a TB treatment program in Bangladesh, researchers conducted a prospective observational study from May 1997 through December 2007 to examine the effectiveness of this strategy. Patients with laboratory-confirmed MDRTB were treated with one of six regimens based on enrollment date (i.e., without randomization). Each regimen differed from the previous one, usually by a single change. All regimens contained a fluoroq...
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看到monoarthritis, 是gout 嗎?

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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...
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