2010年11月24日 星期三

新書預告

書名暫訂《醫與病》

雖然第一本書都還沒出版。


接下來三個月發表的速度應該很慢

因為要去外科了...

等我到小科跟中醫實習

就要開始趕進度.........

2010年11月23日 星期二

肺炎的反直覺統計事實

 ‎26歲以下pneumococcal pneumonia:
咳痰:10%
吐:43%
crackles:40%

 病毒性肺炎:
流鼻水、肌肉痛、跟生病的人接觸的比率不會比細菌性肺炎還多

門診治療的肺炎隨機分配照不照X光:
照X光組被診斷為肺炎或上呼吸道感染的比率比較高
不照X光組被診斷為細支氣管炎的比率比較高
照X光組開抗生素的比率比較高(60.8 versus 52.2).
兩組的復原時間是一樣的

四分之三有consolidation的肺炎是細菌或細菌加病毒,而四分之一是純病毒
細支氣管炎有四分之一會有肺小節塌陷,X光跟肺實質化很難分。
流感病毒肺炎有四分之一X光會有肺泡浸潤


Chest physiotherapy — Chest physiotherapy has no role to play in the management of uncomplicated CAP [1,3,12]. In randomized and observational studies in children and adults, chest physiotherapy had no effect on length of hospital stay, duration of fever, or radiographic resolution [13-16].

Antigen detection by latex agglutination for pneumococcal polysaccharide in urine is not sensitive enough to be useful. However, in children with parapneumonic effusion or empyema who were treated with antibiotics before pleural fluid was obtained, detection of pneumococcal antigen in pleural fluid can confirm the diagnosis


資料來源:uptodate