l******k
发帖数: 27533 | 1 I agree that for the time dependent ABX like beta lactams, it's better to
have frequent doses to maintain adequate concentration for most time.
However, there are several amoxicillin regimens used for strep throat as my
ID professor introduced in the class. I think either one is ok since there'
s evidence for it.
It's also possible that there's new guideline or clinical study to prefer
the QD amoxicillin regimen over others, which is very interesting:)
big |
|
l******k
发帖数: 27533 | 2 去年上的ID课了
当时老师并没有prefer任何一种regimen
所以看到人家residency说儿医们现在更prefer QD，说不定去年的ID课已经out dated
而且lexicomp也只列出了QD
没时间查guideline或者literature呀:(
师妹要有时间帮忙看看，来给我们讲讲就最好了：） |
|
j*****g
发帖数: 8 | 3 Adjuvant systemic therapy in resectable non-small cell lung cancer
Author
Nasser Hanna, MD
Section Editors
Rogerio C Lilenbaum, MD, FACP
James R Jett, MD
Deputy Editor
Sadhna R Vora, MD
Contributor disclosures
All topics are updated as new evidence becomes available and our peer review
process is complete.
Literature review current through: May 2016. | This topic last updated: Nov
30, 2015.
MOLECULARLY TARGETED AGENTS — Despite the activity of tyrosine kinase
inhibitors in patients with metastat... 阅读全帖 |
|
y*****l
发帖数: 5997 | 4 来自主题: _pennystock版 - SPPI Spectrum Pharmaceuticals Announces ZEVALIN(R) and Belinostat Abstracts to Be
Presented at the American Society of Clinical Oncology Annual Meeting
4 hours 16 minutes ago - BIZ via Comtex
BusinessWireSpectrum Pharmaceuticals (NasdaqGS: SPPI), a biotechnology
company with fully integrated commercial and drug development operations
with a primary focus in oncology, today announced ZEVALIN(R) (ibritumomab
tiuxetan) and Belinostat abstracts will be presented at the 2011 Annual
Meeting of the American... 阅读全帖 |
|
p********3
发帖数: 5750 | 5 再让你长长见识：大家看和文献3-6相关的那句话，专门提出了中药的肾脏毒性问题，表明实际上的肾脏毒性比原先预期想象的还要普遍。
大家没有忘记在对Herb Medicine管制更严格的欧盟对中药 Ban了吧。 我上篇文献里面说了欧盟对Herb的管理对美国严格， 谈得比较细，有兴趣的可以仔细阅读。
Author
Marc E De Broe, MD, PhD Section Editor
Gary C Curhan, MD, ScD Deputy Editor
John P Forman, MD, MSc
Last literature review version 19.2: May 2011 | This topic last updated:
June 15, 2010
INTRODUCTION — In 1991, physicians in Belgium noted an increasing number of
women who presented with acute, often near end-stage renal disease
following expo... 阅读全帖 |
|
l****z
发帖数: 29846 | 6 By JONATHAN D. ROCKOFF
Earlier this year, researchers reported impressive results for a treatment
that offered a potential cure for intractable cases of hepatitis C. But now,
millions of patients waiting for such a breakthrough may never get it.
The story of how the promising therapy got stalled despite positive research
illustrates a little-acknowledged truism in the pharmaceutical industry:
Sometimes drugs die not because they don't work or are unsafe, but because
they don't make business sens... 阅读全帖 |
|
d******8
发帖数: 1972 | 7 http://www.thestreet.com/story/12992120/1/abbvies-hep-c-regimen
Abbvie's Hep C Regimen Approved, Marketing Battle With Gilead Up Next
By: Adam Feuerstein Follow | 12/19/14 - 04:16 PM EST
inShare
Comment
Link
Stocks in this article: GILDABBVENTA
U.S. regulators approved a new hepatitis C therapy from Abbvie (ABBV) ,
heralding a new era of market competition with Gilead Sciences (GILD) .
The just-approved Abbvie hepatitis C regimen will be sold in the U.S. under
brand name Viekira Pak. The company... 阅读全帖 |
|
y**s
发帖数: 563 | 8 2014年8月27日讯 /生物谷BIOON/ --丙肝治疗领域，吉利德可谓独领风骚，其明星药物
Sovaldi（sofosbuvir）在今年上半年的销售额突破58亿美元，为其带来了滚滚财源。
然而，这一格局即将打破。
近日，百时美施贵宝（BMS）丙肝新药Daklinza（daclatasvir）获欧盟批准，联合其他
药物，用于所有1、2、3、4基因型慢性丙型肝炎（HCV）成人感染者的治疗。Daklinza
是一种强效的泛基因型NS5A复制复合体抑制剂，在临床试验中，当与吉利德明星药
Sovaldi组成一种全口服、无干扰素鸡尾酒疗法（Daklinza+Sovaldi）时，取得了100%
的治愈率，包括伴有晚期肝脏疾病、基因型3 HCV及既往经蛋白酶抑制剂治疗失败的患
者群体。
目前，吉利德也在开发一种基于Sovaldi的丙肝鸡尾酒疗法ledipasvir/Sovaldi（LDV/
SOF），百时美Daklinza/Sovaldi鸡尾酒疗法的获批，对吉利德LDV/SOF鸡尾酒疗法形成
了直接威胁。
Daklinza/Sovaldi是一种每日一次、全口服、治愈率达100%的丙肝鸡尾酒疗法，为... 阅读全帖 |
|
y**s
发帖数: 563 | 9 2014年8月27日讯 /生物谷BIOON/ --丙肝治疗领域，吉利德可谓独领风骚，其明星药物
Sovaldi（sofosbuvir）在今年上半年的销售额突破58亿美元，为其带来了滚滚财源。
然而，这一格局即将打破。
近日，百时美施贵宝（BMS）丙肝新药Daklinza（daclatasvir）获欧盟批准，联合其他
药物，用于所有1、2、3、4基因型慢性丙型肝炎（HCV）成人感染者的治疗。Daklinza
是一种强效的泛基因型NS5A复制复合体抑制剂，在临床试验中，当与吉利德明星药
Sovaldi组成一种全口服、无干扰素鸡尾酒疗法（Daklinza+Sovaldi）时，取得了100%
的治愈率，包括伴有晚期肝脏疾病、基因型3 HCV及既往经蛋白酶抑制剂治疗失败的患
者群体。
目前，吉利德也在开发一种基于Sovaldi的丙肝鸡尾酒疗法ledipasvir/Sovaldi（LDV/
SOF），百时美Daklinza/Sovaldi鸡尾酒疗法的获批，对吉利德LDV/SOF鸡尾酒疗法形成
了直接威胁。
Daklinza/Sovaldi是一种每日一次、全口服、治愈率达100%的丙肝鸡尾酒疗法，为... 阅读全帖 |
|
f**********g
发帖数: 2252 | 10 18%!
Pharmasset announces expansion of ELECTRON trial in HCV
25 minutes ago - DTM via Comtex
DatamonitorPharmasset, Inc. has announced the addition of three treatment
cohorts to the ELECTRON trial of PSI-7977, a nucleotide analog polymerase
inhibitor, for the treatment of chronic hepatitis C, or HCV.
The rapid and consistent antiviral effects and high barrier to resistance
demonstrated with PSI-7977 to date provide the rationale for additional
exploratory regimens in this setting. This amendment... 阅读全帖 |
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l********u
发帖数: 910 | 11 George J. So, Xin Li, Hooshang Kangarloo, Richard Steckel, Daniel J.
Valentino
UCLA Medical Center, Department of Radiological Sciences 10833 Le Conte, Los
Angeles, California 90024
1. ABSTRACT
Recent advances in telecommunications via the Internet have significantly
improved international communication. We report a case of teleconsultation
using the World Wide Web (WWW) and related technologies on the internet to
facilitate the successful diagnosis and treatment of a rare illness that
occurred ... 阅读全帖 |
|
d******5
发帖数: 4273 | 12 Why Did Gilead Drop Friday? Is It Justified Or Just
An Overreaction?
http://seekingalpha.com/article/2630495-why-did-gilead-drop-fri
Gilead dropped today based on comments during
Abbvie's earnings call that suggested that Abbvie
executives thought their HCV regimen could obtain
an undisclosed market share in 2015.
This is nothing new. Gilead's Harvoni will dominate
the market based on a superior regimen.
Even if Abbvie discounts their regimen, physicians
will still prescribe Harvoni to most pati... 阅读全帖 |
|
d******8
发帖数: 1972 | 13 Dec 19 (Reuters) - U.S. health regulators on Friday approved AbbVie's all-
oral treatment for hepatitis C, providing the first competition for Gilead
Sciences huge selling and expensive medicine for the liver-destroying virus.
The AbbVie regimen consists of four different anti-viral drugs to be taken
as three pills in the morning and one in the evening. The U.S. Food and Drug
Administration approved the regimen, which will be sold under the brand
name Viekira Pak, for patients with genotype 1 fo... 阅读全帖 |
|
p*******r
发帖数: 83 | 14 U.S. FDA approves AbbVie all-oral hepatitis C treatment
Dec 19 (Reuters) - U.S. health regulators on Friday approved AbbVie's all-
oral treatment for hepatitis C, providing the first competition for Gilead
Sciences huge selling and expensive medicine for the liver-destroying virus.
The AbbVie regimen consists of four different anti-viral drugs to be taken
as three pills in the morning and one in the evening. The U.S. Food and Drug
Administration approved the regimen, which will be sold under the... 阅读全帖 |
|
c******t
发帖数: 1733 | 15 The first time I looked into an open chest cavity at a heart muscle working
to pump blood through the body, I was brought up short by the tragic
graffiti of atherosclerotic plaque. This waxy goo, often found in overweight
people, builds up in the vessels surrounding the organ in which,
philosophers tell us, the soul lives. But I quickly pushed any such
distracting thoughts from my mind. I was learning to operate and was frankly
thrilled at the prospect of harvesting a leg vein to bypass the bloc... 阅读全帖 |
|
g*2
发帖数: 658 | 16 Overview of running injuries of the lower extremity
Author
Lisa R Callahan, MD Section Editor
Karl B Fields, MD Deputy Editor
Jonathan Grayzel, MD, FAAEM
All topics are updated as new evidence becomes available and our peer review
process is complete.
Literature review current through: Feb 2012. | This topic last updated: Oct
20, 2011.
INTRODUCTION — Running is one of the world’s most popular forms of
exercise, with millions of regular participants. In the United States alone,
up to 40 mil... 阅读全帖 |
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n***9
发帖数: 3 | 17 It's a tightrope the Chinese government would rather not walk, with the
sensitive 10th anniversary of Tiananmen Square just gone by. Falun Gong,
however, is pressing its own issues with communist leaders. The sect, a
popular quasi-religious movement gaining followers worldwide, desires
official recognition and respect. This has precipitated a power struggle
that has tensions rising.
After being caught off guard by the emerging movement's 25 April 1999 ten-
thousand-plus-member sit-in — a silent ... 阅读全帖 |
|
s******a
发帖数: 472 | 18 http://www.philly.com/philly/health/HealthDay668074_20120827_FD
MONDAY, Aug. 27 (HealthDay News) -- A new pill to treat HIV infection that
combines four medicines and only has to be taken once a day was approved by
the U.S. Food and Drug Administration on Monday.
Stribild, which will be marketed by maker Gilead Sciences, contains the HIV
drugs elvitegravir, cobicistat, emtricitabine and tenofovir disoproxil
fumarate. It will be prescribed to people who have never been treated for
HIV infection, ... 阅读全帖 |
|
yf
发帖数: 272 | 19 http://jop.ascopubs.org/content/early/2013/03/26/JOP.2012.00081
Perspective
Practicing Western Oncology in Shanghai, China: One
Group’s Experience
By David H. Garfield, MD, Harold Brenner, MD, FRCR (Lond), and Lucy Lu, RN
ProMed Cancer Centers–Shanghai, Shanghai, People’s Republic of China
In October 2011, we—David H. Garfield, MD, medical oncologist,
United States; Harold Jacob Brenner, MD, FRCR,
radiation oncologist, Israel; and Lucy Lu, oncology nurse,
Shanghai, China—were part of a group tha... 阅读全帖 |
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s*****e
发帖数: 404 | 20 来自主题: Medicalpractice版 - 求救！ 1. His AST/ALT is OK. If his bilirubin is normal, his liver function should
be fine, even there are liver metastasis.
2. If there has been no change of chemo regimen, given the CT finding, his
disease is resistant to the current regimen. He should switch to a different
regimen.
3. High dose chemotherapy followed by autologus stem cell transplant is a
reasonable next step. Liver transplant is not indicated in this situation.
4. Cancer center at Duke is very good. If he were my family member, I wo... 阅读全帖 |
|
L****n
发帖数: 12932 | 21 这个叫 PCA - patient controlled analgesia. 你按了才有，要是不疼，不去按，它
就不给药。但随便按也不是一直有，有一个internal regimen。 防止过量。 护士让你
随便按-这样医生是可以看到你按了多少次（疼的厉害），得了多少剂量。有需要的话
可以调整这个regimen。 |
|
发帖数: 1 | 22 World Braces for Possible Pandemic
On Saturday, April 25, 2009, under the rules of the International Health
Regulations, the Director-General of WHO declared the 2009 H1N1 outbreak a
Public Health Emergency of International ConcernExternal Web Site Icon and
recommended that countries intensify surveillance for unusual outbreaks of
influenza-like illness and severe pneumonia. Also on April 25, 2009, New
York City officials reported an investigation into a cluster of influenza-
like illness in a h... 阅读全帖 |
|
z*******4
发帖数: 285 | 23 算了，你脑子大概也被活摘过
懒得跟你解释，贴个清单吧：
累计研究数量 注册号 注册日期 研究者单位 研究者单位（英文） 注
册题目 注册题目（英文) 预计纳入参试者日期
1 ChiCTR2000029308 1/23/2020 武汉市金银潭医院（武汉市传染病医院）
Wuhan Jinyintan Hospital (Wuhan Infectious Diseases Hospital) 一项评价
洛匹那韦/利托那韦和干扰素-α2b联合治疗武汉新型冠状病毒肺炎(COVID-19)住院患者
的疗效和安全性随机、开放、空白对照的研究 A randomized, open-label, blank-
controlled trial for the efficacy and safety of lopinavir-ritonavir and
interferon-alpha 2b in hospitalization patients with novel coronavirus
pneumonia (COVID-1... 阅读全帖 |
|
|
l****z
发帖数: 29846 | 25 New once-a-day pill for Hep C wins FDA approval
October 10, 2014 - 2:34 PM
By MATTHEW PERRONE, Associated Press
WASHINGTON (AP) — Federal health officials have approved a daily pill that
can cure the most common form of hepatitis C without the grueling pill-and-
injection cocktail long used to treat the virus.
But the drug's $1,125-per-pill price is sure to increase criticism of
drugmaker Gilead Sciences, whose pricing strategy for an older hepatitis
drug has already drawn scorn from patient gro... 阅读全帖 |
|
l****z
发帖数: 29846 | 26 http://www.wsj.com/articles/the-athletes-who-train-with-soda-14
The Athletes Who Train With Soda
Aaron Rodgers, Tour de France Cyclists and Olympic Medalists Cling to Coke
or Crush
Green Bay Packers quarterback Aaron Rodgers sparked discussion by drinking
grape-flavored Crush after a recent victory. ENLARGE
Green Bay Packers quarterback Aaron Rodgers sparked discussion by drinking
grape-flavored Crush after a recent victory. WLUK-TV Green Bay
.
By
Rachel Bachman
Updated Dec. 9, 2014 2:27 p... 阅读全帖 |
|
z***9
发帖数: 1052 | 27 I just started thinking to buy furniture for my house, and did some research
. I came across this great site www.myfurnitureforum.com with a lot of
information and knowledge in the furniture industry.
Here is an article on leather furniture, I think it's great.
A primer in selecting leather
It just occurred to me I may not have ever made a post about some leather
tips you need to know when you buy leather. Here's a few, and they apply to
every maker for the most part:
Leather Grade: This is a P... 阅读全帖 |
|
m*********t
发帖数: 858 | 28 非常感谢！那给palliative treatment一般还能活多久？我妈妈在省会人民医院的医生
说要找骨髓做移植，您觉得这个方法怎么样？
some bad news first. while pediatric ALL is highly treatable and largely
curable (~80%), the prognosis of adult ALL is significantly worse.
recent pediatric-like high dose chemotherapy regimens benefit some adult
patients up to 45 years old. but in patients older than 45 years old, these
regimens produce higher short-term remission rates without improving
survival.
elderly patients (>=59 yrs in the US) with ALL are convention |
|
l*h
发帖数: 4124 | 29 to be more specific, at this time, if you don't want to go the palliative
path, you should urge your dad's oncologist to consider the following
regimens:
1. a microtubule inhibitor + a platinum derivative or
2. a microtubule inhibitor + a platinum derivative + a conventional
alkylating agent
folate antimetabolites can also be considered but I would not place them
ahead of the above two options.
you should be very cautious to consider bevacizumab. remember, your dad is ~
65 yo. bevacizumab just c... 阅读全帖 |
|
l*h
发帖数: 4124 | 30 because of the location, it is unlikely a metastasis. however, to be safe,
some exams can be done if they don't delay the treatment.
i don't think the description of 脑干 is accurate, but rather in front of or
behind it, ie, pituitary/supersellar or pineal region.
there are numerous types of non-germinoma germ cell tumors. choriocarcinoma
is so special that it responds to methotrexate extremely well, with >90%
cure rate if treatment is done early.
primary intracranial germinoma has a long-term rem... 阅读全帖 |
|
l*h
发帖数: 4124 | 31 hepatitis C is curable in high percentage.
for genotypes 2 and 3, the cure rate is over 95% with pegylated interferon-
alpha-2a/b with ribavirin for about 11 months.
genotype 1 is more difficult to treat. pegylated interferon-alpha-2a/b with
ribavirin for 11 months gives up to 50% cure rate. boceprevir or telaprevir
is recommended to be added to the regimen ( not sure about the cure rate for
this regimen).
because the treatment is long and can cause serious adverse effects, the
patients should b... 阅读全帖 |
|
s******e
发帖数: 493 | 32 Bless!
What is a rhabdoid tumor?
A rhabdoid tumor is a rare and highly malignant tumor of childhood, first
described in 1978. These tumors were initially considered an aggressive
variant of Wilms' tumor of the kidney, however, with newer diagnostic
techniques, these tumors are believed to represent a distinct entity. Since
that time, there have been fewer than 50 cases reported, although it is
likely that some cases previously identified as medulloblastoma or as
primitive neuroectodermal tumo... 阅读全帖 |
|
m******c
发帖数: 1202 | 33 同意老李说的啊，穷人像吃药吃不起,liberal议员们立刻挺身而出来干预价格，结果小
药股倒霉了。
不过青蛙相信gild的定价是经得起考验的。
The outcry about Gilead Sciences' $84,000 price for its hepatitis C wonder
drug, Sovaldi, just got louder. Rep. Henry Waxman and several Democratic
colleagues in Congress wrote Gilead CEO John Martin an excoriating letter on
Friday, demanding to know why the drug costs so much--and whether Gilead ($
GILD) is doing anything to make sure that poor patients get access to it.
"The costs are likely too high for many patients, bot... 阅读全帖 |
|
j***u
发帖数: 836 | 34 No. GILD's Sovaldi is part of it.
The news is on 8月27日. If it had been bad news for GILD, GILD price would
have already been hit down.
Not a bad news.
From many comments that I have read lately, for HVC market, the bigger
threat would come from MRK, but in 2H 2015 or later.
http://seekingalpha.com/article/2451415-gilead-earnings-forecas
"Regarding Hepatitis C, concerns have been raised regarding the market size,
competitors and patent vulnerability. I believe that it is now understood
that this ... 阅读全帖 |
|
h****e
发帖数: 374 | 35 批是批了，但也没见怎么涨啊
：U.S. FDA approves AbbVie all-oral hepatitis C treatment
：Dec 19 (Reuters) - U.S. health regulators on Friday approved AbbVie's
all-
：oral treatment for hepatitis C, providing the first competition for Gilead
：Sciences huge selling and expensive medicine for the liver-destroying
virus.
：
：The AbbVie regimen consists of four different anti-viral drugs to be taken
：as three pills in the morning and one in the evening. The U.S. Food and
Drug Administration approved the regimen, which... 阅读全帖 |
|
O****N
发帖数: 1458 | 36 Express Scripts to cover AbbVie hepatitis C drug, drops Gilead treatment
Reuters
7 hours ago
By Caroline Humer
Dec 22 (Reuters) - The nation's largest pharmacy benefit manager has
lined up a cheaper price from AbbVie Inc on its newly approved hepatitis C
treatment and, in most cases, will no longer cover Gilead Sciences Inc
treatments, Express Scripts said on Monday.
Express Scripts has opposed the $84,000 pricetag of Gilead Sciences'
Sovaldi treatment since it was approved a year ago, saying th... 阅读全帖 |
|
n**d
发帖数: 164 | 37 Good read!
http://online.wsj.com/article/SB1000142405274870343950457611608
By KEVIN HELLIKER
As the wife of an endurance athlete, Caren Waxman wakes up alone every
morning, including holidays.
"Mother's Day really upset me," says the Rockleigh, N.J., mother of three,
age 47, whose husband leaves before dawn each morning for hours of exercise.
In May, he will wish her a happy Mother's Day from Utah, where he will
compete in a triathlon.
More
"It's selfish," concedes her husband, Jordan Waxman, 46... 阅读全帖 |
|
R*****s
发帖数: 41236 | 38 【 以下文字转载自 Tri 讨论区 】
发信人: Rodimus (变叔- 全情投入), 信区: Tri
标 题: Strokes Of Genius: Use Swimming To Stay Fit
发信站: BBS 未名空间站 (Tue Jul 31 20:57:09 2012, 美东)
Strokes Of Genius: Use Swimming To Stay Fit
http://www.bodybuilding.com/fun/strokes-of-genius-use-swimming-
Swimming is a survival skill, but it is also a high-end full-body workout
that increases your aerobic potential and also offers resistance. It抯 a win
win win.
by Shannon Clark Jul 30, 2012
From the moment human beings find themselves immersed ... 阅读全帖 |
|
v***s
发帖数: 1893 | 39 http://www.nytimes.com/2008/11/02/sports/playmagazine/112pewarm
Stretching: The Truth
WHEN DUANE KNUDSON, a professor of kinesiology at California State
University, Chico, looks around campus at athletes warming up before
practice, he sees one dangerous mistake after another. “They’re stretching
, touching their toes. . . . ” He sighs. “It’s discouraging.”
STRAIGHT-LEG MARCH (for the hamstrings and gluteus muscles)Kick one leg
straight out in front of you, with your toes flexed toward the sky. R... 阅读全帖 |
|
|
b******a
发帖数: 12216 | 41 第四篇——itching to Know (破狗，这是为你搬的哦)
(这篇也很长。。。这杂志的编辑真话唠。还是节选吧。。。)
If your dog or cat ahs any of the following symptoms, it may signal a skin
problem. Besure to tell your primary care veterinarian: itchiness; hair loss
; smelly ears; head shaking; foot licking skin lumps
Our pets are susceptible to hundreds of bacterial and fungal infections,
parasites and autoimmune disorders of the skin – ranging from the merely
annoying to the downright deadly. So it’s no wonder that dermatological
issues are the... 阅读全帖 |
|
h********n
发帖数: 4079 | 42 FDA对一个药批准用在什么样的病人/病情上, 基本上取决于临床试验的结果. 所以按我
的理解, 即使他来美国, brentuximab vedotin也不会是首选疗法.
On August 19, 2011, the Food and Drug Administration granted accelerated
approval to brentuximab vedotin (Adcetris™ for Injection, made by
Seattle Genetics, Inc.) for two indications:
--The treatment of patients with Hodgkin lymphoma after failure of
autologous stem cell transplant (ASCT) or after failure of at least two
prior multi-agent chemotherapy regimens in patients who are not candidates
for ASCT.
-... 阅读全帖 |
|
g*****j
发帖数: 1211 | 43 1) I can list 10 things you do may change your blood sugar temporally.
Does that mean patient should stop taking insulin because of that?
2) You probably do not know how insulin is administered nowadays.
外源的胰岛素则做不到这点，如果违背了人体自身的规律，当然会对人体造成伤害。
To be exact, what harm is done? What harm will be done if no treatment
is given?
3) 对于你未知的事情，未必对她的中医就未知。
How does she know? There is no way of monitoring blood sugar before
modern medicine. Which Chinese medicine book can teach her how to treat
high bloo... 阅读全帖 |
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a*********d
发帖数: 2763 | 44 还在西部面试，竟然倒时差，天不亮就醒了，晕，上来凑个热闹，讨论一下术前
insulin的用法。
没有具体的guideline，但是有几点值得讨论一下。
1．手术前病人都是stressed的，糖尿病病人这时候的血糖，不是像同学们担心的bottom down，更多见的是sky high.特别是术前本身血糖就控制不好的病人。血糖控制不好，术后并发症就多，这个是被反复证明的。所以如果原来已经用basal/bolus regimen的病人，术前把basal insulin 停掉，肯定是要引起高血糖的。
2．Lantus是没有peak的long acting insulin, 如果剂量合适的时候，即使病人第二天fasting，也是不会引起低血糖的。问题是不少PCP喜欢用超过病人本身需要的lantus剂量来cover postprandial glucose, 这个应该是由short acting insulin来cover的。所以应该在术前合理调整病人的胰岛素regimen。而不能只是机械地说，给一半，还是不给。有的医院是根据病人的carb counting来给meal insulin，这样是很科 |
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m********4
发帖数: 607 | 45 Winning Their Trust----Anand K. Parekh, M.D., M.P.H.
The ranks of the U.S. medical profession will soon grow by 16,000 physicians
, as the class of 2011 graduates from medical schools throughout the country
. These new physicians will go on to receive graduate medical training that
is superb by global standards. Once in practice, they will be encouraged to
uphold high quality standards through licensing and certification,
activities of specialty societies, and participation in a growing array of... 阅读全帖 |
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a*********d
发帖数: 2763 | 46 I totally agree wtih you, education is the key part of the treatment.
For example, if I just start patient on insulin, it involves a lot of
knowledge and self monitoring, can be very overwhelming to patients. what i
usually do to improve the outcome is
1. start from a simple regimen, such as a single lantus dose at night
2. start from a conservative dose, if the patient has problem (hypoglycemia
or other symptoms), he/she is very unlikely to go back on this medication
any more.
3. try to do the... 阅读全帖 |
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a*********d
发帖数: 2763 | 47 is this a real case or an exam case? answer can vary depending on the
situation. there is absolutely no uniform way to treat a DM patient, lots of
factors should be considered, therapy should be tailored individually.
in this case, if it is a real case, nothing should be done until you look at
the patient's daily glucose data. you SHOULD NOT adjust regimen just base
upon A1c.
it is important to know where the problem is, fasting hyperglycemia?
postprandial hyperglycemia? does he/she have hypogly... 阅读全帖 |
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m********4
发帖数: 607 | 48 Winning Their Trust-----by Anand K. Parekh, M.D., M.P.H.
The ranks of the U.S. medical profession will soon grow by 16,000 physicians
, as the class of 2011 graduates from medical schools throughout the country
. These new physicians will go on to receive graduate medical training that
is superb by global standards. Once in practice, they will be encouraged to
uphold high quality standards through licensing and certification,
activities of specialty societies, and participation in a growing arra... 阅读全帖 |
|
m********4
发帖数: 607 | 49 Winning Their Trust-----by Anand K. Parekh, M.D., M.P.H.
The ranks of the U.S. medical profession will soon grow by 16,000 physicians
, as the class of 2011 graduates from medical schools throughout the country
. These new physicians will go on to receive graduate medical training that
is superb by global standards. Once in practice, they will be encouraged to
uphold high quality standards through licensing and certification,
activities of specialty societies, and participation in a growing arra... 阅读全帖 |
|
R*****s
发帖数: 41236 | 50 Strokes Of Genius: Use Swimming To Stay Fit
http://www.bodybuilding.com/fun/strokes-of-genius-use-swimming-
Swimming is a survival skill, but it is also a high-end full-body workout
that increases your aerobic potential and also offers resistance. It抯 a win
win win.
by Shannon Clark Jul 30, 2012
From the moment human beings find themselves immersed in water, several
things become apparent: It takes a lot of energy to stay afloat, the body
needs to move in unfamiliar ways, using unfamiliar muscle... 阅读全帖 |
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