R**********n
发帖数: 473 | 1 今天看到Kaplan notes TB-- 说不管vaccinated与否，只要PPD阳性，也不管CXR阴性或
阳性。只要PPD阳性，就得上INH+VitB6 治疗9个月。不知实际情况是否如此？那我们很
多中国人，印度人不都得吃药9个月？还有，吃了9个月后难道PPD就变阴性了吗？如果
还是阳性，那不得再吃上9个月？按这么说，得终身吃药了。如果病人不愿意吃药，只
是按Prescription买了9个月的药，然后扔掉，医师又如何辨别病人是否吃了药？
还有，PPD阳性会对做observation,residency 有影响吗？会被强制吃药吗？多谢指教
！ |
a*********d
发帖数: 2763 | 2 PPD阳性的概念对每个不同的人群是不同的，首先这个是应该搞清楚你确实属于阳性。
很多中国人印度人都不是阳性的，特别是现在的年轻人。
如果确实是阳性，应该治疗的，这个其实不是治疗，而是chemoprophylaxi,预防以后你
自己万一免疫机能下降出现active TB,也是health care对病人的保护。
你不吃，医生自然无法知道，我们以前的residency，如果你一次阳性，完成了治疗，
我们不用PPD follow up的，但是我不知道的具体的guideline,你可以去CDC guideline
看一下。 |
s***e
发帖数: 8 | 3 Nowadays people do Quantiferon test. Positive PPD but negative Quantiferon
means BCG vaccination effect. If both are positive but negative chest Xray
then one needs 9mo treatment for latent TB. |
a**e
发帖数: 5094 | 4 what I heard is Quantiferon is non specific.
【在 s***e 的大作中提到】
: Nowadays people do Quantiferon test. Positive PPD but negative Quantiferon
: means BCG vaccination effect. If both are positive but negative chest Xray
: then one needs 9mo treatment for latent TB.
|
a**e
发帖数: 5094 | 5 what I heard is Quantiferon is non specific.
【在 s***e 的大作中提到】
: Nowadays people do Quantiferon test. Positive PPD but negative Quantiferon
: means BCG vaccination effect. If both are positive but negative chest Xray
: then one needs 9mo treatment for latent TB.
|
a**e
发帖数: 5094 | 6 what I heard is Quantiferon is non specific.
【在 s***e 的大作中提到】
: Nowadays people do Quantiferon test. Positive PPD but negative Quantiferon
: means BCG vaccination effect. If both are positive but negative chest Xray
: then one needs 9mo treatment for latent TB.
|
R**********n
发帖数: 473 | |
s***e
发帖数: 8 | 8 It's pretty good. It's only useful in clarifying whether the positive PPD is
from latent TB or BCG vaccine. Doesn't solve the problem of false
negative PPD from anergy. |
a**e
发帖数: 5094 | 9 en, because it is an inflammation marker.
is
【在 s***e 的大作中提到】
: It's pretty good. It's only useful in clarifying whether the positive PPD is
: from latent TB or BCG vaccine. Doesn't solve the problem of false
: negative PPD from anergy.
|
t*******i
发帖数: 315 | 10 I remember my PPD was 10mm (I took it in China). When I came to US for
school they took chest xray for me and found nothing. They recommend drugs
to me but I refused. Then later I started working in the hospital and I told
them my PPD was positive and they just took a chest x-ray for me w/o
mentioning the drugs at all (it was two years ago). So is the drug mandatory
? Are they going to tell me I have to take it if I go work in another
hospital later? |
|
|
f******l
发帖数: 455 | 11 INH for latent TB is not mandatory for residency training. It is required
for greencard application since 2009 (or 2008).
told
mandatory
【在 t*******i 的大作中提到】
: I remember my PPD was 10mm (I took it in China). When I came to US for
: school they took chest xray for me and found nothing. They recommend drugs
: to me but I refused. Then later I started working in the hospital and I told
: them my PPD was positive and they just took a chest x-ray for me w/o
: mentioning the drugs at all (it was two years ago). So is the drug mandatory
: ? Are they going to tell me I have to take it if I go work in another
: hospital later?
|
m****n
发帖数: 322 | 12 这个regimen是终身只要一次，9个月之后PPD也不会是阴性的，似乎也没有检查能证明
你吃过没。。。。
Quantiferon我们学校是用于证明你在过去的一年中没有active的感染过，好像目前CDC
不是很推荐，gamma-interferon还是不是很特异吧。。。因为我自己是PPD阳性的，X-
阴性，做observe之前必须要测个quantiferon。。。。 |
U******u
发帖数: 5829 | 13 agree and same to me.
When I was resident, fellow, and now attending, I changed 3 university, each
PE, PPD +, and I just went to have a CXR, and showed it to health service
it's ng, then I just report each year if I have cough, low fever, weat at
night, and lost weight,etc.
Never taken any INH regimen for chemo.
I think every institute has its own policy. NO universal manditary policy to
take IHN for PPD+ ppl.
dok
CDC
【在 m****n 的大作中提到】
: 这个regimen是终身只要一次，9个月之后PPD也不会是阴性的，似乎也没有检查能证明
: 你吃过没。。。。
: Quantiferon我们学校是用于证明你在过去的一年中没有active的感染过，好像目前CDC
: 不是很推荐，gamma-interferon还是不是很特异吧。。。因为我自己是PPD阳性的，X-
: 阴性，做observe之前必须要测个quantiferon。。。。
|
R**********n
发帖数: 473 | |
R**********n
发帖数: 473 | 15 今天看到Kaplan notes TB-- 说不管vaccinated与否，只要PPD阳性，也不管CXR阴性或
阳性。只要PPD阳性，就得上INH+VitB6 治疗9个月。不知实际情况是否如此？那我们很
多中国人，印度人不都得吃药9个月？还有，吃了9个月后难道PPD就变阴性了吗？如果
还是阳性，那不得再吃上9个月？按这么说，得终身吃药了。如果病人不愿意吃药，只
是按Prescription买了9个月的药，然后扔掉，医师又如何辨别病人是否吃了药？
还有，PPD阳性会对做observation,residency 有影响吗？会被强制吃药吗？多谢指教
！ |
a*********d
发帖数: 2763 | 16 PPD阳性的概念对每个不同的人群是不同的，首先这个是应该搞清楚你确实属于阳性。
很多中国人印度人都不是阳性的，特别是现在的年轻人。
如果确实是阳性，应该治疗的，这个其实不是治疗，而是chemoprophylaxi,预防以后你
自己万一免疫机能下降出现active TB,也是health care对病人的保护。
你不吃，医生自然无法知道，我们以前的residency，如果你一次阳性，完成了治疗，
我们不用PPD follow up的，但是我不知道的具体的guideline,你可以去CDC guideline
看一下。 |
s***e
发帖数: 8 | 17 Nowadays people do Quantiferon test. Positive PPD but negative Quantiferon
means BCG vaccination effect. If both are positive but negative chest Xray
then one needs 9mo treatment for latent TB. |
a**e
发帖数: 5094 | 18 what I heard is Quantiferon is non specific.
【在 s***e 的大作中提到】
: Nowadays people do Quantiferon test. Positive PPD but negative Quantiferon
: means BCG vaccination effect. If both are positive but negative chest Xray
: then one needs 9mo treatment for latent TB.
|
a**e
发帖数: 5094 | 19 what I heard is Quantiferon is non specific.
【在 s***e 的大作中提到】
: Nowadays people do Quantiferon test. Positive PPD but negative Quantiferon
: means BCG vaccination effect. If both are positive but negative chest Xray
: then one needs 9mo treatment for latent TB.
|
a**e
发帖数: 5094 | 20 what I heard is Quantiferon is non specific.
【在 s***e 的大作中提到】
: Nowadays people do Quantiferon test. Positive PPD but negative Quantiferon
: means BCG vaccination effect. If both are positive but negative chest Xray
: then one needs 9mo treatment for latent TB.
|
|
|
R**********n
发帖数: 473 | |
s***e
发帖数: 8 | 22 It's pretty good. It's only useful in clarifying whether the positive PPD is
from latent TB or BCG vaccine. Doesn't solve the problem of false
negative PPD from anergy. |
a**e
发帖数: 5094 | 23 en, because it is an inflammation marker.
is
【在 s***e 的大作中提到】
: It's pretty good. It's only useful in clarifying whether the positive PPD is
: from latent TB or BCG vaccine. Doesn't solve the problem of false
: negative PPD from anergy.
|
t*******i
发帖数: 315 | 24 I remember my PPD was 10mm (I took it in China). When I came to US for
school they took chest xray for me and found nothing. They recommend drugs
to me but I refused. Then later I started working in the hospital and I told
them my PPD was positive and they just took a chest x-ray for me w/o
mentioning the drugs at all (it was two years ago). So is the drug mandatory
? Are they going to tell me I have to take it if I go work in another
hospital later? |
f******l
发帖数: 455 | 25 INH for latent TB is not mandatory for residency training. It is required
for greencard application since 2009 (or 2008).
told
mandatory
【在 t*******i 的大作中提到】
: I remember my PPD was 10mm (I took it in China). When I came to US for
: school they took chest xray for me and found nothing. They recommend drugs
: to me but I refused. Then later I started working in the hospital and I told
: them my PPD was positive and they just took a chest x-ray for me w/o
: mentioning the drugs at all (it was two years ago). So is the drug mandatory
: ? Are they going to tell me I have to take it if I go work in another
: hospital later?
|
m****n
发帖数: 322 | 26 这个regimen是终身只要一次，9个月之后PPD也不会是阴性的，似乎也没有检查能证明
你吃过没。。。。
Quantiferon我们学校是用于证明你在过去的一年中没有active的感染过，好像目前CDC
不是很推荐，gamma-interferon还是不是很特异吧。。。因为我自己是PPD阳性的，X-
阴性，做observe之前必须要测个quantiferon。。。。 |
U******u
发帖数: 5829 | 27 agree and same to me.
When I was resident, fellow, and now attending, I changed 3 university, each
PE, PPD +, and I just went to have a CXR, and showed it to health service
it's ng, then I just report each year if I have cough, low fever, weat at
night, and lost weight,etc.
Never taken any INH regimen for chemo.
I think every institute has its own policy. NO universal manditary policy to
take IHN for PPD+ ppl.
dok
CDC
【在 m****n 的大作中提到】
: 这个regimen是终身只要一次，9个月之后PPD也不会是阴性的，似乎也没有检查能证明
: 你吃过没。。。。
: Quantiferon我们学校是用于证明你在过去的一年中没有active的感染过，好像目前CDC
: 不是很推荐，gamma-interferon还是不是很特异吧。。。因为我自己是PPD阳性的，X-
: 阴性，做observe之前必须要测个quantiferon。。。。
|
R**********n
发帖数: 473 | |
y**q
发帖数: 570 | |
t*****s
发帖数: 139 | 30 PPD positive + CXR negative: lifetime active TB risk 概率 10%
PPD positive + CXR negative + INH 9 Mon: lifetime active TB risk 概率 down
to 1%
PPD test should not be repeated once it's positive. |
