呼吸機相關肺炎 減少方法 Subglottic suction ETT

Endotracheal tube with subglottic suctioning catheter (Armstrong Medical)

Endotracheal Tubes with Subglottic Suction Line

In 5 ICUs at one hospital in Belgium, 352 intubated patients with sublglottic suctioning catheters were randomized to receive regular suctioning, or no suctioning. Subglottic suctioning significantly reduced the incidence of microbiologically confirmed VAP (9% vs. 18%), ventilator days (10 vs. 20), and antibiotic use (a 7% absolute reduction in antibiotic-days, from 69% to 62%). The study was unblinded (subglottic suctioning makes an audible noise).

維他命D3能預防慢性呼吸疾病發作 Vitamine D3 reduces exacerbation of COPD

維他命D3能預防慢性呼吸疾病發作

Vitamin D3 supplementation in patients with chronic obstructive pulmonary disease (ViDiCO): a multicentre, double-blind, randomised controlled trial

The vitamin was given in bolus doses of 3 mg (120,000 IU) six times, 2-monthly, over the course of a year.

including the fact that 87%, in total, had a vitamin D deficiency, defined as serum 25-hydroxyvitamin D levels less than 75 nmol/L, at baseline.

baseline vitamin D deficiency affected the time to exacerbation or infection and found that patients with baseline levels of less than 50 nmol/L had a reduced risk for moderate or severe exacerbation (AHR, 0.57; 95% CI, 0.35 - 0.92; P = .021) with vitamin D administration.

http://www.thelancet.com/…/PIIS2213-2600%2814%2970…/abstract

Vitamin D3 supplementation in patients with chronic obstructive pulmonary disease (ViDiCO): a...

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thelancet.com

留置式胸腔引流對良性肺積水也有成效 Indwelling pleural catheter for benign conditions

Indwelling pleural catheter as a treatment for benign conditions
e.g. congestive heart failure (CHF), hepatic hydrothorax, post lung transplants, post coronary artery bypass graft (CABG) surgery, and chronic exudative pleurisy




http://www.ncbi.nlm.nih.gov/pubmed/22898594

金雀花鹼 - 山草藥 同 西藥 相同戒煙效力, 但平好多

 

Golden rain tree, Laburnum anagyroides (courtesy: Wikipedia)

 

Cytisine for smoking cessation: as good as nicotine replacement — and cheap

Cytisine (金雀花鹼 )
"The lower price of cytisine as compared with that of other pharmacotherapies for smoking cessation may make it an affordable treatment to advance smoking cessation globally."
Cytisine is a pyridine-like alkaloid. Cytisine exhibits similar pharmacological effects to nicotine - the two molecules are structurally similar.

After a month, 40% of cytisine-takers reported continuous abstinence, compared to 31% of those getting nicotine replacement. The benefits held at 6 months, when 22% of those taking cytisine reported smoking abstinence compared to 15% of those using nicotine replacement.
 

 

今年流感針只有23%保護, 流行性感冒

今年流感針只有23%保護
H3N2 不同種類
科學家始終不善於瞎猜

建議醫生於48小時內採用抗流感葯物, 無論病者曾接受過預防針與否

Seasonal Influenza Vaccine Only 23% Effective This Year

Lara C. Pullen, PhD

January 15, 2015


- predominance of influenza A (H3N2) viruses
- overall vaccine effectiveness (VE) was 23%
- This interim VE estimate is relatively low compared with previous seasons when circulating viruses and vaccine viruses were well-matched and likely reflects the fact that more than two-thirds of circulating A (H3N2) viruses are antigenically and genetically different (drifted) from the A (H3N2) vaccine component of 2014–15 Northern Hemisphere seasonal influenza vaccines
-the need for ongoing influenza prevention and treatment measures.

http://news.yahoo.com/photos/chart-shows-percentage-flu-vaccine-efectiveness-2c-x-photo-222923144.html



http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6401a4.htm