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自发性细菌性腹膜炎的抗生素治疗 2015年5月13日
Question 问题：
Spontaneous bacterial peritonitis is diagnosed when the ascitic fluid absolute polymorphonuclear leukocyte count is at least 250 cells/mm3. What is the proper antibiotic treatment for SBP?
当腹水中绝对中性粒细胞计数超过250/ mm3时，可以确诊为自发性细菌性腹膜炎（SBP）。什么是对SBP的正确抗生素治疗？
Answer 答案:
IV 3rd generation cephalosporin (cefotaxime 2g Q 8 hrs or ceftriaxone 2g Q 24 hrs). PO of loxacin 400 mg BID may be used in hospitalized patients without shock, hepatic encephalopathy, renal dysfunction or prior quinolone use.
静脉第三代头孢菌素（2克头孢噻肟，每8小时一次或2克头孢曲松，每天一次）。 没有休克，肝性脑病，肾功能不全或使用过喹诺酮类药物住院患者可以口服氧氟沙星400毫克，每天两次(Clin Liver Dis,4/15,100)。
肝硬化腹水与预后的关系 2015年5月14日
Question 问题：
Patients with ascites frequently present to the ED. The development of ascites in the setting of cirrhosis represents a landmark in the natural history of cirrhosis. Why? In other words, how does the development of ascites determine prognosis?
有腹水患者会经常到急诊科就诊。肝硬化患者出现腹水是肝硬化病情发展的一个标志。为什么呢？换句话说，腹水的出现如何判断预后哪？
Answer 答案:
The development of ascites in the setting of cirrhosis predicts a poor prognosis, with 50% mortality within 3 years.
肝硬化出现腹水后提示不良的预后，3年之内的死亡率将为50％(Ther Adv Chronic Dis.2015 May; 6: 124)。
多形性红斑原因 2015年5月15日
Question 问题：
Erythema multiforme is an acute hypersensitivity reaction with a characteristic rash: an erythematous ring or target lesion with a dusky or pale center. Infections and drugs are the most common causes. What are the 2 most common infectious causes?
多形性红斑是一种有特征性皮疹的急性过敏反应：环形红斑或中心暗淡或苍白的靶行病变。感染和药物是最常见的原因。2个最常见的感染原因是什么？
Answer 答案:
Herpes simplex virus and mycoplasma pneumonia are the most commonly cited infectious causes.
单纯疱疹病毒和肺炎支原体是感染性原因中最常见的(Ann of EM, Vol. 64, pg. 119)。
急性鼻窦炎抗生素的应用 2015年5月16日
Question 问题：
Only 0.5-2.0% of acute sinusitis cases have a bacterial etiology; studies confirm that 60% of presumed acute bacterial sinusitis cases resolve spontaneously. Despite this evidence, antibiotics are prescribed in what percent of acute sinusitis cases?
只有0.5-2.0％的急性鼻窦炎病例由细菌引起；研究证实，60％疑为急性细菌性鼻窦炎病例可以自行缓解。尽管这样，急性鼻窦炎病例中给予抗生素的百分比是多少？
Answer 答案:
Antibiotics are prescribed in 81% to 92% of acute sinusitis cases. 81－92％急性鼻窦炎病例用过抗生素(Mayo Clin Proc, 5/11,pg. 427)。
小儿哮喘持续状态与ECMO 2015年5月17日
Question 问题：
The use of ECMO in status asthmaticus has been a successful option for severe acute respiratory failure and when mechanical ventilation becomes unmanageable due to lung hyperinflation and auto-PEEP. Can ECMO be used for pediatric status asthmaticus?
当哮喘持续状态病人出现严重急性呼吸衰竭和由于肺过度充气或自动PEEP导致机械通气难以管理时，ECMO已成为一个成功的选择。 ECMO能用于小儿哮喘持续状态吗？
Answer 答案:
ECMO has become a vital tool in the management of pediatric acute respiratory failure. Pediatric patients in status asthmaticus placed on ECMO have had a reversal of hypercapnia and acidosis in as little as 2-4 hrs of treatment .
ECMO已成为小儿急性呼吸衰竭抢救的一个重要工具。哮喘持续状态儿童患者在使用ECMO2-4小时内就可以纠正高碳酸血症及酸中毒(JEM, epub, 5/15/15)。 |
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