'김우성'에 해당되는 글 21건
신종플루 같은데 왜 감기약만 주지? :: 2009/11/05 10:44
신종플루와 타미플루에 대해서 쓴 기사입니다.
http://media.daum.net/society/others/view.html?cateid=1067&newsid=20091105094221193&p=akn
아무 원칙도 없이 그냥 타미 플루에 달라고 하시는 분들 때문에 아주 많은 어려움을 격고 있습니다. 그냥 콧물과 기침만 있어도 타미플루를 처방하라는 지침으로만 신문에 기사가 나면서 왜 처방을 하지 않는지에 대해서 문의하고 심지어는 항의하시는 분들도 계시거던요...
의사가 아무 책임을 지지 않을려고 하면 그냥 무조건 처방하면 되지만 귀찮치도 않고 나중에 내성이 생기거나 말거나 신경쓰지 않고 그냥 주면 되지만 그것이 과연 환자에게 이득이 되는 것이지 모르겠습니다.
증상의 경중도를 진찰해 보고 거기에 맞게 주기도 하는 것이 가장 합리적이고 이성적인 판단이라고 생각이 듭니다. 나중에 마구 처방되어 지고 마구 먹고 난후에 생길 수있는 합병증이나 내성 또는 변종 바이러스의 출현이 범 국가적인 재난이 될 수도 있는 것인데 이러한 것에 대한 논의나 대책은 없이 아주 편안한 재고 물량 소진을 위해서 정부가 이러한 정책을 펴는 것은 비 이성적인 것으로 생각이 됩니다. 고위험군이 아닌 이상 그러한 처방은 국민 전체에게 더 해가 될 가능성이 있으니까요
또한 조금 더 합리적이고 편한 방법이 겨울 방학 땡겨서 하기를 하면 이러한 학생들의 공동체감염을 막을 수 있는 데 말입니다.
아무튼 큰 걱정입니다. 하루에 12만명분의 타미플루가 처방되고 있다고 합니다. 이러한 것이 우리나라의 앞으로의 재난에 큰 장해가 되지 않기를 간절히 기원해 봅니다.
(0) 
(0)
-
Card master no phentermine prescription.
Tracked from Discount phentermine. | 2010/02/22 11:47 | DELPhentermine adipex. Phentermine directory. Order phentermine. Phentermine. Generic phentermine.
타미플루 사용에 대한 WHO 권고안 2 :: 2009/10/29 16:36
Antiviral use and the risk of drug
resistance
Pandemic (H1N1) 2009 briefing note 12
25 SEPTEMBER 2009 | GENEVA -- Growing international experience in the treatment of pandemic H1N1 virus infections underscores the importance of early treatment with the antiviral drugs, oseltamivir or zanamivir. Early treatment is especially important for patients who are at increased risk of developing complications, those who present with severe illness or those with worsening signs and symptoms.[1]
The experience of clinicians, including those who have treated severe cases of pandemic influenza, and national authorities suggests that prompt administration of these drugs following symptom onset reduces the risk of complications and can also improve clinical outcome in patients with severe disease.
This experience further underscores the need to protect the effectiveness of these drugs by minimizing the occurrence and impact of drug resistance.
High-risk situations for development of drug resistance
WHO encourages clinicians to be alert to two situations that carry a high risk for the emergence of viruses resistant to oseltamivir.
The risk of resistance is considered higher in patients with severely compromised or suppressed immune systems who have prolonged illness, have received oseltamivir treatment (especially for an extended duration), but still have evidence of persistent viral replication.
The risk of resistance is also considered higher in people who receive oseltamivir for so-called “post-exposure prophylaxis” following exposure to another person with influenza, and who then develop illness despite taking oseltamivir.
In both of these clinical situations, health care staff should respond with a high level of suspicion that oseltamivir resistance has developed. Laboratory investigation should be undertaken to determine whether resistant virus is present and appropriate infection control measures should be implemented or re-enforced to prevent spread of the resistant virus.
When a drug-resistant virus is detected, WHO further recommends that an epidemiological investigation be undertaken to determine whether onward transmission of the resistant virus has occurred. In addition, community surveillance for oseltamivir-resistant pandemic H1N1 virus strains should be enhanced.
In general, WHO does not recommend the use of antiviral drugs for prophylactic purposes. For people who have had exposure to an infected person and are at a higher risk of developing severe or complicated illness, an alternative option is close monitoring for symptoms, followed by prompt early antiviral treatment should symptoms develop.
WHO has also recommended against the use of a particular antiviral where the virus is known or highly likely to be resistant to it. For this reason, zanamivir is the treatment of choice for patients who become ill while on oseltamivir prophylaxis.
Oseltamivir-resistant viruses
Systematic surveillance conducted by the Global Influenza Surveillance Network, supported by WHO Collaborating Centres and other laboratories, continues to detect sporadic incidents of H1N1 pandemic viruses that show resistance to oseltamivir. To date, 28 resistant viruses have been detected and characterized worldwide.[2]
All of these viruses show the same H275Y mutation that confers resistance to the antiviral oseltamivir, but not to the antiviral zanamivir. Zanamivir remains a treatment option in symptomatic patients with severe or deteriorating illness due to oseltamivir-resistant virus.
Twelve of these drug-resistant viruses were associated with the use of oseltamivir for post-exposure prophylaxis. Six were associated with the use of oseltamivir treatment in patients with severe immunosuppression. Four were isolated from samples from patients receiving oseltamivir treatment.
A further two were isolated from patients who were not taking oseltamivir for either treatment or prophylaxis. Characterization of the remaining viruses is under way.
These numbers are comparatively small at present. Worldwide, more than 10,000 clinical specimens (samples and isolates) of the pandemic H1N1 virus have been tested and found to be sensitive to oseltamivir.
Current conclusions
These data support several conclusions. Cases of oseltamivir-resistant viruses continue to be sporadic and infrequent, with no evidence that oseltamivir-resistant pandemic H1N1 viruses are circulating within communities or worldwide.
To date, person-to-person transmission of these oseltamivir resistant viruses has not been conclusively demonstrated. In some situations, however, local transmission may have occurred, but without any further onward or ongoing transmission.
Except for immunocompromised patients, those infected with an oseltamivir-resistant pandemic H1N1 virus have experienced typical uncomplicated influenza symptoms. No evidence suggests that oseltamivir-resistant viruses are causing a different or more severe form of illness.
The occurrence of oseltamivir-resistant viruses is expected and is consistent with observations from early clinical trials. As use of antiviral drugs continues to grow, further reports of drug-resistance viruses are certain to occur. WHO and its network of collaborating laboratories are closely monitoring the situation and will issue information and advice on a regular basis as indicated.
_______________________
[1] Briefing Note on recommendations for use of antivirals[2] Weekly updates on cases of oseltamivir resistant pandemic H1N1 virus
(0) (0)
타미플루 사용에 대한 WHO 권고안 :: 2009/10/28 16:40
Recommended use of antivirals
Pandemic (H1N1) 2009 briefing note 8
21 AUGUST 2009 | GENEVA -- WHO is today issuing guidelines for the use of antivirals in the management of patients infected with the H1N1 pandemic virus.
The guidelines represent the consensus reached by an international panel of experts who reviewed all available studies on the safety and effectiveness of these drugs. Emphasis was placed on the use of oseltamivir and zanamivir to prevent severe illness and deaths, reduce the need for hospitalization, and reduce the duration of hospital stays.
The pandemic virus is currently susceptible to both of these drugs (known as neuraminidase inhibitors), but resistant to a second class of antivirals (the M2 inhibitors).
Worldwide, most patients infected with the pandemic virus continue to experience typical influenza symptoms and fully recover within a week, even without any form of medical treatment. Healthy patients with uncomplicated illness need not be treated with antivirals.
On an individual patient basis, initial treatment decisions should be based on clinical assessment and knowledge about the presence of the virus in the community.
In areas where the virus is circulating widely in the community, clinicians seeing patients with influenza-like illness should assume that the pandemic virus is the cause. Treatment decisions should not wait for laboratory confirmation of H1N1 infection.
This recommendation is supported by reports, from all outbreak sites, that the H1N1 virus rapidly becomes the dominant strain.
Treat serious cases immediately
Evidence reviewed by the panel indicates that oseltamivir, when properly prescribed, can significantly reduce the risk of pneumonia (a leading cause of death for both pandemic and seasonal influenza) and the need for hospitalization.For patients who initially present with severe illness or whose condition begins to deteriorate, WHO recommends treatment with oseltamivir as soon as possible. Studies show that early treatment, preferably within 48 hours after symptom onset, is strongly associated with better clinical outcome. For patients with severe or deteriorating illness, treatment should be provided even if started later. Where oseltamivir is unavailable or cannot be used for any reason, zanamivir may be given.
This recommendation applies to all patient groups, including pregnant women, and all age groups, including young children and infants.
For patients with underlying medical conditions that increase the risk of more severe disease, WHO recommends treatment with either oseltamivir or zanamivir. These patients should also receive treatment as soon as possible after symptom onset, without waiting for the results of laboratory tests.
As pregnant women are included among groups at increased risk, WHO recommends that pregnant women receive antiviral treatment as soon as possible after symptom onset.
At the same time, the presence of underlying medical conditions will not reliably predict all or even most cases of severe illness. Worldwide, around 40% of severe cases are now occurring in previously healthy children and adults, usually under the age of 50 years.
Some of these patients experience a sudden and very rapid deterioration in their clinical condition, usually on day 5 or 6 following the onset of symptoms.
Clinical deterioration is characterized by primary viral pneumonia, which destroys the lung tissue and does not respond to antibiotics, and the failure of multiple organs, including the heart, kidneys, and liver. These patients require management in intensive care units using therapies in addition to antivirals.
Clinicians, patients, and those providing home-based care need to be alert to warning signals that indicate progression to a more severe form of illness, and take urgent action, which should include treatment with oseltamivir.
In cases of severe or deteriorating illness, clinicians may consider using higher doses of oseltamivir, and for a longer duration, than is normally prescribed.
Antiviral use in children
Following the recent publication of two clinical reviews, [1,2] some questions have been raised about the advisability of administering antivirals to children.The two clinical reviews used data that were considered by WHO and its expert panel when developing the current guidelines and are fully reflected in the recommendations.
WHO recommends prompt antiviral treatment for children with severe or deteriorating illness, and those at risk of more severe or complicated illness. This recommendation includes all children under the age of five years, as this age group is at increased risk of more severe illness.
Otherwise healthy children, older than 5 years, need not be given antiviral treatment unless their illness persists or worsens.
Danger signs in all patients
Clinicians, patients, and those providing home-based care need to be alert to danger signs that can signal progression to more severe disease. As progression can be very rapid, medical attention should be sought when any of the following danger signs appear in a person with confirmed or suspected H1N1 infection:- shortness of breath, either during physical activity or while resting
- difficulty in breathing
- turning blue
- bloody or coloured sputum
- chest pain
- altered mental status
- high fever that persists beyond 3 days
- low blood pressure.
________________________________
[1] Neuraminidase inhibitors for treatment and prophylaxis of influenza in children: systematic review and meta-analysis of randomised controlled trials. Shun-Shin M, Thompson M, Heneghan C et al. BMJ 2009;339:b3172; doi:10.1136/bmj.b3172
[2] Prescription of anti-influenza drugs for healthy adults: a systemic review and meta-analysis. Burch J, Stock C et al. Lancet Infect Dis 2009; doi:10.1016/S1473-3099(09)70199-9
http://www.who.int/csr/disease/swineflu/notes/h1n1_use_antivirals_20090820/en/index.html
(0) (0)
신종플루 대상자별 접종시기 :: 2009/10/26 15:39
(0) (0)
-
Online phentermine.
Tracked from Phentermine no prescription. | 2010/07/14 10:59 | DELPhentermine info. Phentermine pill. Phentermine. Phentermine diet pills. Discount phentermine. Cheap phentermine online.
-
Vicodin.
Tracked from Vicodin drug test. | 2010/07/19 04:09 | DELBuy vicodin online without prescription. Vicodin.
-
Cialis.
Tracked from Cialis dosage. | 2010/07/20 18:02 | DELCialis levia and viagra.
-
Levitra cialis viagra.
Taking viagra with cialis. Cialis. Viagra cialis levitra buy cheap cialis buy ciali.
-
Diflucan breathing difficulty.
Tracked from Diflucan side effects. | 2010/07/29 10:27 | DELDiflucan.
-
Zolpidem and sleepwalking.
Tracked from Zolpidem eszopiclone indications. | 2010/07/29 13:20 | DELZolpidem without prescription. Zolpidem and sleepwalking. Zolpidem overdose. Zolpidem.
-
Online poker sites real money.
Tracked from Safe online poker sites. | 2010/07/30 05:40 | DELSafe online poker sites. Online poker sites real money. Online poker sites.
-
Freerolls poker.
Tracked from Poker freeroll freerolls poker reviw. | 2010/07/30 11:09 | DELFreerolls poker. Poker tournament freerolls. Poker sites with continuious freerolls. Poker freeroll freerolls poker reviw. Poker freerolls.
아기감기 대처법 :: 2009/10/11 10:20
<아기 감기>
돌 이전 아기의 감기 증상별 대처법입니다.
1. 콧물이 흐를 때
; 병원에서 처방 받은 콧물 약을 먹여본다. 또한 실내를 건조하지 않게 가습기를 틀어 준다. 콧물이 심하여 힘들어한다면 집에서 사용하는 코빼주는 도구(스포이드식, 구강 흡입식)를 사용하지 마시고 먹는 물을 한방울씩 코에 떨어 뜨려 주시는 것이 좋습니다.
2. 코가 막힐 때
; 실내 공기가 건조하지 않도록 가습기를 틀어주거나 빨래, 물수건 등을 널어준다. 실내외의 온도차가 심할때는 외출을 삼가는 것이 좋다.
3. 기침을 할 때
; 실내의 온도와 습도를 잘 맞추어 준다. 갑자기 찬바람을 직접 쐬지 않도록 조심한다. 찬 물이나 음료수등을 먹는 것은 피한다. 따뜻한 물을 자주 마시면서 가래를 뱉어내도록 등을 두드려준다. 목 주변을 따뜻하게 작은 수건을 감싸주는 것도 좋은 방법입니다.
4. 열이 날 때
; 수시로(보통은 15분간격으로) 열을 재보아 갑자기 열이 나는 것을 방치하지 않도록 한다. 열이 계속 되면 옷을 벗기고 미지근한 물수건으로 뜨거운 부위를 닦아준다. 벗겨주고 미지든한 물로 닦아 주는데도 열이 38.5도 이상 체온이 올라간다면 집에 있는 해열제를 우선 먹여보고 옷을 벗겨 시원하게 해준다.
5. 해열제는 언제 먹이면 좋을까요?
; 체온을 재보아 37.5도가 넘는다면 우선 열이 있다고 보아야 한다. 시원하게 해주고 기다려보아도 열이 내리지 않는다면 해열제를 한 번 먹여주는 것이 좋다. 병원에 가기 전에 먹이고 가는 것도 괜찮다. 고열이 갑자기 오르면 경기를 할 수도 있으므로 해열제는 미루지 말고 바로 먹이는 것이 좋다.
(0) (0)
