แนวทางเวชปฎิบัติการรักษาวัณโรคในผู้ใหญ่...
DESCRIPTION
แนวทางเวชปฎิบัติการรักษาวัณโรคในผู้ใหญ่ พ.ศ.2555 (พิมพ์ครั้งที่2 ฉบับปรับปรุงเพิ่มเติม)TRANSCRIPT
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1
ISBN : 978-616-11-1839-6 2 ()
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.. 2555
1 2555 5,000
2 2556 5,000()
12812
.10400
1281
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116()
.10120
ISBN 978-616-11-1839-6
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77 .. 2463 2 ..253619..2553 22 80 22 22
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22
..2555
80,000 119
30
5
22
.. 2555 86,000
12430
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..2555 () ()..2555
.. 2555
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1.
1.1
1.2
1.3
1.4
1.5
1.6
1.7
1.8
1.9
1.10
1.11
1.12
1.13
1.14
1.15
1.16()
1.17
1.18
1.19
1.20
1.21
2.
2.1
2.2
2.3
2.4
2.5
2.6
.. 2555
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2.7
2.8
2.9
2.10
2.11
2.12
2.13
2.14
2.15
2.16
2.17
2.18
2.19
2.20
3.
3.1
1)
2)
3.2
1)
2)
3)
4)
5)
6)
7)
8)
9)
10)
11)
12)
13)
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AFB Acid-fastbacilli
AIDS Acquiredimmunodeficiencysyndrome
ALT Alaninetransaminase
ART Antiretroviraltherapy
AST Aspartatetransaminase
Cs D-cycloserine
CSF Cerebrospinalfluid
CXR ChestX-ray
DOT Directlyobservedtherapy
DST Drugsusceptibilitytesting
DRTB Drug-resistanttuberculosis
E,EMB Ethambutol
Eto Ethionamide
EPTB Extrapulmonarytuberculosis
FDC Fixed-dosecombination
FLDST First-linedrugsusceptibilitytesting
H,INH Isoniazid
HIV Humanimmunodeficiencyvirus
INF Interferon
IGRA Interferon-gammareleaseassay
Km Kanamycin
Lfx Levofloxacin
MDRTB Multidrug-resistanttuberculosis
MTB Mycobacteriumtuberculosis
NNRTIs Non-nucleosidereversetranscriptaseinhibitors
NRTIs Nucleosidereversetranscriptaseinhibitors
NTM Non-tuberculousmycobacterium
NTP Nationaltuberculosiscontrolprogramme
PAS Para-aminosalicylicacid
PCR Polymerasechainreaction
(Abbreviation)
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PIs Proteaseinhibitors
PMN Polymorphonuclearcell
PTB Pulmonarytuberculosis
PTB+ Sputumsmearpositivepulmonarytuberculosis
PTBneg. Sputumsmearnegativepulmonarytuberculosis
RapidDST Rapiddrugsusceptibilitytesting
R,RMP Rifampicin
RT-PCR Real-timePCR
SLDST Second-linedrugsusceptibilitytesting
S,SM Streptomycin
SSC Standardshort-coursechemotherapy(2HRZE/4HR)
TAD Treatmentafterdefault
TAF Treatmentafterfailure
TB Tuberculosis
TB/HIV HIV-relatedTB
TST Tuberculinskintest
WHO Worldhealthorganization
XDRTB Extensivelydrug-resistanttuberculosis
Z,PZA Pyrazinamide
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(strength of recommendation)
++ (strongly recommend)
(costeffective)
+ (recommend)
+/- (neither recommend nor against)
- (against)
- - (strongly against)
(quality of evidence)
I
(systematic review)
(randomize-controlledclinicaltrials)
(well-designed,randomize-controlled,clinicaltrial)1
II
(systematic review)
(non-randomized,controlled,clinicaltrials)
(well-designed,non-randomized,controlledclinicaltrial)
(Strength of Recommendation and Quality of Evidence)
-
(cohort)
(casecontrolanalyticstudies)
/
(multiple time series)
..2480
III
1)(descriptivestudies)
2)(fair-designed,
controlledclinicaltrial)
IV
1)
(consensus)
2)
2
V
(anecdotalreport)
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.. 2555
.. 2555
(ABBREVIATION)
(STRENGTHOFRECOMMENDATIONANDQUALITYOFEVIDENCE)
1
1 3
2 5
2.1 5
2.1.1 5
2.1.2 5
2.1.3 6
2.1.4 tuberculinskintest,interferongammareleaseassays(IGRA) 7
2.2 10
2.2.1 10
2.2.2 10
2.2.3 13
2.2.4 18
(treatmentafterinterruption)
2.2.5 19
(organizationoftuberculosistreatmentunit,TBClinic)
3 23
3.1 23
3.2 26
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4 (first-lineanti-tuberculosisdrugs;FLD) 29
4.1 29
4.2 30
4.3 31
4.4 35
5 37
5.1/ 37
5.2 40
5.3 40
5.4 41
43
1 44
1.1 44
1.2 47
2 48
3 rapid molecular testing 49
4 51
2556
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1 ..2010-2012 1
..2011
2 12
3 13
4 16
(Re-treatmentregimenwithfirst-linedrugs)
5 23
6 24
7 25
8 26
(Standardshort-coursechemotherapy;SSC)
9corticosteroid 27
10 29
11 32
12 39
(Primaryprophylaxis)CD4
13 41
creatinineclearanceE
H
H
R
4.3.1
3
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33
4
(++,III)
maculopapular rash
prednisolone
systemicsteroidprednisolone40-60
o HREZ
o 1/3 1/2
2-3
o
4.3.2 /
H,RZbilirubin
AST/ALTR
> 60
(++,III)
55.2
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34
4
(++,III)
AST/ALTtotalbilirubin(TB)
AST/ALTTB1-21
(++,III)
AST/ALT 3
H,RZE,quinolone,streptomycin
AST/ALT < 3
3
(++,III)
TB > 3 ./ AST/ALT 3
R
AST/ALT 5
H,RZE,quinolonestreptomycin
AST/ALT < 5
1
re-challenge (++,II)
fulminant hepatitis
AST/ALT