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,按一下以編輯母片標題樣式,*,按一下以編輯母片,第二層,第三層,第四層,第五層,實證醫學討論會,Angiotensin II receptor blockade reduces new-onset atrial fibrillation and subsequent stroke compared to atenolol The Losartan Intervention For End point reduction in hypertension(LIFE)study,Journal of the American College of Cardiology,Volume 45,Issue 5,1 March 2005,Pages 712-719,Dr.,林百揚96.11.15,實證醫學討論會Angiotensin II receptor,1,Case Presentation,Name：林鳳X,病歷號：26421134,年紀：47 y/o,性別：Female,Case PresentationName：林鳳X,2,Chief Complaint,Palpitation at night in 2007/11/6,Chief ComplaintPalpitation at,3,Present Illness,chills and fever for 4-5 days,accompanied with dizziness,head heavy sensation,neck stiffness,poor appetite,and bil.flank soreness,Present Illnesschills and feve,4,Lab data at ER,WBC：15500,CRP:217.8,Na：124.6,K：2.83,U/A:WBC:70-80/HPF,Lab data at ER,5,Personal History,Allergy:denied,1.Medical history：,Hypertension：nil,Diabetes mellitus：nil,Others：Visual field defect.,2.Surgical history：s/p C/S,Personal HistoryAllergy:denied,6,Physical Examination,Conscious:clear,TPR=36.7/,140160,/18,BP=135/92,Abd:,Flat,no striae,no engorged vein,Soft,no rebound pain,Physical ExaminationConscious:,7,EKG,2007/11/2,Normal Sinus Rhythm,2007/11/6,Atrial fibrillation,EKG2007/11/2,8,Impression,New onset of atrial fibrillation,ImpressionNew onset of atrial,9,Clinical Problems,What is the treatments for a patient of,new onset,of,atrial fibrillation,Clinical ProblemsWhat is the t,10,P,atient and/or problem,:,誰是相關的病人，是否具有何種問題？,I,ntervention/or exposure,：有興趣的治療處置、診斷工具或暴露因子為何？,C,omparison(if relevant),：如果有的話，對照組的處置、診斷工具或暴露因子為何？,O,utcomes,：與病人最相關之（可測量）結果是什麼？,Patient and/or problem:誰是相關的,11,PICO,P,atient and/or problem,:Atrial fibrillation,I,ntervention/or exposure,:EKG and EKG monitor,C,omparison,:new onset Af(no Af v.s.Af),etiology,O,utcomes:the preferable treatments,PICOPatient and/or problem:A,12,Key words 以Cochrane為例,#1 atrial fibrillation,#2 treatments,#3 etiology,#4 new onset,#1 and#2 and#3 and#4 11 results,Key words 以Cochrane為例#1,13,Key words 以Cochrane為例,#1 atrial fibrillation,#2 treatments,#3 comparison,#4 new onset,#1 and#2 and#3 and#4,PUBMED 16265553,Key words 以Cochrane為例#1 atri,14,Search Result,Can losartan prevent new-onset atrial fibrillation in hypertensive patients more effectively than atenolol?,PUBMED 16265553,Link:,http:/ ResultCan losartan prev,15,Then,Angiotensin II receptor blockade reduces new-onset atrial fibrillation and subsequent stroke compared to atenolol The Losartan Intervention For End point reduction in hypertension(LIFE)study,Journal of the American College of Cardiology,Volume 45,Issue 5,1 March 2005,Pages 712-719,http:/ II receptor b,16,Thank You For Listening!,Thank You For Listening!,17,
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