Christopher Spitters

Recent Contributions

Reply to Injections and Deafness

April 3, 2013
Another option to consider for patients who are experiencing ototoxicity due to injectable drugs is interruption of the offending agent. This approach calls for exercise of clinical judgment and a risk-benefit analysis taking into account bacillary load at the time of the decision, extent of drug resistance, residual potency of ...

Reply to [ARCHIVED] Integrating M&E for Health Systems Strengthening

March 28, 2012
With regard to Sarah Gimbel's thoughtful contribution, please also consider the following quotes from DA Henderson: ³Real People, Real Solutions A public health preoccupation today seems to be the creation of ever-more elaborate technologies that harvest hitherto unimaginable quantities of data. ... It seems to me that it would be ...

Reply to smear negative, culture possitive mdr-tb

March 23, 2012
I do not know what the baseline CT showed, but that could shed light on your decision making. Other things to consider when there is a dissociation between laboratory and clinical or radiographic results include: false positive MTB culture (e.g., laboratory cross contamination), false resistance in DST results. Also consider ...

Reply to Smear positive/Culture negative

March 3, 2012
Smear-positive/culture-negative results are indeed a challenge to interpret and manage, especially in the absence of clinico-radiographic and mycobacteriologic history regarding the patients. Nevertheless, possible explanations include but may not be limited to: 1. continued expectoration of dead organisms beyond the period of true culture conversion (not uncommon in patients with ...

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