k**i
发帖数: 10191 | 1 目前该帖尚未被删除。https://mp.weixin.qq.com/s/U_Jo0KteTRgK4eLVQAn7Wg?dt_
dapp=1
目前有近200（还在上升）名婴儿痉挛症病患家长发现自己孩子发病与接种疫苗有直接
关系，所有证据指向武汉生物和长春长生两家疫苗生产厂家，以下是所有案例详情：
1
（我自己的孩子）广东省广州市疫苗受害者闵天诚，家长：闵文（信息收集者，群主松
松爸1010粤@4），联系方式：18665739973。
出生于2010年10月30日，2011年3月15日在广州白云区石井街道接种（武汉生物 批号：
20100102-4）百白破疫苗后当天孩子出现发烧（当时有问过防疫站接种人员，说是正常
反应，我们就没有太在意。）
连续3天高烧不退，第三天出现轻微点头症状，并持续每天都出现轻微点头，当时并没
有在意，以为孩子只是在玩。
后来越来越严重，出现成串点头拥抱状痉挛发作，后于4月底在安徽省立儿童医院确诊
婴儿痉挛症，并于2011年5月2日在佛山高明脑病研究院开始接受治疗。
孩子今年8岁，虽然发作最终控制，但至今智力发育严重落后，无法说话，无法正常上
学，只能就读于特殊儿... 阅读全帖 |
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o***s
发帖数: 42149 | 2 “我侄子得了幼儿痉挛，请大家帮忙找一种药，厂家是上海第一生化药业有限公司，中文名：注射用促皮质素（ACTH）。”近日，网友“@胖迪胖迪我是胖小黄”在微博上求助，想买这种药物。据了解，这种药对幼儿痉挛症的治疗效果很好。今年6月1日国家药价放开以前，对这种药物的价格控制在7.9元一支，是典型的廉价药。然而现代快报 (微博)记者调查发现，近年以来，这种药物在全国各地都处于“买不到”的状态，在黑市上已经飙升到3800元一盒的天价。但在与厂家的交谈中，记者却了解到，这种药物目前库存超过5万支，完全不能说是紧缺。
究竟是哪个环节“堵住了”，使得完全富余的库存药品无法正常抵达患者的手中？现代快报记者展开了调查。
现代快报记者 吴怡
背景
治宝宝痉挛的廉价药:
一盒十支仅76元
注射用促皮质素，简称ACTH，在几年前，它其实并没有这么火。根据解放军八一医院药剂科主任周永刚介绍，它是一种激素，适应症为活动性风湿病、类风湿性关节炎、红斑性狼疮等胶原性疾患，由于同类的替代药物很多，因此过去并不受到重视，医院本身也进货量不多。
而近年来，有临床发现这种ACTH药物，能够有效治疗婴儿痉挛症，而且价格低廉，国家发... 阅读全帖 |
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d****y
发帖数: 2180 | 3 ☆─────────────────────────────────────☆
zhu84518 (lot) 于 (Wed Aug 8 22:41:34 2012, 美东) 提到:
A previously healthy 32-year-old woman who works as a nurse comes to the
emergency department because of a 3-week history of episodes of dizziness,
nausea, and profuse sweating that resolve with eating. She does not smoke.
She drinks four glasses of wine weekly. Vital signs are within normal limits
. Physical examination shows no abnormalities. While in the emergency
department, she becomes dizzy and... 阅读全帖 |
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h*******y
发帖数: 1220 | 4 Steps are:
1. Low dose dex (sensitive but not specific) to exclude; if (-), stop; if (+
):
2. 24 h cortisol / urine (expensive but specific); if (-): look for other
reasons such as stress...; if (+):
3. High dose dex:
positive: adrenal or puituitary adenoma
--high ACTH = pituitary = MRI;
--low ACTH = adenoma of adrenal gland;
Negative high dose = small cell carcinoma (high ACTH) or adrenal Ca (low
ACTH). |
|
w*********g
发帖数: 30882 | 5 来源: austraveller 于 2018-07-26 07:28:55 [档案] [博客] [旧帖] [给我悄悄话]
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[转帖]仅几个群就有近200例注射疫苗导致婴儿癫痫
[转帖]仅几个群就有近200例注射疫苗导致婴儿癫痫
【铁证如山！所有证据指向武汉生物和长春长生！近200例接种疫苗后导致婴儿痉
挛症真实案例！】 ———（信息收集人： 群主 闵文（松松爸1010粤@4），电话
18665739973，QQ337634432，微信：huotian）
婴儿痉挛症是一种小儿难治性癫痫，该病死亡率13%，预后90%智力低下。目前有近
200名婴儿痉挛症病患家长发现自己孩子发病与接种疫苗有直接关系，所有证据指向武
汉生物和长春长生两家疫苗生产厂家，以下是所有案例详情：
1、辽宁省本... 阅读全帖 |
|
h**s
发帖数: 1757 | 6 You r right, however what u discribed is primary Addision's disease. If I
mean primary Addision's, the patient should have high pigmentation which
means low cortisol high ACTH. Obviously not this case. That is why we won't
go to answer A.
Then, u can think may secondary Addision's disease. That is the disease of
pituitary. Then low ACTH , low Cortisol. Patient won't have high
pigmentation due to low ACTH . Right?
Usuarally, in an emergency situation, cortisol ,as a very important hormone,
should... 阅读全帖 |
|
z*******4
发帖数: 285 | 7 算了，你脑子大概也被活摘过
懒得跟你解释，贴个清单吧：
累计研究数量 注册号 注册日期 研究者单位 研究者单位（英文） 注
册题目 注册题目（英文) 预计纳入参试者日期
1 ChiCTR2000029308 1/23/2020 武汉市金银潭医院（武汉市传染病医院）
Wuhan Jinyintan Hospital (Wuhan Infectious Diseases Hospital) 一项评价
洛匹那韦/利托那韦和干扰素-α2b联合治疗武汉新型冠状病毒肺炎(COVID-19)住院患者
的疗效和安全性随机、开放、空白对照的研究 A randomized, open-label, blank-
controlled trial for the efficacy and safety of lopinavir-ritonavir and
interferon-alpha 2b in hospitalization patients with novel coronavirus
pneumonia (COVID-1... 阅读全帖 |
|
t********h
发帖数: 413 | 8 国内朋友的儿子从出生就有这个病, 但现在已经两岁半了, 还没有最终确疹是什么病,
家人在国内, 台湾(妈妈是台湾人),看了很多医生都没用. 我把症状写下来, 请大家看
看, 哪位医生朋友遇到过这样的情况, 是什么病, 美国哪家医院治疗最好. 先谢过了!
因为不懂医学,症状都是朋友MSN发给我的,我就照搬了, 如果有什么问题, 我再去问.
朋友考虑一旦经济条件允许, 就来美国看看.
************************************
症状是出生的时候全身皮肤黑
嗜睡
不吃奶
后来还没发病的时候送进医院检查
有代谢性酸中毒, 电解质紊乱
怀疑是CAH,先天性肾上腺皮质增生
后来做过基因检测和2年左右的血液指标跟踪，判断不是这个病
现在的主要问题是，每次检查ACTH都高，不在正常范围内
孩子的肠胃功能不好，经常会过段时间就吃坏肚子了
医生一直让孩子吃氢化可的松,从出生就吃, 但ACTH还是偏高.
孩子身高体重偏下
父母和孩子都没有基因缺陷和突变
**************************************
谢谢! |
|
t********h
发帖数: 413 | 9 发在医学版了, 转过来, 说不定有爸爸妈妈们见过类似的病历.多谢.
发信人: tradtofash (多点时间睡觉), 信区: Medicine
标 题: [求助]请医生朋友帮忙看看
发信站: BBS 未名空间站 (Fri Dec 30 01:42:38 2011, 美东)
国内朋友的儿子从出生就有这个病, 但现在已经两岁半了, 还没有最终确疹是什么病,
家人在国内, 台湾(妈妈是台湾人),看了很多医生都没用. 我把症状写下来, 请大家看
看, 哪位医生朋友遇到过这样的情况, 是什么病, 美国哪家医院治疗最好. 先谢过了!
因为不懂医学,症状都是朋友MSN发给我的,我就照搬了, 如果有什么问题, 我再去问.朋
友考虑一旦经济条件允许, 就来美国看看.
************************************
症状是出生的时候全身皮肤黑
嗜睡
不吃奶
后来还没发病的时候送进医院检查
有代谢性酸中毒, 电解质紊乱
怀疑是CAH,先天性肾上腺皮质增生
后来做过基因检测和2年左右的血液指标跟踪，判断不是这个病
现在的主要问题是，每次检查ACTH都高，不在正常范围内
孩子的肠胃... 阅读全帖 |
|
s********3
发帖数: 231 | 10 《科学》对STAP手稿的专家评审意见曝光
《科学》对传说中的STAP细胞论文的三名评审专家意见，过去一直被雪藏，今天终于
被曝光。专家对这一研究的评价不高，认为非常全面的描述性研究，如果结果确定，可
能导致发育生物学大厦的颠覆，其实是不相信这种研究结论。因为没有当时的投稿件，
所以没有办法对这些评价进行更深入分析。不过这些资料显然都在某个地方，只是拥有
的人不愿意拿出来。
Retraction Watch readers are of course familiarwith the STAP stem cell saga,
which was punctuated by tragedy last month whenone of the authors of the
two now-retracted papers in Nature committed suicide.
In June, Science‘s news section reported:
Sources in the scientific community confirm that early version... 阅读全帖 |
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D*********t
发帖数: 140 | 11 I agree with hmis! First, the low limit of C peptide level together with a
high limit insulin level rules out insulinoma. This is because C peptide is
cleaved from proinsulin together with insulin and thus it should be always
parallel to the insulin level. Second, I think the possibility of pituitary
disease is the low level of cortisol. In hypoglycemia condition, cortisol
should be increased as response to stress. But cortisol in this patient is
still in low limit, indicating a failure to respo... 阅读全帖 |
|
f******I
发帖数: 769 | 12
cortisol level should be low at night, its productions peak in early morning
and nadir at night, it's regulated by ACTH, why do you have it checked at
fist place anyway? |
|
f******D
发帖数: 332 | 13 同学 女儿才4岁 脑瘤3年了 由于化疗太多 现在只能吃药治疗但是国内没有这方面的
药可以吃
有谁知道美国有什么 吃了可以控制脑垂体内“促肾上腺皮质激素”的分泌
的药吗 只要药名就好了
谢谢大家了 |
|
|
T*C
发帖数: 5492 | 15 Orphan Label
"qualify for tax credits for certain clinical testing expenses and for a
seven-year exclusivity period during which the FDA is prohibited from
approving any other ACTH formulation for IS unless the other formulation is
demonstrated to be clinically superior to Acthar or is considered by the FDA
to have an active ingredient that is different from the active ingredient
of Acthar. " |
|
l**a
发帖数: 12455 | 16 这是允许服用医生开的一定剂量的某种药物的单子，
Betamethasone is a steroid medication.[1] It is used for a number of
diseases including rheumatic disorders such as rheumatoid arthritis and
systemic lupus erythematosus, skin diseases such as dermatitis and psoriasis
, allergic conditions such as asthma and angioedema,
第二个是一种测试剂
Tetracosactide is used to test if the adrenal glands are functioning
correctly.
Tetracosactide acts on the adrenal glands in the same way as natural ACTH.
This means if the adrenal glands are hea... 阅读全帖 |
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b******z
发帖数: 387 | 17
jaudice
with
high dosage applied,
wonder if this is ACTH (ADRENOCORTICOTROPIC HORMONE), which has another name
corticotropin; or natural/synthetic corticosteroids, which might generally
used. sorry, cant recall more, just for information confirmation. go ahead to
make it sure. it shoudnt be hard.
immune system suppression
better know the exact effective composition of the medicine, otherwise, dont
make sense.
|
|
e******e
发帖数: 364 | 18 41. During a routine examination, a 20-year-old man is found to have a
firm, bilaterally enlarged thyroid gland and lymphadenopathy. His father
died of thyroid cancer at the age of 40 years. Which of the following
hormones is most likely associated with this patient's findings?
O A) ACTH
O B) ADH (vasopressin)
O C) Aldosterone
O D) Calcitonin
O E) Growth hormone
O F) G3-hCG
O G) Insulin
O H) Parathyroid hormone
O I) Thyroid-stimulating hormone
0 J) Thyroxine (T4)
Why it is D? |
|
s*h
发帖数: 1538 | 19 A 60 y.o. man with a history of a small cell lung cancer comes to the
physician complaining of confusion, constipation, and lethargy. He was
diagnosed wit metastatic lung cancer four months ago, and has since had high
-dose chemotherapy and radiation for treatment of lymphadenopathy in his
neck. His physician suspects a paraneoplastic syndrome, which is most likely
due to secretion of a hormone-like substance analogous to which of the
following?
A. ACTH
B. Calcitonin
C. Growth hormone
D. PTH
E. ... 阅读全帖 |
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s********o
发帖数: 3319 | 20 thanks for clarifying it.
actually this is not a good Q. in step 1, small cell lung cancer produces
ACTH or ADH.
PTHrp comes from squamous cell cancer. |
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J*********4
发帖数: 1274 | 21 Thank great discussion from both of you. hmis, I agree with you on most of
thing. But the question ask here is " what tumor" is most likely. Can you
think of a pituitary tumor that reduce level of ACTH?
I think what the question here limited a lot of possibilities.. and in
reality, there are more scenario...
|
|
e****0
发帖数: 678 | 22 • leukemia
ALL AML CLL
child adult elderly
BM lymphoblasts 25%myeloblasts
lab Lymphocyte 5000, mature-appearing cells
• Osgood-schlatters disease
Adolescent male athletes
Traction apophysitis—quadriceps tendon put the traction on the
apophysis of the tibial tubercle where patellar tendon inserts.
A firm mass =heterotopic bone formation
Pain can be reproduced by extending the kne... 阅读全帖 |
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m*********s
发帖数: 56 | 23 On Ln 12, PP 120 of MTB2, "Once the ACTH level is elevated and does NOT
suppress with high dose dexamethasone, scan the brain with an MRI". I think
the "NOT" should not be there. How do you think? |
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f*****y
发帖数: 464 | 24 同意楼主。而且这句话本身就说得不对，明明是cortisol被suppressed,怎么变成ACTH
被suppressed了？
查了一下老版MTB，是没有这半句话的。
think |
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t********o
发帖数: 228 | 25 Just found out i passed it. Well, not a big surprise and finally, I can say
good by to USMLE
Material: MTB3 and UptoDate. Step 1/Step2: 250/249 but those were 3 years
ago. Step 3: 227. Time: on/off for 3 months.
Good luck to everybody.
Not a whole lot of thoughts about this test. if you can memorize MTB3 and UW
, then there should be NO problem to pass it.
here are some thoughts about this CCS (combined mine and others)
Step I: patients: VASCULAR
Vitals/Age/Sex/Chief complaint/Urgent sympt... 阅读全帖 |
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j*****o
发帖数: 137 | 26 41. During a routine examination, a 20-year-old man is found to have a firm,
bilaterally enlarged thyroid gland and lymphadenopathy. His father died of
thyroid cancer at the age of 40 years. Which of the following hormones is
most likely associated with this patient's findings?
A) ACTH
B) ADH (vasopressin)
C) Aldosterone
D) Calcitonin
E) Growth hormone
F) G3-hCG
G) Insulin
H) Parathyroid hormone
I) Thyroid-stimulating hormone
J) Thyroxine (T4)
What is the answer and desease on this patient? |
|
A**********9
发帖数: 151 | 27 请版上同学帮忙看看这两道题。
1. A 16-year-old boy is brought to the physician for a routine examination.
He has a lifelong history of developmental delays and unusual movements such
as hand flapping. He has a meager vocabulary. Two maternal uncles have
mental retardation. Physical examination shows coarse facial features and
macro-orchidism. DNA testing shows an expansion of a trinucleotide repeat.
The patient comes from a family of four daughters. If the parents appear
healthy, on
average how many of their d... 阅读全帖 |
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m****9
发帖数: 48 | 28 A 3-year-old woman has her pituitary stalk inadvertently transacted during
an operation to remove a tumor adjacent to the hypothalamic area. Secretion
of which of the following pituitary hormones is most likely to be increased
in this patient as a result of the transection?
A) ACTH
B) Growth Hormone
C) Luteinizing hormone
D) Prolactin
E) TSH |
|
A*******s
发帖数: 9638 | 29 我google了一下， 希望有所帮助：
Most neonates with hypopituitarism have normal or even high birth weights
and lengths and no history of intrauterine growth retardation. However, they
often have histories of breech presentation (particularly neonates with
MPHD), although the explanation for this is unclear. Microgenitalia, mainly
in males, may result from a gonadotropin deficiency or from GH deficiency.
The hypoglycemia risk is higher in neonates with hypopituitarism, with
various manifesting symptoms, such ... 阅读全帖 |
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a*********d
发帖数: 2763 | 30 first, have to make sure she actually has hypoglycemia, include document low
blood glucose, symptoms with hypoglycemia which resolves after hypoglycemia
corrected.
if confirmed, she needs complete work up for hypoglycemia, her hyperglycemia
can be a reactive glucose due to the hypoglycemia. insulin, c-peptide,
sulfonylurea screen, etc. sometimes 72 hour fasting is needed.
if hypoglycemia without hyperinsulinemia was found, should get ACTH stim
test to rule out adrenal insufficiency.
the most dif... 阅读全帖 |
|
b******a
发帖数: 704 | 31 more detail of the CBC, blood smear exam? BMP? blood vitamin B12 level?
any exam on the endocrine hormones, like ACTH level? just my wild guess. |
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d**o
发帖数: 618 | 32 CBC and BMP done a week before the visit were normal except for the results I listed. Fasting glucose on the BMP was 96. Random glucose in the clinic, at the moment of encounter, was 160. This was in the afternoon and pt had lunch.
Vit B12 and folic acid were not available at this encounter, but were measured later and found out normal. As for ACTH ... let me make it clear, this is an outpatient encounter, and you as PCP need to tell the pt something before you have all the fancy tests you want.... 阅读全帖 |
|
|
M***D
发帖数: 249 | 34 有时产后严重感染能引起腺垂体功能减退，你太太的primary care physician有没有给
她查TSH, 甲状腺激素, ACTH或肾上腺激素...等等这些激素水平？ |
|
o**********n
发帖数: 10 | 35 来自主题: Neuroscience版 - 急！求助！ 发现孩子delay了，随后六个月的时候开始有spasms，诊断为infantilespasms。一线的
药都用过了。两轮acth，spasms控制住了。可是孩子还是不笑，连自己的头也支撑不住
。mri，spinal tap，metabolic，都查过了。还需要查什么，或者有推荐的医院医生吗
？现在ucla看。 |
|
