c****r
发帖数: 49 | 1 媽媽最近在美小住，三天前右側腰痛，懷疑是腎結石犯了，因為以前查出結石。遂去醫
院驗尿無血，照X光，結果說左側腎門有9.9mm的鈣化點，懷疑不確定是結石還是血管瘤
。想聽聽大家的意見。下部應該如何檢查確證。因為在這邊全部自費，所以，希望有的
放矢。謝謝大家意見。
X光檢查結果。我們初翻譯了一下，中英文如下。
IMPRESSION: A 9.9 mm calcification in the region of the left renal hilum
suspicious for a renal artery aneurysm. CT would be necessary to distinguish
between aneurysm and renal calculus.
No other urinary tract calculi identified, although the tracts are largely
obscured by bowel contents.
Some calcification... 阅读全帖 |
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L****n
发帖数: 12932 | 4 sorry, haven't been in here for a while. there are a few points i didn't
mention in the PM: first of all, make sure the diagnosis is clear: arterial
sternosis/blockage is different from deep vein thrombosis, from causes to
signs/symptoms to treatment. If it's arterial blockage (thin people can
still have atherosclerosis 动脉粥样硬化）， the main treatment, besides stop
smoking of course, is surgery. angioplasty of bypass. It's a surgery
frequently done here. he will need to be on anti-coagulation therap |
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H****r
发帖数: 16240 | 5 【 以下文字转载自 Military 讨论区 】
发信人: desesperado (Estoy), 信区: Military
标 题: 南都周刊: 波士顿天价隧道工程改善城市交通拥堵
发信站: BBS 未名空间站 (Tue Jan 18 18:47:59 2011, 美东)
http://discover.news.163.com/11/0117/10/6QJIGMGJ000125LI.html
2011-01-17 10:51:13 来源: 南都周刊(广州)
核心提示：大挖掘项目的独特挑战在于它的整个实施过程没有对波士顿的交通、商业和
居民生活造成中断。
2006年7月，波士顿，车辆驶出93号州际公路的南端出口，畅通无阻。
在美国历史文化名城波士顿市中心，曾横贯着一条半程高架半程隧道的公路—约翰·菲
茨杰拉德的高速公路。上世纪20年代，美国汽车制造业兴盛，全美陷入了修建高速公路
的热潮。这条被称作“中央干道（Central Artery）”的93号州际公路也正是在这种背
景下被提上议程。
这条中央干道是在联邦州际公路标准制定之前建成的，不仅给城市带来严重的交通问题
，还把波士顿的... 阅读全帖 |
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O***n
发帖数: 13127 | 6 zz:
Why You Don’t Want
Reduced Fat Milk in Your Diet!
If you were to visit a milk processing plant, you would see it is filled
with all types of stainless steel equipment and machinery.
Inside that machinery, the milk shipped from farms around the processing
plant is completely re-made, so that there is so much protein, so much
butterfat, etc.
This is done so that the milk products produced are both uniform and meet
the standards for milk products set by the U.S. Department of Agriculture.
First... 阅读全帖 |
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o****n
发帖数: 9475 | 7 http://www.sandiego.gov/cip/projectinfo/featuredprojects/tedwil
Ted Williams Parkway Pedestrian Bridge at Shoal Creek Drive Project
Background
Ted Williams Parkway, between I-15 and Highland Ranch Road, is a 6-lane
primary arterial with an average daily traffic volume of over 25,000 trips.
The posted speed is 55 mph and a reduced speed of 25 mph near Shoal Creek
Elementary School. The proposed pedestrian bridge would facilitate crossing
of the intersection, especially by children attending the a... 阅读全帖 |
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i*****s
发帖数: 15215 | 8 LONDON (Reuters) - Britain's Prince Philip, the 90-year-old husband of Queen
Elizabeth, had heart surgery to ease a blocked artery on Friday after being
rushed to hospital with chest pains as he prepared to celebrate Christmas
with the royal family.
Britain's longest-serving royal consort, known for his outspoken and
sometimes brusque manner, needed an operation to fit a small tube known as a
stent that keeps the blood vessel open.
Philip had been preparing to spend Christmas with other members ... 阅读全帖 |
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c******t
发帖数: 1733 | 10 The first time I looked into an open chest cavity at a heart muscle working
to pump blood through the body, I was brought up short by the tragic
graffiti of atherosclerotic plaque. This waxy goo, often found in overweight
people, builds up in the vessels surrounding the organ in which,
philosophers tell us, the soul lives. But I quickly pushed any such
distracting thoughts from my mind. I was learning to operate and was frankly
thrilled at the prospect of harvesting a leg vein to bypass the bloc... 阅读全帖 |
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g*****y
发帖数: 6325 | 11 Importance of True Raw Almonds
Before we discuss the many health benefits of almonds, it is critical to
stress that not all almonds are “created” equal. When choosing almonds to
include in your diet, make sure they are both organic and raw. Almonds that
are cooked or processed not only lose many of their benefits, but can
actually become harmful. However, you need to be aware that almonds labeled
raw are not always truly “raw.” Most commercially grown almonds in the U.S
. are sterilized by one o... 阅读全帖 |
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M**u
发帖数: 10158 | 12 In a testimonial for his health club's website, Michael Kudryk, a Freehold,
N.J., businessman who died of an apparent heart attack in Sunday's Nautica
New York Triathlon, wrote about being transformed by exercise.
“Besides losing weight and going down one belt size, I feel I look better,
I feel physically stronger and every morning I feel energized,” wrote Mr.
Kudryk, noting that he lost 20 of his 223 pounds in four months of going to
the gym and working with a trainer. He also kept the weight o... 阅读全帖 |
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A********y
发帖数: 1649 | 13 Aries/1st house:
head, brain, eyes, face, muscles, pineal gland;anything to do with the head.
Headache, migraine, sinus problems, head colds, nosebleeds, fever,
inflammation, haemorrhage, high blood pressure, eruptions, burns, scalds,
insect bites and stings.
Taurus/2nd house:
neck, throat, thyroid gland, larynx, chin, lower jaw, ears,
tongue, vocal chords, jugular vein, tonsils;
anything to do with the throat or neck, sore throat, stiff neck, tension,
excess weight, under-active thyroid gland
G... 阅读全帖 |
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z*i
发帖数: 58873 | 14 http://www.heart.org/HEARTORG/Conditions/Cholesterol/AboutChole
Cholesterol comes from two sources: your body and food. Your liver and other
cells in your body make about 75 percent of blood cholesterol. The other 25
percent comes from the foods you eat. Cholesterol is only found in animal
products.
A cholesterol screening measures your level of HDL and LDL. HDL is the "
good" cholesterol which helps keep the LDL (bad) cholesterol from getting
lodged into your artery walls. A healthy level of ... 阅读全帖 |
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h*d
发帖数: 19309 | 15 有人熟悉这个么？
SIOUX FALLS, S.D. - North Dakota's state coroner says the lead guitarist for
the heavy metal band GWAR died of a heart condition. Records show that a
drug screening detected cocaine and opiates in his system.
State medical examiner Dr. William Massello (muh-SEHL'-oh) III says in his
report that Cory Smoot died of "coronary artery thrombosis brought about by
his pre-existing coronary artery disease."
The formation of such blood clots can result in a heart attack.
The 34-year-old Smoot pe... 阅读全帖 |
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b*s
发帖数: 82482 | 16 Virtually every cell in the body can use glucose for energy. In contrast,
only liver cells break down fructose. What happens to fructose inside liver
cells is complicated. One of the end products is triglyceride, a form of fat
. Uric acid and free radicals are also formed.
None of this is good. Triglycerides can build up in liver cells and damage
liver function. Triglycerides released into the bloodstream can contribute
to the growth of fat-filled plaque inside artery walls. Free radicals (also
... 阅读全帖 |
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H****r
发帖数: 16240 | 17 【 以下文字转载自 Military 讨论区 】
发信人: desesperado (Estoy), 信区: Military
标 题: 南都周刊: 波士顿天价隧道工程改善城市交通拥堵
发信站: BBS 未名空间站 (Tue Jan 18 18:47:59 2011, 美东)
http://discover.news.163.com/11/0117/10/6QJIGMGJ000125LI.html
2011-01-17 10:51:13 来源: 南都周刊(广州)
核心提示：大挖掘项目的独特挑战在于它的整个实施过程没有对波士顿的交通、商业和
居民生活造成中断。
2006年7月，波士顿，车辆驶出93号州际公路的南端出口，畅通无阻。
在美国历史文化名城波士顿市中心，曾横贯着一条半程高架半程隧道的公路—约翰·菲
茨杰拉德的高速公路。上世纪20年代，美国汽车制造业兴盛，全美陷入了修建高速公路
的热潮。这条被称作“中央干道（Central Artery）”的93号州际公路也正是在这种背
景下被提上议程。
这条中央干道是在联邦州际公路标准制定之前建成的，不仅给城市带来严重的交通问题
，还把波士顿的... 阅读全帖 |
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i***a
发帖数: 11826 | 18 嗯，这个小鸭丫很亭亭玉立~，照片下方还附送了laptop和纤纤手吗~：）
artery还ok,毛细血管就拼不正确了。楼上你的粉丝同学更强，我猜他讲heart是对应循
环系统，下次你写篇人工神经网络镇他，算法类肯定没问题。
drama或者musical，咳咳，前面想到的是搞笑轻drama，就不展开了。你+U~
artery 这个字真不太认识～～～你怎么什么都知道～～～介么专业的～～～
赞舞台剧？我在东岸有时候蹭免费concerto，我不大喜欢drama，对musical也一般，基
本上局限在纯器乐--大概我真是挺讨厌人的，哈哈。
这诗没有特别处，平实写完，从头到尾没有一句虚构，哈哈。。。一天傍晚downtown
block开party，我正好路过，，，有若干band，我最喜欢这三个老头～～～very
emotional... 歌词也是他们的，不过未必是一首歌，，汗，字句为了押韵的关系也有
变动，我本来也没记太清。。。
原来我倒是计划写的有趣点，弄成双线--乐手一条线，观众：狗狗，跑来跑去的小孩子
，当然最重要是我，，，本来“我”是一条大主线，准备每个stanza都露面，，，汗，
下笔发... 阅读全帖 |
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i*****t
发帖数: 10 | 19 Congenital harelip;
Serious congenital cardiac disease, diagnosed as:
Complete transposition of great arteries, with
general cardiac enlargement;
Interventricular septum defect;
Abnormal derivation of great vessels;
Pulmonary artery flow acceleration,
valvular pulmonary stenosis with localized back flow;
Persistent foramen ovale.
The guys of Department of thoracic surgery in Beijing Fuwai
Hospital concluded this case could not be radically cured in China.
________________________________________ |
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h*d
发帖数: 19309 | 20 发信人: strong (大拿~恭祝清华百年华诞), 信区: TsinghuaCent
标 题: 清华大学的2010
发信站: 水木社区 (Sun Apr 24 14:46:09 2011), 站内
清华大学的2010
注：本文由水木社区BBS世纪清华版（TsinghuaCent）整理，各项资料来自清华大学网
站、清华大学新闻网、北京协和医学院（清华大学医学部）网站和水木社区BBS世纪清
华版等。
正文：
本文系统总结2010年度清华大学、北京协和医学院（清华大学医学部）师生校友荣获的
各类学术和社会荣誉、学科竞赛成绩以及学校在教学科研领域中获得的各类成果和进展
。限于篇幅，在关于各类获奖成果的统计中，本文仅统计获得过一等奖、金奖（国家科
学技术奖除外）以上的成果（绩）。
*********************
一．最高荣誉
●清华大学数学科学中心主任丘成桐教授获得2010年沃尔夫（Wolf）奖，以表彰他在几
何分析领域的贡献，以及在几何和物理的多个领域都产生的“深刻而引人注目的影响”
。这是丘成桐继1982年获得菲尔茨奖后，再... 阅读全帖 |
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l**l
发帖数: 458 | 21 J Cardiovasc Surg (Torino). 2006 Feb;47(1):65-70.
Outcome after one-stage repair of tetralogy of Fallot.
Lee C, Lee CN, Kim SC, Lim C, Chang YH, Kang CH, Jo WM, Kim WH.
Source
Department of Cardiovascular Surgery, Sejong General Hospital, Sejong Heart
Institute, Bucheon, Kyungki-do, South Korea.
Abstract
AIM:
The purpose of this study was to evaluate the outcome after one-stage repair
of tetralogy of Fallot (TOF).
METHODS:
Between May 1997 and December 2002, 240 patients with a median age of 9
m... 阅读全帖 |
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n***w
发帖数: 2405 | 22 想问问pericyte到底cover些什么地方？
arteriole, venule and capillary? not artery or vein?
also, do veins express a lot of a-sma or just artery express a-sma？
thanks. |
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e*****i
发帖数: 114 | 23 pericytes cover capillary, vein and artery.
aSMA+ SMCs cover artery. Major collective vein is also covered by aSMA SMCs. |
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M******n
发帖数: 43051 | 24 Basic research has long been the missing foundation of China’s aspiration
to develop a world-class drug industry. The country has become a global
powerhouse in the manufacture of bulk pharmaceutical chemicals. It is a
preferred destination for major drug companies that outsource research work
to reduce costs. To date, however, none of the world’s major drugs has been
either invented or developed in China.
The country wants to change that in a big way. The government is spending $7
billion over t... 阅读全帖 |
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d**********e
发帖数: 72 | 25 A-a: alveolar-to-arterial gradient
ABG: arterial blood gas
ABI: ankle-brachial index
Abx: antibiotics
AMA: against medical advice
A&P: assessment and plan
BE: base excess
Bid: twice daily
BM: bowel movement
BMP: basic metabolic panel, aka, Chem 7 (Na, K, Cl, HCO3, BUN, Cr, Glucose)
BNP: brain natriuretic peptide
BP: blood pressure
BSOO: bilateral salpingoopherectomy
BTP: breakthrough pain, is pain that comes on suddenly for short periods of
time and is not alleviated by the patients' normal pain |
|
k**e
发帖数: 2728 | 26 wiki says:
Acetylcholine is normally released by the parasympathetic nervous system (PS
NS) at rest, and causes dilation of the coronary arteries. While acetylcholi
ne induces vasoconstriction of vascular smooth muscle cells through a direct
mechanism, acetylcholine also stimulates endothelial cells to produce nitri
c oxide (NO). NO then diffuses out of the endothelial cells, stimulating rel
axation of the nearby smooth muscle cells. In healthy arterial walls, the ov
erall indirect relaxation in |
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e******e
发帖数: 364 | 27 5. A 44-year-old woman is brought to the emergency department 40 minutes
after being stabbed in the left groin. Her blood pressure is 128/84 mm Hg,
pulse is 100/min, and respirations are 16/min. Examination of the wound
shows a small hematoma and no external bleeding. Popliteal and pedal
pulses are palpable in the left lower extremity below the injury.
Lacerations of the femoral artery and vein are found and repaired. Two
days postoperatively, she has progressively severe pain of the left lower
... 阅读全帖 |
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s********p
发帖数: 1319 | 28 水晶好认真——听诊比我仔细得多！
主动脉瓣狭窄（AS）向颈部传导，我们的注意力，应该多放在胸骨右缘第二肋间，在心
脏听诊方面，那里的杂音和心音的改变比较明显（详细情况见图，说明）。这是和单纯
动脉粥样硬化（Arthroscleroses, AS）所致颈动脉狭窄所导致的Carotid bruits收缩
期杂音的主要鉴别要点。
单纯动脉粥样硬化（Arthroscleroses, AS）所致颈动脉狭窄时，听到carotid bruits
收缩期吹风样杂音的时候，心脏本身的杂音和心音变化并不明显。此时，“Duplex
ultrasound imaging provides a direct, noninvasive means of assessing both
the anatomical characteristics of peripheral arteries and the functional
significance of arterial stenoses.”
此外，颈部听诊时还有个连续的静脉杂音，见图2。
不知道说清楚没有？
等我Step 12 考完后，一同和XDJM们探讨些... 阅读全帖 |
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h***y
发帖数: 834 | 29 ☆─────────────────────────────────────☆
Aplusplus (Hakuna Matata) 于 (Sun Mar 27 11:11:49 2011, 美东) 提到:
首先我申明，我放弃我的ignore list， 欢迎所有ID参加。
每个医生护士或者其他相关人员， 无论在中国还是美国， 肯定都有一些case刻骨铭心
。 请大家把你印象最深的一例写出来， 与大家分享。 比方说， 清华男被鉈杀案，
那个中国来的护士就是诊断的关键， 相信本例就是她一辈子也忘不了的诊断。
我觉得这样的讨论有助于大家提高学医热情，丰富医学知识，开拓临床思维， 间接帮
助考版医生复习，准备CS，和 interview. 你要是能从中挑一个case让你PD
impressed，我想我的目的就达到了。
希望所有ID， 包括考生， resident， fellow， attending，PA/NP, nurse 和中国来
的医生不再从事医疗工作的， 都能奉献你的pearl. 英文中文都行。
我先来：
CC: Left leg pain for 5 days.
35 y... 阅读全帖 |
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h***y
发帖数: 834 | 30 ☆─────────────────────────────────────☆
Aplusplus (Hakuna Matata) 于 (Sun Mar 27 11:11:49 2011, 美东) 提到:
首先我申明，我放弃我的ignore list， 欢迎所有ID参加。
每个医生护士或者其他相关人员， 无论在中国还是美国， 肯定都有一些case刻骨铭心
。 请大家把你印象最深的一例写出来， 与大家分享。 比方说， 清华男被鉈杀案，
那个中国来的护士就是诊断的关键， 相信本例就是她一辈子也忘不了的诊断。
我觉得这样的讨论有助于大家提高学医热情，丰富医学知识，开拓临床思维， 间接帮
助考版医生复习，准备CS，和 interview. 你要是能从中挑一个case让你PD
impressed，我想我的目的就达到了。
希望所有ID， 包括考生， resident， fellow， attending，PA/NP, nurse 和中国来
的医生不再从事医疗工作的， 都能奉献你的pearl. 英文中文都行。
我先来：
CC: Left leg pain for 5 days.
35 y... 阅读全帖 |
|
n*****n
发帖数: 119 | 31 别处看到的，觉得还不错，不排除有些拼写错误~
POMR (Problem-Oriented Medical Records)表格式住院病历
Biographical data:
一般项目：
Name Age Sex Marital status Nativity Race
姓名 年龄 性别 婚否 籍贯 民族
Occupation Date of admission Informant History
职业 入院日期 病史叙述者 病史
Chief complaint
主诉
History of present illness
现病史
Past history
既往史：
Previous health status: well ordinary bad Infectious diseases
平素健康状况： 良好 一般 较差 传染病史
Immunizations Allergies: N Y clinical manifestation
预防接种史 过敏史 无 有 临床表现
allergen: Trauma: Surgery:
过敏原 外伤... 阅读全帖 |
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k******e
发帖数: 80 | 32 我是08年10月底开始申请加州考试的，今年1月底通过审核。中间因为找学校教务处盖
章很麻烦，耽误了2个多月，材料才得以从学校寄出。个人觉得申请算是比较顺利。把
我当时准备的情况跟大家说一下也许对将要申请的人有一点帮助。
我个人从这里寄出去的材料包括：
1.国内护士执照的公正，在这里网上找的公证处，在纽约，叫最佳公正，电话
7183212810
2.指纹卡，就在我住的地方的警察局办的，free
3.handbook上的申请表，贴一张照片在右下角（handbook链接：http://www.rn.ca.gov/pdfs/applicants/exam-app.pdf）
这一页有一项是填社会安全号，我当时没有就空着的，没有关系。
4.两张支票，一张办指纹的($51)，一张申请的($75)
5.写了一封信，表示感谢，一张纸，很客气的几句话
从学校寄出的材料：
1.中英文成绩单（学校有，我来之前到学校教务处办好的）
2.学位证书和毕业证书中英文版（来之前自己办好到学校教务处办好的，盖好了章）
3.课程描述9门（内外妇儿、精神科护理、生理、解剖、免疫、微生物，好像是这些，
请参考的人自己再斟酌。）... 阅读全帖 |
|
l*******8
发帖数: 1745 | 33 写的很好！刚开始培训，被人使唤很正常。我经常早会一结束就交代医学生他们今天要
做的事情，并指出几点前我需要哪个report. CHF病人是很麻烦，ejection fraction很
低的话，补液是不能给多。最讨厌的是CHF+ESRD on HD with no urine output的病人
，一但补液多了搞出个pulmonary edema,用lasix是不会管用的，因为病人本身就无尿
啊，只好去emergent HD,这在我co-intern身上发生过，折腾的他一晚上都没有睡好。
central line里抽血是可以但是要小心别带来不必要的感染，我不太会抽静脉血，如果
要抽血，我基本上都是从病人的radial artery or brachial artery抽血，估计抽了一
百多例以上了，就等于是做个ABG. IV access在那些黑人或胖子身上是很难打，护士
们都在病人胳膊上都打不出来，就call我，我只好做EJ line,要是我找不到EJV,就只好
喊外科来做central line了。妹妹一定要格外格外小心niddle stick,还有要做好
isolation防护 |
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u*****d
发帖数: 1009 | 34 CLBBB, or complete left bundle branch block is something that's seen on EKG.
It most likely indicates coronary artery disease or cardiac abnormalities.
Does your father have symptoms associated with it? And does he have other
coronary artery diseases? (Ex. high blood pressure, high cholesterol?) If he
does, then I think treating the underlying cause is very important.
I don't know how serious his CLBBB is right now, but I assume putting in a
pacemaker or undergoing surgery should both be options |
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a*i
发帖数: 1652 | 35 http://247wallst.com/2011/07/18/the-eleven-most-implanted-medic
11. Implantable Cardioverter Defibrillators
> Number of procedures: 133,262
> Total annual expenditure: $5.5 billion
> Average cost per procedure: $40,000
> Major manufacturer: Medtronic (40%), St. Jude Medical, and Boston
Scientific
Cardiac arrhythmia, or improper electric signaling in the heart, occurs in
millions of people a year. While the vast majority are benign, a select few
— usually in patients with a history of heart attac... 阅读全帖 |
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A*****8
发帖数: 8590 | 37 Report Information:
Publication date: 11/07/2012
Number of Pages: 145
Report Details:
In 2011, the medical device market worldwide was worth $309bn, with high
single-digit growth from the year before . Despite being a vast and mature
market, there are number of sectors likely to experience fast growth during
the next 10 years. Much of this growth is linked to the prevalence of a
number of diseases worldwide, as well as an aging population. The rise in
neurological disorders will drive both the d... 阅读全帖 |
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s********o
发帖数: 3319 | 38 【 以下文字转载自 MedicalCareer 讨论区 】
发信人: herby (小臭宝), 信区: MedicalCareer
标 题: [合集] 你有生以来做出的最佳临床诊断是什么？
发信站: BBS 未名空间站 (Thu Jun 2 00:01:26 2011, 美东)
☆─────────────────────────────────────☆
Aplusplus (Hakuna Matata) 于 (Sun Mar 27 11:11:49 2011, 美东) 提到:
首先我申明，我放弃我的ignore list， 欢迎所有ID参加。
每个医生护士或者其他相关人员， 无论在中国还是美国， 肯定都有一些case刻骨铭心
。 请大家把你印象最深的一例写出来， 与大家分享。 比方说， 清华男被鉈杀案，
那个中国来的护士就是诊断的关键， 相信本例就是她一辈子也忘不了的诊断。
我觉得这样的讨论有助于大家提高学医热情，丰富医学知识，开拓临床思维， 间接帮
助考版医生复习，准备CS，和 interview. 你要是能从中挑一个case让你PD
impressed，我想我的... 阅读全帖 |
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s********o
发帖数: 3319 | 39 【 以下文字转载自 MedicalCareer 讨论区 】
发信人: herby (小臭宝), 信区: MedicalCareer
标 题: [合集] 你有生以来做出的最佳临床诊断是什么？
发信站: BBS 未名空间站 (Thu Jun 2 00:01:26 2011, 美东)
☆─────────────────────────────────────☆
Aplusplus (Hakuna Matata) 于 (Sun Mar 27 11:11:49 2011, 美东) 提到:
首先我申明，我放弃我的ignore list， 欢迎所有ID参加。
每个医生护士或者其他相关人员， 无论在中国还是美国， 肯定都有一些case刻骨铭心
。 请大家把你印象最深的一例写出来， 与大家分享。 比方说， 清华男被鉈杀案，
那个中国来的护士就是诊断的关键， 相信本例就是她一辈子也忘不了的诊断。
我觉得这样的讨论有助于大家提高学医热情，丰富医学知识，开拓临床思维， 间接帮
助考版医生复习，准备CS，和 interview. 你要是能从中挑一个case让你PD
impressed，我想我的... 阅读全帖 |
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J****C
发帖数: 1465 | 40 Paraplegia is not an uncommon complication of TAA(or AAA) surgery. It's
hard to believe what you said "其实这类手术出现的并发症全美国只有4例". I
personally have seen 2 cases so far. Fortunately one case had relief
after emergent spinal drainage placement. The etiology is spinal
anterior column ischemia from underperfusion of the artery of Adamkewicz
which is a branch of the aorta and an important supplier of anterior
spinal artery, however with quite variable origin point. This is
described in every textbook and ... 阅读全帖 |
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J****C
发帖数: 1465 | 41 Paraplegia is not an uncommon complication of TAA(or AAA) surgery. It's
hard to believe what you said "其实这类手术出现的并发症全美国只有4例". I
personally have seen 2 cases so far. Fortunately one case had relief
after emergent spinal drainage placement. The etiology is spinal
anterior column ischemia from underperfusion of the artery of Adamkewicz
which is a branch of the aorta and an important supplier of anterior
spinal artery, however with quite variable origin point. This is
described in every textbook and ... 阅读全帖 |
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A*******s
发帖数: 9638 | 42 大家在学习过程中， 肯定看到很多有趣的，经典的临床综合症。 希望大家每人贡献一
个case， 图文并茂， 奖励办法由futurehw公布。
我开个头： Bow hunter's syndrome
It is named after how a bow hunter's who usually turn their head
significantly to shoot the bow and arrow. Bow Hunter's syndrome is a
condition where the contralateral vertebral artery is stenosed, compressed,
or occluded. Since the vertebral arteries supply blood to the posterior
portion of the cranium, then patients are going to have issues with sight,
vertigo and occasions of syncope. When the co... 阅读全帖 |
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R*******t
发帖数: 367 | 43 Carotid stenosis and renal artery stenosis at 60-70% is not critical. I have
seen a lot of patients follow even more severe stenosis.
Your father eventually needs diagnostic angiogram with aortic and bilateral
lower extremities run-off to evaluate for occlusion. Or he should at least
get arterial dopplers to check the waveforms and ABI (ankle brachial index)
first. |
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A*******s
发帖数: 9638 | 44 Migraine？
aphasia is from ischemia of left middle cerebral artery. Ataxia, nausea and sluured speech are from basilar artery.
To put them togather, only migraine makes sense to me.
Food poisoning is another possibility but i doubt it.. |
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A*******s
发帖数: 9638 | 45 我的病人除非有症状我才做carotid U/S， 如果over 70%, refer to surgeon。 这些
病人是symptomatic。
如果是syncope， 我从来不做carotid u/s。 因为将近90%是vasovagal 和
cardiogenic。 剩下的还要考虑orthostasis和seizure。 如果是TIA， 应该是基底动
脉的问题， carotid u/s不如MRA。
可恶的美国医疗体系是你order的test越多赚的钱就越多， 所以就有了过分的order
carotid， 一旦发现了超过70的stenosis， 就把他们refer到surgeon。 surgeon当然
求之不得， 可能是手术容易做， reimbursement高， 这些surgeon一看到我就提醒我
有没有case， 竞争不是一般的激烈。 可以想象他们的门槛会多低。
carotid stenosis并不见得一定是artery-to-artery amboli， 它的存在可能导致供血
不足， 而引起远端动脉的thrombosis。 所以清除plague只是改善血供， 不见得可以
消... 阅读全帖 |
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h*********t
发帖数: 116 | 46 a 78 year old male with past medical history of hypertension and DM
presented with an syncopal episode and had MRI and MRA head/neck. The MRI
showed no acute findings but MRA showed right vetebral artery high grade
stenosis. echo normal, no history of afib or sss, telemetry did not reveal
any arrhthmia. what would you do about the right vetebral artery high grade
stenosis? do you think his syncope is related to this vetebral art stenosis?
thanks!!! |
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b******a
发帖数: 704 | 47 Case 12-2013 — An 18-Year-Old Woman with Pulmonary Infiltrates and
Respiratory Failure
N Engl J Med 2013; 368:1537-1545
Presentation of Case
Dr. James Sawalla Guseh (Medicine): An 18-year-old woman was admitted to
this hospital because of pulmonary infiltrates and respiratory failure.
The patient had been well until 3 weeks before admission, when fever and a
cough productive of white, nonbloody sputum developed. During the next week,
night sweats, extremely painful pharyngitis, pleuritic chest ... 阅读全帖 |
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M********3
发帖数: 269 | 48 just my two cents:
What is the Dx?
from the AP x-ray:
1. nonarticular proximal tibia fracture
2. LCL tear ?
What does the patient like to have in physical exam?
1. local tenderness and swelling
2. pain on weight bearing
3. limited ROM
4. knee unstable
5. foot cool and pale, no pulse of the dorsalis pedis artery --> blood
supply impairment, e.g. popliteal artery injury --> can cause thrombus
6. numbness of the foot --> nerve injury
7. 5 and 6 --> compartment syndrome ? --> if yes --> emergency O... 阅读全帖 |
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j****2
发帖数: 3211 | 49 你这听着不象是眼睛的问题，建议自己掏钱做个血管b超查carotid artery。distal
ica 堵塞造成ophthalmic artery供血不足，会出现短暂的视觉半黑，只是有可能啊，
具体你自己定，b超没多少钱 |
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