y***c
发帖数: 676 | 1 【 以下文字转载自 MedicalCareer 讨论区 】
发信人: hudson (hudson), 信区: MedicalCareer
标 题: 6个月宝宝患肛门瘘管 rectal abscess (转载)
发信站: BBS 未名空间站 (Thu Apr 3 23:21:30 2008)
发信人: hudson (hudson), 信区: NextGeneration
标 题: 6个月宝宝患肛门瘘管 rectal abscess
发信站: BBS 未名空间站 (Thu Apr 3 23:20:42 2008)
宝宝屁股上有一个包，很久了，一直没在意。 最近才带宝宝去看，结果发现宝宝得了
肛门瘘管。(rectal abscess) 医生说看情况可能要引流，或者要进一步全麻手术治疗
。虽然医生安慰不是因为我做了或没做什么，还是强烈的自责和愧疚。 想请问有没有
宝宝得过这个(rectal abscess)的家长和我分享一些信息和经历。也可以发到我站内信
箱。万分感激！
补充，这个包一直是硬的，有一个多月了，好像没有变化。医生说一般情况很快就会溃疡，但他有些奇怪一个多月了一直是硬的 |
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n******g
发帖数: 27 | 2 还有一个月就DUE了，新妈还有好多不明白向大家讨教
1、正在考虑买不买这个Avent Express Microwave Steam Sterilizer 奶瓶消毒器，大
家觉得有必要吗？还有这个是不是什么牌子的奶瓶都可以用，比如DRbrown's 的
2、不买消毒器的话大家都是用什么刷奶瓶的，直接用温水吗？用不用买特殊的清洗剂
3、买了这个Vicks Baby Rectal Thermometer体温计，没用过rectal的体温计，大家说
说具体用法呗，另外需要买什么样的润滑剂？
多谢多谢 |
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w*******y
发帖数: 60932 | 5 Lumiscope Jumbo Display Digital Thermometer (L2013) for Oral, Rectal and
Under Arm Use. With Large Digital Display and Last Memory Recall. Beeps When
Ready.:
http://tracklink.meritline.com/c.html?rtr=on&s=ecg7,1f42r,4tyo,
Lumiscope Jumbo Display Digital Thermometer (L2013) for Oral, Rectal and
Under Arm Use. With Large Digital Display and Last Memory Recall. Beeps When
Ready.
$3.99
(Item#280-005-001)
$3.99 w/Code: MLC216TN For First 150 Orders (This code also applies to some
other items in this ... 阅读全帖 |
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b********7
发帖数: 12906 | 6 我觉得给Baby用rectal的温度计不是一个好主意。 想想， 正在量体温的时候。。。突
然。。。:) |
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h******c
发帖数: 723 | 7 准备老二用品. 发现rectal thermometer 不能用了 也许是没电池了 打算买个新的。
欢迎大家推荐. |
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h******c
发帖数: 723 | 8 这个review 很好. Ear 不是rectal.
给infant 用行么? |
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h******c
发帖数: 723 | 9 这是个好主意 . 我也倾向用rectal. 放心一些 . 这个连续测几次 数值一致么？，
测耳朵的那个。review有很多人抱怨温度变化大。如果连测几次温度不一样 就傻眼了 |
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p**********n
发帖数: 316 | 10 其实rectal用起来很麻烦的，而且娃大了以后根本就不配合，每次量个体温像杀猪一样。
后来索性换成耳温计了，用起来觉得也挺好的。 |
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H*******r
发帖数: 3143 | 12 rectal费老劲才测出来一次，哪那么容易连测两次比较啊 |
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h******c
发帖数: 723 | 13 谢谢妹妹们答复 己amazon 下单买了
老大刚上daycare 的一年里 发了好几次高烧。虽然几年过去了 想起来还是后怕 一到
关键时我还是要测rectal 温度2-3 次.
现在年纪大了 , 精力大不以前, 这些多给准备着 . 图个心里踏实 |
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m********r
发帖数: 259 | 14 关键词： radiochemotherapy + rectal cancer
有需要的请站短联系我，最好带上自己的简短介绍，我直接copy给editor。
祝大家圣诞快乐！ |
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c******r
发帖数: 3778 | 15 大姐您什么意思？给我列50篇paper让我看？你都看了？还是这是lz那篇文章的
references？
我又不是卖牛奶的，我也不养牛，也不挤奶。我自己一年也喝不了两瓶奶，那个没必要
让大家天天喝一升奶，也没必要让大家一滴奶不喝。
科学研究本来就是有支持有反对，你列一大堆文献，都说了啥？那个表根本没法看。比
列文献，我也会啊，但是要说明问题，不能这样往别人脸上一扔就完事啊。
没功夫篇篇都看，第二篇：
What causes prostate cancer?
关于这个问题是这么说的：“case control studies have found a positive
association between animal fat especially from dairy products and prostate
cancer risk, particularly for advanced cancers.”
后面接着介绍了可能的机制：
“One possible explanation for these associations is that fat intake from
ani... 阅读全帖 |
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w******y
发帖数: 4871 | 16 Febrile seizures
Author
Marvin A Fishman, MD
Section Editor
Douglas R Nordli, Jr, MD
Deputy Editor
Janet L Wilterdink, MD
Last literature review version 19.1: January 2011 | This topic last updated:
February 3, 2011 (More)
INTRODUCTION — Febrile seizures are a common cause of convulsions in young
children. They occur in 2 to 4 percent of children younger than five years
of age, but the incidence is as high as 15 percent in some populations. This
incidence has been attributed to closer living arr... 阅读全帖 |
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l******g
发帖数: 278 | 17 NBME form 4
1. A 22-year-old woman with asthma comes to the physician for a follow-up
examination. She feels well. She has been treated for six acute episodes of
wheezing and nonproductive cough during the past year; her last episode was
1 month ago. Her symptoms are exacerbated when she is outside during the
spring and fall. Current medications include an albuterol inhaler and
echinacea. She has smoked one-half pack of cigarettes daily for 5 years and
does not drink alcohol. She is employed in ... 阅读全帖 |
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M****a
发帖数: 577 | 18 Correct. Thanks for the clarification. The lower 1/3 of rectum is drained by
the inferior rectal vein, which further drains into the internal iliac vein
then IVC.
If you still recall from Step I FA, in patients with portal hypertension,
one of the four portal-systemic anastomoses is between the superior rectal
vein (middle rectal vein should also be included, FYI) and the inferior
rectal vein. This anastomsis can cause hemorrhoid and subsequent bleeding. |
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w****m
发帖数: 1245 | 19 http://www.mitbbs.com/pc/pccon_3509_t1018_160585.html
ZT: 新生儿必备
1．Bottle: 1 pack of 3 9oz Avent bottle. (Dr. Brown).
About the baby bottle, don't buy more than one bottles of the same kind (
brand), because you don't know which one you baby will like. Also, I prefer
the disposable bottle (I use
the Avent one), there is less gas for the baby. But more important, you don'
t have to sterilize them. After each use, throw away the liner, rinse the
bottle, you are done.
2．Carseat & stroller: Graco Quo... 阅读全帖 |
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w*********8
发帖数: 3339 | 20 有时候病毒感染后会合并着细菌感染，所以医生会开些抗生素，这是没错的。。。
我家宝宝也是在家烧到103，到医院一量，正常体温。后来我发现，我在家都是量
rectal体温，医院大多是额头。我很不相信额头的温度，因为rectal的温度是最接近体
内温度的。所以我一直以rectal的温度为标准来量宝宝的体温，也是根据这个给宝宝吃
退烧药。
还有家里买个大浴盆，在下一次退烧药还没有due的时候，如果体温上来了，让宝宝坐
在里面物理降温。洗澡是没有用的。。。
大家都是越带越有经验的，呵呵。。。没关系的。。。一起努力。。。 |
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o*****t
发帖数: 1540 | 21 【 以下文字转载自 USANews 讨论区 】
发信人: oosmart (oosmart), 信区: USANews
标 题: 中情局虐囚细节曝光：屁眼喂食 - 新技能 Get！
发信站: BBS 未名空间站 (Tue Dec 9 14:31:16 2014, 美东)
最新爆料中情局虐囚的新细节中包括把囚犯关在冷的囚室内，淋冰水，对一些绝食的囚
犯会从屁眼里喂食（估计是水，葡萄糖？）。这个屁眼喂食是不是美国的创新？
Detainees Held in Cold Cells, Force-Fed Rectally in CIA Program
(Bloomberg Dec.9,2014) A CIA-led interrogation program kept suspects in cold
cells, doused them with refrigerated water and force-fed some rectally,
according to graphic details revealed today in a report by Senate Democra... 阅读全帖 |
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o*****t
发帖数: 1540 | 22 最新爆料中情局虐囚的新细节中包括把囚犯关在冷的囚室内，淋冰水，对一些绝食的囚
犯会从屁眼里喂食（估计是水，葡萄糖？）。这个屁眼喂食是不是美国的创新？
Detainees Held in Cold Cells, Force-Fed Rectally in CIA Program
(Bloomberg Dec.9,2014) A CIA-led interrogation program kept suspects in cold
cells, doused them with refrigerated water and force-fed some rectally,
according to graphic details revealed today in a report by Senate Democrats.
At least one detainee died in an unheated cell. Another tried to chew his
arm and committed acts of self-mutilation. Others hallucinate... 阅读全帖 |
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g***r
发帖数: 285 | 23
liver
intestinal tract drains through portal system so most of the time when
intestinal cancer spreads, it often involves liver first, then lungs and
brain and other organ systems later,
however, distal rectal cancer drains through inferior rectal vein that
drains directly into inferior vena cava, so it could spare the liver and
spread to lungs first, |
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u*****t
发帖数: 292 | 24 colace OTC first.
if failed,
senokot,
if failed,
milk of magnesia 30mg before sleep as needed.
if failed,
if bisacodyl rectal.
if failed,
one fleed enema rectally.
jiu bu xin ni la cu chu lai. |
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g*****j
发帖数: 1211 | 25 Depending on your age, rectal bleeding can be nothing or can be concerning.
If you are 50+ or has colon cancer in your family, you should get a
colonoscopy to rule out cancer.
If you are in your 20s, 30s, rectal bleeding is likely due to anal fissure
or hemorrhoids. Dietary changes as your friend recommended will be the
right thing to do, especially if your stool is hard. It is not something
that you try for a couple of days. You have to keep doing that EVERY single
day ...
If you get bloody... 阅读全帖 |
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j****i
发帖数: 496 | 26 Ok, that's what I have too. Did she have surgery? What kind of treatments
have been done? What stage of rectal cancer does she have?
First of all, if the pain is severe and she cannot pass gas, she needs to go
to ER right away to rule out bowel obstruction. Do not use any laxatives
unless you have ruled out bowel obstruction first.
I don't like narcotics for pain relieve. For rectal pain, try warm water
sitz bath with Epsom salt. And I also find the Prep H suppositories
soothing. For colon... 阅读全帖 |
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j****i
发帖数: 496 | 27 Ok, that's what I have too. Did she have surgery? What kind of treatments
have been done? What stage of rectal cancer does she have?
First of all, if the pain is severe and she cannot pass gas, she needs to go
to ER right away to rule out bowel obstruction. Do not use any laxatives
unless you have ruled out bowel obstruction first.
I don't like narcotics for pain relieve. For rectal pain, try warm water
sitz bath with Epsom salt. And I also find the Prep H suppositories
soothing. For colon... 阅读全帖 |
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M****0
发帖数: 877 | 28 I don't like your comment. Even this is a public forum, you should not use
harsh words.
The chance for a relatively healthy person to have cancer is probably less
than 1%, but this chance may let you lose your medical license if you miss
it. Of note, I do see few colon cancer patients who are less than 30, even
without a family history.
To banshouren: I am not sure if you mentioned to your doctor that you have
hemorrhoids and if your doctor has done a digital rectal exam. I probably
would do a d... 阅读全帖 |
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j****i
发帖数: 496 | 29 1. Depends on stage, yes, for recurrent and advanced rectal cancer, certain
US medical centers have technologies, expertise, or trials that may improve
survival. For anything stage 1 or stage 2, I don't think treating in China
vs in US makes a lot of difference.
2. Just the rectal cancer inpatient surgery alone (no radiation therapy no
chemo) medical bill from top Bay Area hospital is $135K. If you decide to
stay here and treat, you might want to send him to a cheaper cancer center.
Your insur... 阅读全帖 |
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w****m
发帖数: 1245 | 30 V．Formula:
就是婴儿配方奶粉了. 因为一直决定母乳喂养，这个research作得最少. 只知道好几种
畅销品牌，比如similac，Enfamil，nestle，gerber，etc. 其实各种牌子，差别应该
不大，都是按指标配出来的么. 每种牌子还有不同的细类. 可能还分不同的stage，给
年龄不一的小宝吃.
奶粉先不买呢. 去它们厂家的网站注册，会收到样品. 医院应该也有样品. 够用一阵子
了. Research我以后用得着再作吧. 现在能懒一点是一点拉.
不过记得从哪儿看来过一条有用信息，说是一个宝宝本来喝similac的，后来便秘拉，
换Enfamil就好了. 所以我暂时倾向Enfamil现在.
VI．Diapers and related:
1．Diapers:
纸尿裤是也. 不同大小的宝宝用不同size的尿裤: newborn，1，1-2，3，4,…每种尿裤
都标明了适用于多重的宝宝. Newborn的是给刚出生的宝宝用的,比别的size都贵.一般
医院会送一些.然后看不同宝宝的长势需要几十到100多片不等. 尽管1号的也可以给新
生宝宝用，但据说腰比较高，容易... 阅读全帖 |
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l********e
发帖数: 1220 | 31 还有，我觉得孩子的腋下体温容易偏低，你如果很担心，还是量个rectal的。护士如果
回电话了，也会问你rectal温度的。 |
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y***n
发帖数: 6764 | 32 礼拜五，公寓里把暖气关了，我们也大意了，晚上宝宝把被子踢掉了，早上起来发现他手脚很冷，测了体温（rectal），99.9F, 后来半天温度就退了，这是礼拜六的事情。胃口很好。
礼拜天，一早，又有烧了，100.1F, 联系了儿医，送到诊所，让医生（实际是RN）看了，听了心肺，背部，看了喉咙，耳朵，RN说没事，在诊所的rectal体温是100.2F. 回家后温度也维持低烧。胃口很好。
礼拜一，白天都没事，晚上临睡测体温 - 99.8F。胃口不如前两天，有点吐奶。
礼拜二，今天，刚测的体温 - 100.3F，又准备给儿医打电话。 |
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az
发帖数: 16686 | 33 吃药了嘛？医生说需要吃么？别着急，不行带孩子再去看看医生？确保没有发炎什么的
，没事的，小孩子温度本身偏高，肛温100度算不算发烧呢，我不太记得了，算发烧也
是一点点一点点啦，估计是有点小感冒，这两天还着实有点冷呢，阴晴不定的。不急，
看医生怎么说，大大的bless
他手脚很冷，测了体温（rectal），99.9F, 后来半天温度就退了，这是礼拜六的事情
。胃口很好。
了，听了心肺，背部，看了喉咙，耳朵，RN说没事，在诊所的rectal体温是100.2F. 回
家后温度也维持低烧。胃口很好。 |
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l********0
发帖数: 642 | 34 宝宝八周了，到今天已经第五天没有拉臭了。这几天加过两次奶粉，一次3oz, 还一次
1oz。早上给儿医信息，说明情况。儿医除了说吃奶粉时多喝些温水，还一句是这么回的
Rectal stimulation with a rectal thermometer today will help as well.
请问这是什么意思 |
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G********r
发帖数: 3161 | 35 楼主买Braun的：
https://www.amazon.com/Braun-IRT6500US-Ear-Thermometer/dp/B00MUK6M82/
Your child has a fever if he or she:
Has a rectal, ear or temporal artery temperature of 100.4 F (38 C) or higher
Has an oral temperature of 100 F (37.8 C) or higher
Has an armpit temperature of 99 F (37.2 C) or higher
Keep in mind that an armpit temperature might not be accurate. If you're in
doubt about an armpit temperature reading, use another method to confirm the
results.
In general, contact your child's docto... 阅读全帖 |
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m******j
发帖数: 5079 | 36 http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001308/
Symptoms：
Abdominal pain and tenderness in the lower abdomen
Blood in the stool
Diarrhea, constipation, or other change in bowel habits
Narrow stools
Weight loss with no known reason
Signs and tests
With screening colon cancer can be detected before symptoms develop. This is
when the cancer is most curable.
Your doctor will perform a physical exam and press on your belly area. The
physical exam rarely shows any problems, although the doctor ma... 阅读全帖 |
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b*****d
发帖数: 61690 | 37 【 以下文字转载自 Military 讨论区 】
发信人: oosmart (oosmart), 信区: Military
标 题: 中情局虐囚细节曝光：屁眼喂食 - 新技能 Get！ (转载)
发信站: BBS 未名空间站 (Tue Dec 9 14:32:01 2014, 美东)
发信人: oosmart (oosmart), 信区: USANews
标 题: 中情局虐囚细节曝光：屁眼喂食 - 新技能 Get！
发信站: BBS 未名空间站 (Tue Dec 9 14:31:16 2014, 美东)
最新爆料中情局虐囚的新细节中包括把囚犯关在冷的囚室内，淋冰水，对一些绝食的囚
犯会从屁眼里喂食（估计是水，葡萄糖？）。这个屁眼喂食是不是美国的创新？
Detainees Held in Cold Cells, Force-Fed Rectally in CIA Program
(Bloomberg Dec.9,2014) A CIA-led interrogation program kept suspects in cold
cells, doused them with... 阅读全帖 |
|
p********f
发帖数: 5148 | 38 Does she have annal prolapse or rectal prolapse? Did the vet find the
underlying cause?
According to this article:
http://www.sniksnak.com/cathealth/prolapse.html, anal Prolapse is more of an irritating problem for the cat and the guardian. But Rectal Prolapse is more life threatening.
, |
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k*****e
发帖数: 372 | 39 其实很简单，说
"Mr. XXX, I think we have to do rectal exam later. I know it is a little
embarrassing, but it is a cost-effective way to find out what is going on.
Is it okey with you?"
因为是设定好的场景，病人一般会同意
在PN的workup plan上写rectal exam就好了 |
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p***o
发帖数: 3 | 40 这个说法很不错，谢谢！
其实很简单，说
"Mr. XXX, I think we have to do rectal exam later. I know it is a little
embarrassing, but it is a cost-effective way to find out what is going on.
Is it okey with you?"
因为是设定好的场景，病人一般会同意
在PN的workup plan上写rectal exam就好了 |
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s********g
发帖数: 290 | 41 You are out of context now. FOBT in an outpatient setting is valuable.
However, in an inpatient setting, FOBT test does not change too much on
management.
If on rectal exam, you don't see melena, maroon stool, or fresh blood, but
FOBT is positive, in an inpatient setting, you will most likely follow H/H
again. In fact, even if I don't do FOBT, if I see a H/H drop, I'll still
follow H/H again. A responsible GI physician will not do an emergent scope
based on FOBT. FOBT can be positive from a bloo... 阅读全帖 |
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d******0
发帖数: 296 | 42 Case 1
Opening scenario:
Sharon Smith, a 48-year-old female,comes to the clinic complaining of
abdominal pain. Married with four children.
Vital signs:
BP:135/70 mmHg
Temp:98.5 F
RR:16/minute
HR:76/minute, regular
Protocol:
Knock three times with confidence, a smile, walk in and say:
Good morning, Ms Smith. I am Dr. Dora, and I am here to see you today as
your physician. Nice to meet you .Shake hands. Is everything in the room
alright for you? Let me cover you with this to make you a little m... 阅读全帖 |
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k********e
发帖数: 168 | 43 Tele9999
内科第一年intern
从去年开始，traditional call system（每3、4、5天call一次）不符合现在的要求，
现在新规定出来后intern连续工作不能超过16or24小时（不确定）
自己所在program，有night float，从前天晚上（偶不确定是晚上还是早上。。。）六点到第二天早上七点半，每人每年轮一个月
不值night float的时候，就值白班
一、Intern之前的准备：
（一）Limited license：
根据所在州的决定，工作一、两年后，可以申请full license，正式去program上岗前，必须拿到limited license，最好在7月1日前， 有了这个之后，才能有以下的两个号：NPI（你的全国的编号）、DEA（你签名开药需要）
tele所在州board of medicine一个月开一次会，review一次你所交的资料
tele是七年制：毕业证书是五年的时候拿到，但在五年之前没有实习，是七年的后两年实习，类似这种情况，任何时候有discrepency，就要自己所在的医学院出具文件说明
一些需要注意的意外：
1.... 阅读全帖 |
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m******r
发帖数: 1904 | 44 ☆─────────────────────────────────────☆
dora2010 (dora) 于 (Wed Feb 29 16:55:46 2012, 美东) 提到:
Case 1
Opening scenario:
Sharon Smith, a 48-year-old female,comes to the clinic complaining of
abdominal pain. Married with four children.
Vital signs:
BP:135/70 mmHg
Temp:98.5 F
RR:16/minute
HR:76/minute, regular
Protocol:
Knock three times with confidence, a smile, walk in and say:
Good morning, Ms Smith. I am Dr. Dora, and I am here to see you today as
your physician. Nice to meet you .Shake ha... 阅读全帖 |
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M******C
发帖数: 623 | 45 ☆─────────────────────────────────────☆
amisha (amisha) 于 (Fri Oct 28 23:11:51 2011, 美东) 提到:
看见有病人，床架子上，一边挂个foley catheter 的袋子，一边挂个收集2号的袋子，
这个装置好像不象是直肠造瘘后挂的袋子，连着很长很粗的一根管子，难道是直接从
anus连到直肠里面的？叫什么名字呢？我忙的也忘记自己看了，也没想起来把病人翻开
来看一下（有些病很重，没敢翻也翻不动）
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bepsazo (崭新) 于 (Fri Oct 28 23:33:38 2011, 美东) 提到:
flaxiseal? 有不同的厂家，名字起的不一样，我有时管它叫rectal tube, 大家也都明
白。
☆─────────────────────────────────────☆
amisha (amisha) 于 (Fri Oct 28 23:40:41 2011, 美东) 提到:
对的，就是这个，... 阅读全帖 |
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L****n
发帖数: 12932 | 46 i do like to know your reference regarding :"发生肠麻痹的机率是很高的。真发
more likely from bowel perforation (肠穿孔), rather than bowel paralysis.
and the former can be treated with npo/tpn/rectal decompression.
实际的问题就是， 没有确诊（活检）， 仅靠临床诊断是否需要手术。 algorithm 的
下面是if this is emergency (bowel extention, sign of rupture etc)-if no,
observe then biopsy。megacolon is only in 25% of all newborn intestinal
blockage. if yes, whether can be relieved conservatively (fleet enema,
rectal tube etc), if no, surgery, if yes go ... 阅读全帖 |
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M****a
发帖数: 577 | 47 Lower 1/3 of rectal.
But I'll take rectal as the correct answer :-) |
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D********3
发帖数: 786 | 48 未解之迷2：
Surgery
1. A 54 year old male was found to have a 4cm x 3cm mass during a routine
colonoscopy. Biopsy showed moderately differentiated adenocarcinoma. He
occasionally has small amount of bright red blood in stool but denies other
symptoms. He has no past medical or surgical history. He does not smoke or
drink alcohol. CT scan showed two masses, 2cm x 2cm and 1cm x1cm, on his
right lung. No mass lesions were found in his liver, brain, or bones.
Where in the GI tract is the most likely lo... 阅读全帖 |
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A*******s
发帖数: 9638 | 49 下面这个case是一个医生俱乐部贴出来的，我给了他们一个建议，结果今天看到LZ回帖
证实了我的诊断，并且根据诊断治疗有效，病人出院了！
网上咨询看来确实有它的实际效果。
大家讨论一下，第一个答对的请版主发奖。
??? ANY IDEAS REGARDING HYPOTHERMIA????
68 year old family with no past medical history except basal cell carcinoma
of face who has no primary care physician and is on no chronic medications
presents with altered mentation. She has difficulty speaking, hearing,
ambulating and seems "catatonic" per family who admits she has been severely
withdrawn and depressed since the death of her 98 year ... 阅读全帖 |
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M*****y
发帖数: 641 | 50 2011 - 2012 PHYSICIAN SALARY SURVEY
Specialty
National 6 yrs Practicing Average
Median Starting Range
Allergy & Immunology
$246,000.00
$190,000.00
Anesthesiology
$360,000.00
$265,000.00
Cardiac & Thoracic Surgery
$522,875.00
$360,000.00
Cardiology
$402,000.00
$272,000.00
Colon & Rectal Surgery
$389,700.00
$290,000.00
Critical Care Medicine
$258,750.00
$198,000.00
Dermatology
$365,450.00
$234,000.00
Diagnostic Radiology – Interventional
$469,800.00
$335,000.00
Diagnostic Radiology – Non-Intervent... 阅读全帖 |
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