g********e
发帖数: 30 | 1 PS 0 means performance status of zero
老板要在中国办关于肺癌的讲座，要我翻译slides成中文。
请问个位前辈有没有人知道performance status of zero怎么翻译？
前后文是：
3 Patients
No distant disease
Able to tolerate any therapy (PS 0)
Assume Resectable
在此先谢谢了！ |
|
n***8
发帖数: 634 | 2 This is what I think , the Correct answer is E.
On FA : "1. Resect of the 1st lesion." is the number 1 in Treatment. |
|
r********0
发帖数: 22 | 3 来自主题: MedicalCareer版 - 肝癌求助 you don't have liver cancer but breast cancer metastasis to the liver.
Nexavar will not work. your doctor should follow metastatic breast cancer
treatment algorithm, eg aggressive liver resection, hormonal therapy, or
systemic chemotherapy with or without her2 targeted agents. |
|
r********0
发帖数: 22 | 4 来自主题: MedicalCareer版 - 肝癌求助 She should be referred to an oncology specialist who could offer better
advice. If that means she has to go to Shanghai to find an oncologist then
by all means she should go.
It would be hard to answer your question without knowing more details about
her disease. The key piece missing is histo-pathology findings. Primary
cancers of skin, breast and liver and their histology subtypes have very
different prognosis and life expectancy.
Therefore before she leaves for Shanghai, she should take all... 阅读全帖 |
|
V**y
发帖数: 788 | 5 病理诊断 ：
贲门小弯侧：溃疡型低分化腺癌，局部为印戒细胞癌，侵及全层达浆膜外脂肪，侵犯神
经，累及食管下段。
瓶装上下切缘（－）；网膜（－）。“第2，4，5组”示脂肪。
第3组（1／3）；第1组（1／2）淋巴结见转移癌。
第7组（0／1）；8A（0／2）淋巴结未见转移癌。
Pathology diagnosis:
Cardiac stomach,lesser curvature: ulcerative poorly differentiated
adenocarcinoma with focal signet ring cells, invades full thickness of
stomach wall to periseroal adipose tisse, perineural invasion identified,
lower segment of esophagus involved.
Negative resection margins;negative omentum.
"groups #2, 4, 5" show adipose tissue.
Group #3... 阅读全帖 |
|
O****y
发帖数: 79 | 6 【 以下文字转载自 Physician 俱乐部 】
发信人: Oldray (麦地.prajnaparamitahrdayasutra), 信区: Physician
标 题: Last dark report's webinar about pathology fellowship application
发信站: BBS 未名空间站 (Tue May 10 10:25:23 2011, 美东)
The Essential Guide to Achieving the Perfect Pathology Fellowship:
Useful Advice and “Must-Do’s” for First-, Second- and Third-Year
Residents
The Dark Report
4/28/11
Justin Clark
Hello, everyone, I’d like to welcome you to the latest Dark Report’s new
PREP webinar series. The Pathology Resident Ed... 阅读全帖 |
|
A*G
发帖数: 256 | 7 （左上肺叶肿块，左下肺叶肿块) (Mass at left superior lung lobe, and left
lower lung lobe)
高分化腺癌，以细支气管肺泡癌为主，肿块大小分别为1.5*1.0*0.8cm和1.0*0.6*0.8cm
，局部累犯脏层胸膜。Well differentiated adenocarcinoma, mainly bronchioloalveolar (
BAC), tumor size:1.5*1.0*0.8cm & 1.0*0.6*0.8cm，locally invaded to visceral
pleural.
未见明确脉管内癌拴及神经侵犯。There is no tumor emboli and no perineural invasion.
（左上肺叶后段肿块）可见部分肺泡扩张，符合肺气肿改变。另见部分区肺泡上皮不典
型增生伴癌变，病灶大小φ 0.5cm。
(mass at left superior lobe posterior lung segment) There are some alveolar inflation, ... 阅读全帖 |
|
g******p
发帖数: 111 | 8 很感谢ACG, Cassowary, pathdoctor, and lovelypony的热心专业的帮助！！
我妈妈是四月份发病，后在上海肿瘤医院进行的手术。术后医院进行多学科会诊，不建
议adjuvant chemotherapy.我不是很确定，读了nccn的指南，感觉指南对多中心的bac
也讨论不多。
我想大家可能在医学院或者medical center，能帮我妈妈的这种情况作个咨询吗？是否应该进行adjuvant chemotherapy，什么方案比较好？
---病史---
妈妈四月家乡体检发现左上肺磨玻璃阴影（GGO,Ground glass opacity)，约1.5cm,无
任何其他症状。 60岁，从不吸烟，家庭成员无吸烟。
五月在上海肿瘤医院薄层CT,发现两肺更多结节。穿刺怀疑肺腺癌。未发现远端转移。
五月底对左肺的三个结节作了契形切除wedge resection，手术后石蜡病理报告如下。
基本上是“双肺多发性肺腺癌，以肺泡细胞癌为主”。
分子检测 EFFR 未见肯定突变。
医院多学科会诊不建议术后的放化疗，建议3个月后CT随访。
目前手术后两个半月，偶有干咳，无痰，... 阅读全帖 |
|
L********r
发帖数: 37 | 9 21. A previously healthy 85-year-old man has had abdominal distention,
decreased caliber of stools, and decreased appetite over the past 2
weeks and a 9-kg (20-lb) weight loss over the past 3 months. On
sigmoidoscopy, he is found to have a constricting adenocarcinoma of the
sigmoid colon; imaging studies show three 1-cm metastases to the liver.
Which of the following is the most appropriate next step in management?
A) No treatment
B) Radiation therapy
C) Chemotherapy
D) Combination radiation the... 阅读全帖 |
|
L********r
发帖数: 37 | 10 41. A 67-year-old man comes to the physician for a follow-up exam. Three
years ago, he underwent radical resection of a T3 N0 M0 epidermoid carcinoma
of the floor of his mouth and supraomohyoid dissection of his neck. He
currently takes no medications. He smoked three packs of cigarettes daily
for 40 years but stopped 3 years ago. Vital signs are within normal limits.
Exam shows well-healed surgical scars. There are no signs of local
recurrence. An x-ray of the chest shows a 3-cm mass in the med... 阅读全帖 |
|
b***r
发帖数: 40 | 11 尝试翻译了一下出院小结部分，大家多指教～
Discharge summary：
Date of Admission:2012-1-4
Date of Operation:2012-1-10
Date of Discharge：2012-1-29
1-year old female with acute awareness of complete vision loss,OU.
Exam:
General:well-appear
CN:unremarkable. no physical findings
Visual Acuity: NLP,OU
Pupil: 3mm, no light perception,OU (NLP-->3mm?)
MRI brain: irregular T1 and T2 signals in intrasellar and suprasellar.CE MRI
showed no apparent enhanced lesions.
Admitting diagnosis: Sellar occupying disease, probabaly a mal... 阅读全帖 |
|
h*******r
发帖数: 182 | 12 Last Easter Sunday, We had dinner with friends. 男主人头发全白了, 看了让人难
过.
Earlier his wife called us, asking us praying for his health, especially for
his deteriorating renal function. When I asked the detail, he could not
give the exact number, but he said if it still goes down, he has to consider
dialysis. He took too many medications, a lot of them I don't quite agree.
Please take a look, and give some kind suggestions.
75 year old African American, 20+ years high BP,12+ year prostate cancer
after c... 阅读全帖 |
|
a*********4
发帖数: 352 | 13 【 以下文字转载自 Nursing 讨论区 】
发信人: appleworm84 (jessica), 信区: Nursing
标 题: ileus vs small bowel obstruction
发信站: BBS 未名空间站 (Wed Jun 20 01:51:12 2012, 美东)
我一直不明白这两个诊断究竟有什么不同呢？
我最近有个病人是COLON RESECTION 之后，因为 small bowel obstruction再次入院，
之后是NGT + LIS ， 一直有观察KUB，一开始是small bowel obstruction， 后来是
AIR FILLED LOOPS MORE LIKELY ileus,医生就给他出院了，病人肚子还是很涨的。好
像ileus要比 BOWEL OBSTRUCTION 好一点啊，究竟有什么不同呢？请各位指点，谢谢！ |
|
e****0
发帖数: 678 | 14 • Exaggerated deep tendon reflexes can be seen in lock in syndrome.
• Non bleeding varices are managed with nonselective beta-
adrenergic antagonists, such as propranolol.
• Sclerotherapy, endoscopic band ligation, and surgery are
indicated after a patient has a first episode of variceal bleeding.
• TIPS is a last resort in variceal bleeding unresponsive to
medical and endoscopic intervention.
• Ischemic colitis
CT—thickening of eth bowel ... 阅读全帖 |
|
e****0
发帖数: 678 | 15 Endometrial hyperplasia types. Risk of cancer treatment
simple 1% Cyclic progestin
complex 3% Cyclic progestin
Simple atypical 8% THA or progestins
Complex atypical 29% THA or progestins
• Prolatinoma and hypothyroidism galactorrhea
• Anesthesia can reduce uterine activity if in the latent phase
• Contraceptive for lactating mother
Progestin-only oral contraceptive
• Pregnancy luteoma
African-ameri... 阅读全帖 |
|
g******p
发帖数: 111 | 16 another file, many thanks for your help!
Open-chest surgery (left lung) under general anesthesia. Three wedge
resections on the three nodules in the left lung in total: two in the left
upper lobe and one in the left lower lobe. Decortication of the lung. (is
this correct?) Four group lymph nodes in mediastinum dissected. |
|
c****e
发帖数: 188 | 17 endoscopic mucosal resection of moderate dysplasia |
|
M*****1
发帖数: 371 | 18 Endoscopic resection (or biopsy) of gastric mucosa with moderate dysplasia |
|
yf
发帖数: 272 | 19 stage? pathology? R0 resection or not?
No information, how to answer your question. Just check NCCN guideline and
figure out. |
|
yf
发帖数: 272 | 20 stage? pathology? R0 resection or not?
No information, how to answer your question. Just check NCCN guideline and
figure out. |
|
d*********n
发帖数: 18 | 21 Confusion case: O CFDP P ADL, IADL, TIA/stroke, depression, DM, thyroid,
normal pressure hydrocephalus, PAMHUGSFOSS
insulin induced hypoglycemia
Electrolyte abnormalities
Vitamin B12 deficiency
Medications
TIA
Multi-infarct dementia
Chronic subdural hematoma
Alzheimer’s dementia
Normal pressure hydrocephalus
Intracranial tumor
Neurosyphilis
Depression
Hypyothyriodism
DDx Confusion
DEMENTIA
D-Diabetes /Dementia/ Drugs
E-Epilepsy
M-Migraine/Mult Infarct Dementia
E-Ethanol (withdrawl / Toxicity)
N... 阅读全帖 |
|
r*****1
发帖数: 805 | 22 My CCS protocol:
P.S.：多有重复，谨防遗漏，仅供参考。
Screening test: General—Lipid profile/ multi-vitamin; Elderly—DEXA scan&
Calcium& VitD/ Colonscopy or FOBT/ vaccination; F-- >18yo Pap smear; >50yo
Mammogram; reproductive age- folate; menopause- Lipid/DEXA/FOBT; M-- >50yo
PSA; sickle cell dz child-prophylaxis w penicillin till 5yo, CF-prophylaxis
w Abx
Prophylaxis: Pantoprazole, pneumatic compression stocking;
Acute abd w perforation: triple Abx- Gentamycin/ Ampicillin/
Metronidazole (口诀：阿扁举旗庆国庆)
E... 阅读全帖 |
|
z******8
发帖数: 844 | 23 ☆─────────────────────────────────────☆
rhcrc11 (Rebel) 于 (Thu May 15 00:13:42 2014, 美东) 提到:
Step3考场壮烈回来。第一天挺累人，最后一个block甚至做到有心无力状，看着题反应
不过来，导致来不及做完。非常没有信心能否通过。所以match之前先考Step3的童鞋，
需要考前调整生物钟，坚持锻炼，提高耐力。
MCQ没有资格说，CCS有一点小感受，拿出来分享下。大家请轻拍砖。
复习资料：
UW 52 online cases : 基础。最好复习早起找高手一起过一遍，尽快摸熟软件，进入
状态。第二遍找一位水平相近童鞋过一遍，不断总结protocol. 考前迅速做一遍，熟练
运用protocol.
UW 41 offline cases: 我当时和partner每个case仔细做一遍，虽然不像online有反馈
，但对练临床思维，补充protocol非常有帮助。最后考试与41 case有异曲同工之处，
遇到复杂case也不慌神。
CD 6 cases： 最后再熟悉下考试软件。与UW相近，但... 阅读全帖 |
|
t******a
发帖数: 408 | 24 continue from part1,
http://www.mitbbs.com/article_t/MedicalCareer/31568337.html
here is the second part.
四、motivate yourself/ mental preparation
找到very very strong reason for doing this USMLE. Preparing for Step 2 CK is
like preparing for a marathon.
Start with a motivation: Motivation and mental preparation are critical in
starting this journey. 这会帮助我们在准备考试的学习中，truly enjoy 这个过程
，而不是觉得痛苦。
五，Do NOT fall in the trap of being familiar with something!!!
Active recall is the way to go （王道）.
If you ... 阅读全帖 |
|
N****e
发帖数: 31 | 25 在美国，通常先做liver biopsy, usually done by interventional radiology. They
can look at the CT film to see whether that tumor is accessible by biopsy
needle. If they can do it, they will obtain tissue for pathology diagnosis,
then decide the next treatment plan.
For primary liver carcinoma (Hepatocelluar carcinoma), there are several
other options,? resectable? chemoembolization (but according to the size you
mentioned, it might be too big)? liver transplantation?
I have a few patient with Primary live... 阅读全帖 |
|
L****n
发帖数: 12932 | 26 微创手术做肺叶切除？ 不是很make sense。
7分钟血氧40%-60%对大脑有多大的损伤？有没有什么办法评估？
could range from brain dead to nothing at all. No easy way to evaluate at
this point.
这有可能是麻醉师犯错了吗？
could be. but hard to prove. get the record and have other anesthesiologist
check through it.
下次手术，还应该在同一家医院吗？
better change hospital. just for the slim chance of system error.
下次手术还会发生类似危险的情况吗？
of course. thoracotomy for lope resection is a highly invasive high risk
procedure on even normal adult. let alone a 6month old baby. |
|
T*R
发帖数: 36302 | 27 这个不同意。
我经常在外科工作。我常去的是一个有60张床的大外科。最常见的是LAP APPI/CHOLE，
THR/TKR，LAMINECTOMY，COLON RESECTION, TURP/CYSTOSCOPY， HERNIA REPAIR。
我个人的感觉是外科管理比内科严格，CNA什么的也更PROFESSIONAL一些。
但是，你每天都会碰上一些ORTHO SURG的PT，他们基本都是完全COMPLETE或是需要很多
ASSIST的。想想THR PATIENT吧。
unit, |
|
y******7
发帖数: 17 | 28 The following is what I collected when I was a student doing capstone in a
local hospital. Not sure if it is useful.
Lidocaine topical is a amide-type local anesthetic. for production of
topical anesthesia, relief of pain associated with postherpetic neuralgia,
reduction of gagging during dental procedures, prevention and control of
urethral pain, anesthetic lubricant for endotracheal intubation, and relief
of hemorrhoidal pain.
Polyethylene glycol(Miralax) is a nonabsorbed solution used to trea... 阅读全帖 |
|
a*********4
发帖数: 352 | 29 我一直不明白这两个诊断究竟有什么不同呢？
我最近有个病人是COLON RESECTION 之后，因为 small bowel obstruction再次入院，
之后是NGT + LIS ， 一直有观察KUB，一开始是small bowel obstruction， 后来是
AIR FILLED LOOPS MORE LIKELY ileus,医生就给他出院了，病人肚子还是很涨的。好
像ileus要比 BOWEL OBSTRUCTION 好一点啊，究竟有什么不同呢？请各位指点，谢谢！ |
|
y*****g
发帖数: 193 | 30 Our unit just converts into a neuroscience unit. We have cerebral/spinal
stroke pts, and neurosurgery pts like SDH, SAH, IPH, post coiling or post
stent, post brain tumor resection,agniogram,ect... We deal with same
problems as other surgical/medical pts. Not much difference if you treat pt
systemically. |
|
y******g
发帖数: 317 | 31 嗯。。又仔细看了一下原文，发现我说得不太对。
事实是，他们用电击刺激患有颞叶癫痫的病人，结果病人会有dreamy state以及deja
vu的类似感觉。并且只有在刺激hippocampus 和amygdala的情况下可以实现。
In 1959,Mullan and Penfield performed electrical stimulation and
intracranial
EEG recording during temporal lobe resection in epileptic patients, and
elicited a “dreamy state” akin to déjà vu. In 1978,Halgren obtained
similar results by stimulating the deeper structures of the hippocampus and
floor of the amygdala but could not reproducibly do so in the non-diseased
hemisphere
至于另一个 |
|
C*****D
发帖数: 1299 | 32 Per our oncologist, the well differentiated one, liver mets need to be cut
aggressively, survival rate is pretty high with disease free.
If can't be cut,the prognosis is not good. Radioablation and drug are the
options. though the recent study showed the drug has some promising result,
he still prefer aggressive surgery.
My suggestion is to find out whether the liver mets are resectable or not.
The cost will be very high for liver rescetion in USA due to long post-
surgery care |
|
C*****D
发帖数: 1299 | 33 Per our oncologist, the well differentiated one, liver mets need to be cut
aggressively, survival rate is pretty high with disease free.
If can't be cut,the prognosis is not good. Radioablation and drug are the
options. though the recent study showed the drug has some promising result,
he still prefer aggressive surgery.
My suggestion is to find out whether the liver mets are resectable or not.
The cost will be very high for liver rescetion in USA due to long post-
surgery care |
|
I****a
发帖数: 407 | 34 Sorry, the report does not apply to your 外公. It is for patient who has
anatomically resectable liver cancer but does not have enough liver reserve
to tolerate the surgery. Aside from Sarafenib,there is no real good way to
treat metastatic hepatocellular carcinoma. |
|
L****n
发帖数: 12932 | 35 hey, i sincerely do wish you good luck on your board exam because your logic
in the discussion here makes me a little worry. Preparing for board don't
necessarily make you a 内行。 preparing a patient for surgery and decision
process leading to surgery is something i do everyday for many years. so
please stick to the point and refrain from negative comments, which don't
showcase your professionalism very well among your peers.
main pathological mechanism of hirshsprung's disease is bowel obstructi... 阅读全帖 |
|
h**s
发帖数: 1757 | 36 一道题目，不太搞得清。这末老还能作手术吗？
还是手术用来缓解症状呢？
帮忙讲一下，大包子伺候。。。：>D
发信人: LittleHair (LittleHair), 信区: MedicalCareer
标 题: CK NBME 2 Block 3 - Q 21
发信站: BBS 未名空间站 (Wed Sep 21 22:22:10 2011, 美东)
21. A previously healthy 85-year-old man has had abdominal distention,
decreased caliber of stools, and decreased appetite over the past 2
weeks and a 9-kg (20-lb) weight loss over the past 3 months. On
sigmoidoscopy, he is found to have a constricting adenocarcinoma of
the
sigmoid colon; imaging studies show three 1-cm ... 阅读全帖 |
|
I****a
发帖数: 407 | 37 One of the few indications for palliative primary tumor resection in
metastatic setting, anther is bleeding. |
|
V**y
发帖数: 788 | 38
biopsy美国这边都是怎么治呢？surgical removal (resection) of the abnormal
section of the colon国内医院说如果确诊也要等到三个月才能做手术，这边也一样吗
？In most cases, surgery is done within the first months after birth.我暂时 |
|
J******s
发帖数: 7538 | 39 Thanks for your sharing.:-)
For the second case, there are some similar reports.
Is pancreatic resection necessary?
.
by
positivity
far. |
|
b******a
发帖数: 704 | 40 Here are some links about this topic. Thanks for sharing such an interesting case!
1. World J Gastroenterol. 2011 November 21; 17(43): 4747–4756.
Pancreatic metastases from renal cell carcinoma: The state of the art
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3229623/
"Tumor cells apparently have a high affinity for the parenchyma of the pancreas and only there do they find the conditions they need to mature to manifest metastases. The high affinity of some renal cancer cells for the parenchyma... 阅读全帖 |
|
h*******r
发帖数: 182 | 41 贴在Medicareer只有围观没人回应, 只好来这里求助.原来贴在Medicareer, 也是希望
教授,老师们能评点以下这一治疗方案,让成长的麦穗们学习一下.多谢多谢!
Last Easter Sunday, We had dinner with friends. 男主人头发半年之内全白了, 看
了让人难
过.
Earlier his wife called us, asking us praying for his health, especially for
his deteriorating renal function. When I asked the detail, he could not
give the exact number, but he said if it still goes down, he has to consider
dialysis. He took too many medications, a lot of them I don't quite agree.
Please take a look, and give some kind s... 阅读全帖 |
|
A*******s
发帖数: 9638 | 42 来自主题: Medicalpractice版 - 周末笑话 这些都是medical records，据说都是真的， lol
1. She has no rigors or shaking chills , but her husband states she was very
hot in bed last night.
2. Patient has chest pain if she lies on her left side for over a year.
3. On the second day the knee was better, and on the third day it
disappeared.
4. The patient is tearful and crying constantly. She also appears to be
depressed.
5. The patient has been depressed since she began seeing me in 1993.
6. Discharge status: Alive but without my permission.
7. Healt... 阅读全帖 |
|
a*********4
发帖数: 352 | 43 【 以下文字转载自 Nursing 讨论区 】
发信人: appleworm84 (jessica), 信区: Nursing
标 题: ileus vs small bowel obstruction
发信站: BBS 未名空间站 (Wed Jun 20 01:51:12 2012, 美东)
我一直不明白这两个诊断究竟有什么不同呢？
我最近有个病人是COLON RESECTION 之后，因为 small bowel obstruction再次入院，
之后是NGT + LIS ， 一直有观察KUB，一开始是small bowel obstruction， 后来是
AIR FILLED LOOPS MORE LIKELY ileus,医生就给他出院了，病人肚子还是很涨的。好
像ileus要比 BOWEL OBSTRUCTION 好一点啊，究竟有什么不同呢？请各位指点，谢谢！ |
|
s*****e
发帖数: 404 | 44 Does he have known metastasis? If it is locally advanced tumor which is
unresectable, the strategy is systemic chemotherapy +/- radiology with the
goal of shrink the tumor and make it resectable. If it is metastatic disease
, the main treatment is systemic chemotherapy for palliation. If he has
very good performance status, use FOLFIRINOX; with OK performance status,
use gemicitabine based chemo regimens. If he has poor performance status,
recommend t focus on comfort care and no chemotherapy. ... 阅读全帖 |
|
s*****e
发帖数: 404 | 45 He will need to have CT of chest, abdomen, and pelvis to stage the disease
if not done already. Like I said, advanced pancreatic cancer is very poor
prognosis. Studies show people with metastatic disease in average live about
11 months with the best standard treatment (FOLFORINOX); without treatment,
the mean survival is about 6 months. Even people with early and resectable
disease, only 20% of them can be cured. This is the sad and realistic fact.
I doubt that bring him here is a better option,... 阅读全帖 |
|
i***e
发帖数: 180 | 46 PT History
1)
stomach had the Gastric wedge resection
(the final biopsy report was swchannoma 神经鞘瘤) in Mayo clinic in 2009.
2)
the smptomas have been over 2 month.
Indigestion and stomach discomfort
A bloated feeling after eating
Mild nausea
Loss of appetite
3)
in the last two weeks
weakness,...felt something in the up stomach against Stomach when eating.
The local GI Doc. was ganna to take EUS and PET CT.
She changed her idea before the appointment day.
(PT had waited the APPT for over one mont... 阅读全帖 |
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M****a
发帖数: 577 | 48 Surgical resection is a little too vague... |
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A*******s
发帖数: 9638 | 49 "Empty Nose" Syndrome
What Is Empty Nose Syndrome?
What are Turbinates?
Turbinate Surgeries
How do you prevent ENS?
Treatment
What Is Empty Nose Syndrome?
The nasal turbinates are shelf-like structures in the nasal cavity (which
begins where the inside of your nose enters your head). They serve to
provide moisture, warmth, and airflow for breathing, and many of the body's
natural defenses against infection. There are a variety of different
problems associated with the turbinates. Sometimes the t... 阅读全帖 |
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k********n
发帖数: 756 | 50 PA in neurosurgery are managing neurosurgery patients on the floor. They
never/rarely operate on patients in the OR.
It would be impposssible for any neurosurgeon in the wordl to perform 400s
surgeries annually and to specilize in both turmor resection and vascular
malformation.
If it is a true story and CMG here make excuses for Ding, there would be no
wonder that physicians in China are notoriously known for cheap labor and
their greedy. |
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