f********r
发帖数: 3155 | 1 激光测距普及的今天，一枪下去，POI低了十个MIL的可能是在不大，平常应用EBR-2B应
该够用了
TReMoR2 那个30MIL的Reticle，是否可以理解成是给如下用途
1。直接用Reticle hold over，不调高低和风偏塔轮
2。超远程射击，镜子内部调节不够，可以加上Reticle hold over，实现四五十MIL的
drop
如果我的理解正确，TReMoR 2无敌了，除了不知道对观测的干扰有多大 |
|
G***a
发帖数: 27294 | 2 (1) 首先parkinson，是motor disorder，不是“痴呆”，至少在一期二期，脑子很清楚
没有记忆障碍，没有认知障碍。不能叫痴呆啊，所以不能分到“老年痴呆”里面吧
为了confirm这点，我又查了专业的neurology的医典（当初花了很多银子，今天终于派
上用场）
完全没有cognitive impairment症状
(2)发病机理是这样的，脑干有一个结构叫substantia nigra,它的主要功能，制造
dopamine
dopamine是一种神经递质，运动皮层（motor cortex)需要它才能发出信号
而帕金森的病人，substantia nigra无法制造足够多巴胺，于是无法有足够的运动信号
送出
导致主要症状：Bradykinesia(行动迟缓）, hypokinesia（自主运动降低）,
akinesia（难以开始一个动作）, tremor（颤抖）, rigidity（僵硬）,
postural instability（站不稳）, drooling（嘴歪留口水）
gait impairment（驼背站不直）
（3）很多时候，手颤，不是因为帕金森本身，... 阅读全帖 |
|
G***a
发帖数: 27294 | 3 (1) 首先parkinson，是motor disorder，不是“痴呆”，至少在一期二期，脑子很清楚
没有记忆障碍，没有认知障碍。不能叫痴呆啊，所以不能分到“老年痴呆”里面吧
为了confirm这点，我又查了专业的neurology的医典（当初花了很多银子，今天终于派
上用场）
完全没有cognitive impairment症状
(2)发病机理是这样的，脑干有一个结构叫substantia nigra,它的主要功能，制造
dopamine
dopamine是一种神经递质，运动皮层（motor cortex)需要它才能发出信号
而帕金森的病人，substantia nigra无法制造足够多巴胺，于是无法有足够的运动信号
送出
导致主要症状：Bradykinesia(行动迟缓）, hypokinesia（自主运动降低）,
akinesia（难以开始一个动作）, tremor（颤抖）, rigidity（僵硬）,
postural instability（站不稳）, drooling（嘴歪留口水）
gait impairment（驼背站不直）
（3）很多时候，手颤，不是因为帕金森本身，... 阅读全帖 |
|
s**p
发帖数: 702 | 4 http://www.23andMe.com/a/ff1/y1v8a
Offer Expires: Dec. 27th, 2011
这个折扣好久没有了，上次还是2010年的DNA day，那次是99元，那次原本说全天打折
，可是到了下午4点多就提前结束了。
这次只要79！！！大家快去抢啊！
可以测出以下疾病的得病概率
Abdominal Aortic Aneurysm
Age-related Macular Degeneration
Alcohol Dependence
Alopecia Areata
Ankylosing Spondylitis
Asthma
Atopic Dermatitis
Atrial Fibrillation
Atrial Fibrillation: Preliminary Research
Attention-Deficit Hyperactivity Disorder
Back Pain
Basal Cell Carcinoma
Behçet's Disease
Bipolar Disorder
Bipolar Disorder: Preli... 阅读全帖 |
|
s**p
发帖数: 702 | 5 以下疾病的得病概率
Abdominal Aortic Aneurysm
Age-related Macular Degeneration
Alcohol Dependence
Alopecia Areata
Ankylosing Spondylitis
Asthma
Atopic Dermatitis
Atrial Fibrillation
Atrial Fibrillation: Preliminary Research
Attention-Deficit Hyperactivity Disorder
Back Pain
Basal Cell Carcinoma
Behçet's Disease
Bipolar Disorder
Bipolar Disorder: Preliminary Research
Bladder Cancer
Brain Aneurysm
Breast Cancer
Breast Cancer Risk Modifiers
Celia... 阅读全帖 |
|
m*****n
发帖数: 7450 | 6 这个我也不太清楚，不过我不会俄语，没法读原文。一般来说，我觉得托斯陀耶夫斯基
的小说很多这样的，他风格明显嘛，各种人物心理描写交叉和意识流手法。而且关于长
句，不知道这里有没有一个翻译体的原因。我查这段的英文如下，感觉读起来顺很多。
But it had become quite a different matter with Aglaya. All the affectation
of manner which she had displayed at the beginning disappeared as the ballad
proceeded. She spoke the lines in so serious and exalted a manner, and with
so much taste, that she even seemed to justify the exaggerated solemnity
with which she had stepped forward. It was impossible to discern in her now
anyth... 阅读全帖 |
|
K*****u
发帖数: 241 | 7 怎么一个故事写了两次，前后描述还有差异？恳请能看懂的人指点。
Nothing Has Changed by Colin Thubron
Colin Thubron started his career in documentary film and in TV. He made
his reputation, though, as a travel writer, especially in the Middle East.
He has more recently turned to novels. There is a journey in this story; it
is an exploration of the writer's own feelings when faced with both his loss
and someone else's. Whether the woman in the story really existed or not
does not matter; the situation is a very human one.
We writ... 阅读全帖 |
|
g*****y
发帖数: 1488 | 8 有啊，那个是Joan Didion 成名作吧。Slouch 那个是Yeats诗里来的，所以我一直觉得
那本书会很有末日临近的味道，但读下来主要感觉Didion是个自己都难伺候自己的人，
呵呵。 不过文笔功力真厉害：
Once, in a dry season, I wrote in large letters across two pages of a
notebook that innocence ends when one is stripped of the delusion that one
likes oneself. Although now, some years later, I marvel that a mind on the
outs with itself should have nonetheless made painstaking record of its
every tremor, I recall with embarrassing clarity the flavor of those
particular ashes. |
|
d****d
发帖数: 358 | 9 从地心窜出 Tremors 1-4
杀出个黎明 From Dusk Till Dawn 1-3
林正英 僵尸系列 |
|
m*****d
发帖数: 13718 | 10 我又想起一个来
Tremors 1,2,3
行。 |
|
A****h
发帖数: 1486 | 11 让贝神给大家讲解讲解小黑屋的感受吧，是不是有withdraw symptom 啊，比如说
tremor,
restlessness,seizure什么的。 |
|
r*z
发帖数: 1679 | 12 这个女孩是同事的朋友。日本的社会治安相当好啊。
Things here in Sendai have been rather surreal. But I am very blessed to
have wonderful friends who are helping me a lot. Since my shack is even
more worthy of that name, I am now staying at a friend*s home. We share
supplies like water, food and a kerosene heater. We sleep lined up in
one room, eat by candlelight, share stories. It is warm, friendly, and
beautiful.
During the day we help each other clean up the mess in our homes. People
sit in their cars, looking at news... 阅读全帖 |
|
|
S**K
发帖数: 3648 | 14 是啊，不准你拿这个开玩笑。patients很可怜，如果插对了地方，resting tremor全消
失。 |
|
G*********o
发帖数: 49669 | 15 骚蕊
没有开玩笑
那你经常给帕金森病人治疗？
是啊，不准你拿这个开玩笑。patients很可怜，如果插对了地方，resting tremor全消
失。 |
|
S**K
发帖数: 3648 | 16 lol
resting tremor?
patpat |
|
G*********o
发帖数: 49669 | 17 是的，谢谢安慰。
lol
resting tremor?
patpat |
|
x****o
发帖数: 21566 | 18 The following is the 500-mile email story in the form it originally appeared
, in a post to sage-members on Sun, 24 Nov 2002.:
From [email protected]
/* */ Fri Nov 29 18:00:49 2002
Date: Sun, 24 Nov 2002 21:03:02 -0500 (EST)
From: Trey Harris <[email protected]
/* */>
To: [email protected]
/* */
Subject: The case of the 500-mile email (was RE: [SAGE] Favorite impossible
task?)
Here's a problem that *sounded* impossible... I almost regret posting the
story to a wide audienc... 阅读全帖 |
|
H********g
发帖数: 43926 | 19 万灵药啊
Diphenhydramine is an antihistamine mainly used to treat allergies.[5] It is
also used for insomnia, symptoms of the common cold, tremor in parkinsonism
, and nausea. |
|
t******g
发帖数: 3641 | 20 止痛药：
Side effects of gabapentin can include dizziness, poor coordination,
drowsiness, blurred vision, double vision, irregular eye movement, nausea,
vomiting and tremors.
Store gabapentin at room temperature and keep the medication away from
moisture.
---------------------------------------------
驱虫药：
Fenbendazole is a generic drug, but it is also available under the brand
name Panacur.
Vomiting
Some cats and dogs may vomit shortly after they ingest the drug,
although most animals wi... 阅读全帖 |
|
m*******u
发帖数: 6052 | 21 貌似不可以的，按照shelter的说法，是猫妈孕期中出现的问题
The vet thinks that the kitties mother was exposed to Feline Panleukopenia
Virus (FPV), also known as Feline distemper when she was pregnant. The
exposure could've resulted in the disorder in both kitties called Cerebellar
Hypoplasia which causes jerky movements, tremors and generally
uncoordinated motion. |
|
s****t
发帖数: 17096 | 22 Puppies who display trembling in the legs or other areas and who have not
been fully vaccinated may be suffering from distemper, according to WebMD.
Distemper is a viral infection that also causes coughing, fever and runny
nose. Treatments for distemper include antibiotics, hydration via fluids,
airway dilators and physical therapy.
Dogs of certain breeds are prone to shaking from what is known as GTS or
General Tremor Syndrome. WebMD and PetMD explain that GTS occurs in dogs
between the ages of... 阅读全帖 |
|
w********h
发帖数: 12367 | 23 Edward Carpenter, 1905, The Ocean of Sex
The Ocean of Sex
To hold in continence the great sea, the great ocean of Sex, within one,
With flux and reflux pressing on the bounds of the body, the beloved
genitals,
Vibrating, swaying emotional to the star-glint of the eyes of all human
beings,
Reflecting Heaven and all Creatures,
How wonderful!
Scarcely a figure, male or female, approaches, but a tremor travels across
it.
As when on the cliff which bounds the edge of a pond someone moves, then in
the |
|
s***s
发帖数: 352 | 24 还是等到mega tremor真来了的时候再看吧，忠不忠看行动
事 |
|
i**i
发帖数: 1500 | 25 Parkinson’s disease affects 6.3 million people worldwide, causing weakness
and tremors, but there's no objective way to detect it early on. Yet.
Applied mathematician and TED Fellow Max Little is testing a simple, cheap
tool that in trials is able to detect Parkinson's with 99 percent accuracy
— in a 30-second phone call. |
|
j***h
发帖数: 4412 | 26 New Zealand Building Code Gave All-Clear Before Quake
Wall Street Journal - Geoffrey Rogow * MARCH 1, 2011
CHRISTCHURCH—Experts are questioning why so many of the buildings damaged
in last year's earthquake in New Zealand were given the all-clear, an
alleged oversight that some say added to the calamity brought by last week's
quake in Christchurch.
"Everything had been weakened by that first quake, that's for sure," said
Steve Calanog, a federal "on scene" coordinator for the U.S. Environm... 阅读全帖 |
|
K**********n
发帖数: 1197 | 27 学术界珍稀有限的原版外文资料，
Remote Mind Control Technology
Reprinted from SECRET AND SUPPRESSED: BANNED IDEAS AND HIDDEN
HISTORY, edited by Jim Keith, $12.95, available from
1-800-680-INET.
There had been an ongoing controversy over health effects of electromagnetic
fields (EMF) for years (e.g., extremely low frequency radiation and the
Navy's Project Seafarer; emissions of high power lines and video display
terminals; radar and other military and industrial sources of radio
frequencies and micr... 阅读全帖 |
|
l********y
发帖数: 2295 | 28 I am confused too, I checked few different text books, looks like tremor is
never considered normal.
someone else did uw sim, and found in one of the explanation, it
said decreased vib sensation is normal in elderly. that was why i checked
the text book.
again i am not sure that's why i am posting the questio here.
right? |
|
s******t
发帖数: 579 | 29 For the vibration and tremor, let me ask a neurologist first.
I know we should do EKG to rule out the most dangerous condition - MI or
something similar and A-fib as you said, but he got MI in the past, we know
his heart has problem, now we need to do echo to find more information, but
I would do EKG first, since it won't take long and will give us good
information.
Can you change your title to call acne and springstep to take a look at
those questions since they are the specialist? |
|
A*******s
发帖数: 9638 | 30 国人喜酒，没酒怎么能开party？ 酒精能让人感觉high，忘乎所以，滔滔不绝，甚至公
布隐私。大学时代，酒精带给我们的回忆至今仍历历在目： 一杯酒下去， 脸红了，
眼迷了， 暗恋的对象暴露了。。呵呵。
可惜事物都有两面性。
美国有一大批酒鬼，每年政府花费了大量的财富。 在当今medicare面临破产的窘境中
，居然没人提任何法案加以管制， 令人郁闷。
圣诞节期间，我在ICU看了3个因酒精入院的。都是30-50岁， intoxication, seizure
，和delirium tremor。这种人都没有保险，在ICU一呆就是3-7天， 花的都是纳税人的
钱哪！我牺牲我的假日， 得不到任何回报， 还要倒贴， 为的只是这帮酒鬼的花天酒
地。 要知道， 这些瘾君子戒酒的可能性只有1%，只要活着出院，肯定又是beer加
liquor，一杯又一杯。 就这样医院-家-酒店-医院，日复一日， 年复一年，Medicare
不破产才怪呢。
酒精引起肝硬化，肿瘤， 抑郁自杀， 消化道出血， 阳痿， 记忆下降，车祸 和婚姻
危机。 所以找对象离瘾君子远点。 这些人一般很nice，绝对的海誓山盟。 我记得... 阅读全帖 |
|
c*****t
发帖数: 625 | 31 昨天回来的早，花了点时间读了几篇相关的文献，写了一个minireview，供大家参考和
讨论。谢谢大家的参与和建议。
The literature does not indicate that beta1-
selective betablocking agents have adverse effects on
glucose metabolism, prolong hypoglycemia or mask
hypoglycaemic symptoms. Specifically, some studies described diminished
occurrence of tremor and heart-pounding, but increased sweating. In diabetic
nephropathy
betablockers are as nephroprotective as ACEI (J of internal medicine, 2001).
But beta-blockers should not be used as a first-line ch... 阅读全帖 |
|
s******h
发帖数: 103 | 32 因为时间短，纽约学习班的重点是查体，问病史教的很简略，而SP是随机抽取case，老
师即兴讲。问题就是不一定能完全覆盖，而且笔记也不一定记完整。所以自己回来总结
口诀反复练习是很重要的。比如我总结的Fatigue的鉴别诊断：
Fatigue and weight loss (DAMN SHiT)
Diabetes mellitus
1. Do you have any change of urination?
2. Are you more thirsty? Increased snacking?
3. How about your appetite? Do you have any change of your body weight?
Diet?
Depression:
1. How is your mood?
2. Did you thought to hurt yourself? Do you have any plan?
3. Do you have family to support you? Do you have any friend... 阅读全帖 |
|
e****0
发帖数: 678 | 33 • 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 |
|
i**********d
发帖数: 853 | 34 Hawthrone effect: Hauthrone好手 --> 我们是“好手” --> 知道被研究时好好表现。
Collagen 4型 (部分是从别的同学那里听来的)：
1型：老大硬：筋骨皮牙本硬，角膜瞪人，伤口愈合晚不怕
2型：老二软：骨软韧性好，眼睛玻璃软，脊梁髓核软
3型：三妹红彤彤：粉红皮肤，生孩子--> 子宫切，见血管，现胚胎组织，愈合有肉芽
组织
4型：最小，位置最低，住在basement
Hemophilia A (8因子) & B (9因子)--> 阿爸8必救9
Fragile X --> CGG 脆哥哥 --> 脆弱的哥哥注意力不集中 --> ADHD
Spiramycin: given to the mother to prevent vertical transmission of
toxoplasmosis. “弓”黄忠射箭, 披靡-箭是螺旋状 Spiramycin
螺旋霉素
Podophyllin (刨倒树林--把黑树林里的wart给刨了):
1. Remove genital warts; 2. Molluscum... 阅读全帖 |
|
i**********d
发帖数: 853 | 35 Hawthrone effect: Hauthrone好手 --> 我们是“好手” --> 知道被研究时好好表现。
Collagen 4型 (部分是从别的同学那里听来的)：
1型：老大硬：筋骨皮牙本硬，角膜瞪人，伤口愈合晚不怕
2型：老二软：骨软韧性好，眼睛玻璃软，脊梁髓核软
3型：三妹红彤彤：粉红皮肤，生孩子--> 子宫切，见血管，现胚胎组织，愈合有肉芽
组织
4型：最小，位置最低，住在basement
Hemophilia A (8因子) & B (9因子)--> 阿爸8必救9
Fragile X --> CGG 脆哥哥 --> 脆弱的哥哥注意力不集中 --> ADHD
Spiramycin: given to the mother to prevent vertical transmission of
toxoplasmosis. “弓”黄忠射箭, 披靡-箭是螺旋状 Spiramycin
螺旋霉素
Podophyllin (刨倒树林--把黑树林里的wart给刨了):
1. Remove genital warts; 2. Molluscum... 阅读全帖 |
|
b*******s
发帖数: 954 | 36 第一道题，在elora 以及jbh2009的回答上，再补充一下
是Fragile X。
(1) X-link的疾病，现在的看法是x-dominant或者x-recessive的提法签妥当(请看
uptodate或者其他资源）
(2) 对Fragile X来说，5'-UTR的CGG有expansion.
Normal: CGG repeats < 45
Grey zone: 45 < CGG repeats < 55
Premutation: 55 < CGG repeats < 200
Premutation由于有较长的5'-UTR转录出的RNA, 这些RNA可能会特别稳定，作为sink,
和一些重要的蛋白作用，影响这些蛋白的功能。
Full mutation: 200 < CGG repeats
Full mutation的5'UTR被methylated, FXMR蛋白无法表达
Premutation和full mutation的重要差别是premutation仍然可以表达FXMR蛋白。所以
premutation和full mutation的症状非常不一样。premutation... 阅读全帖 |
|
r*********n
发帖数: 130 | 37 自己当时整理了不少。。等有空了再整理出来分享。现在先分享下网上当时找到的一些
觉得不错的。
PANICS( taken from FA for step 1)
1.Panic, paresthesia
2.Abdominal disturbances, anxiety
3.Nausea
4.Intensive fear of dying
5.Chest pain, chills, chocking
6.Sweating, shacking, shortness of breath
Jaundice case.
JAUNDICE B
1.Journey overseas/Joint pain
2.Abdominal pain/appetite changes
3.Up temperature( fever)
4.Nausea/vomiting
5.Diarrhea/constipation
6.Itch(rash)/Immunizations
7.Color of urine and stool
8.Eating habits -weight changes
9.Blood transf... 阅读全帖 |
|
T****g
发帖数: 705 | 38 E
hypoglycemia (tremors, sweating, palpitations)=sympathetic system mediated.
b-blockers block catecholamine actions, so it masks the hypoglycemic
symptoms. |
|
T****g
发帖数: 705 | 39 Agree.
Patient does not completely meet the major depression criteria. I picked it,
because of "2 months history of cognitive changes", tearful appearance, not
functional well to take Insulin.
Diabetic encephalopathy presents itself both mentally and physically. It can
induce an altered mental state, cognitive decline, changes in personality,
memory lapses, or severe impairment like dementia. The complication can also
cause tremors, lack of coordination, and even seizures.
It can be caused by hy... 阅读全帖 |
|
H*********e
发帖数: 163 | 40
对不起 我还没有正式工作！只是得到了offer！但是我的preceptor 是在小医院做得！
当时做得是ER OB and med surg！ 小医院工作起来比较轻松，相对压力小很多！ 人都
非常nice！起码表现出来的是这样的。我在ER 工作的时间比较多，对病人做基本的
assessment，询问病情病史 全部都是有电脑显示的，只需要照着问。start IV， EKG
，这是基本，采集血sample urine sample， sometimes， nasal swab。然后就是给
药，医生开药 给药！最多的就是协调工作，和医生的协调，主要报告病人情况，还有
就是把医生的意见传达给病人！ 和各个检验科的联系，CT MRI ultrasound， floor
nurse if need admitted。 然后就是chart. 刚开始回比较忙，因为有时候好多病人，
需要统筹规划！ 还有就是和病人的交流比较重要，explain everthing. do not
assume they already know what is going on here. let them prep... 阅读全帖 |
|
b******8
发帖数: 1251 | 41 anticholinergic for tremor, for example: benztropine or trihexyphenidyl, all
by prescription. |
|
n****l
发帖数: 15 | 42 同意这种情况没有亲自检查，只能泛泛而谈。我觉得首先最主要是定位，确定是周围神
经病 （CTS and ulnar neuropathy at the elbow, ?HNPP) 还是中枢神经受损导致的
肌肉痉挛或focal dystonia (writer's hand), 这需要一个合格的神经传导/肌电图检
查。也觉得Wilson 和 tremor (不会有无力和疼痛）的可能小， 治疗上Botox 是另一
种选择。 |
|
A*******s
发帖数: 9638 | 43 最近看到报道国内专家门诊号1000元，而目前普通号也就是几块钱。
专家凭什么拿这么高的挂号费？当然是他们丰富的临床经验，年资越长，经验越丰富，
特别是中医这类的，中国人买这个帐。
美国的情况显然不同，专科医师收费比家庭医生稍高，当然一倍也不到。 这取决于他
们受训需要的时间，而不是工作后的时间长短。 1000：2这样500倍的差距也太大了。
举一个例子，Essential Tremor，症状就是手抖不能写字，诊断不难，治疗依据是
evidence based medicine，Class Ia当然是最好，当然也有Class II的， 美国医生都
了然于心，刚刚毕业的跟工作几十年的，治疗方法都差不多，凭什么老医生多要病人的
钱？
标准化的诊断和治疗实际上就是缩小年轻医生和老年医生差距的根本原因，在真理面前
人人平等，中国现在在追求循证医学（Evidence based medicine），可国内的主任教
授们如果知道
循证医学一旦在中国普及，他们的特权就会烟消云散，中医的地位也会沦落到辅助医学
，中国医学就真的翻天了， 我打赌金字塔顶上的当权者肯定不能同意。
当然医学还不纯粹是科学，艺术... 阅读全帖 |
|
A*******s
发帖数: 9638 | 44 从2个西药的信息我猜测这个病人有肌肉僵硬,所以用第一个药; 这个病人肯定有行走困难
,所以用第2个药, 加上病史中病人有手抖, 摔倒, 所以我大胆猜测这个病人有巴金森氏
病的4大特征:
1.Tremor
2.Bradykinesia
3.Postural instability
4.Rigidity
如果诊断正确,药物治疗没准可以让老人重新独立行走.
至于其他5个药估计是有回扣的,反正吃不死人,呵呵
在网上替人猜病是不是像写侦探小说? |
|
A*******s
发帖数: 9638 | 45 从7个药的信息我猜测这个病人有肌肉僵硬,所以用第一个药; 这个病人肯定有行走困难
,所以用第2个药, 加上病史中病人有手抖, 摔倒, 所以我大胆猜测这个病人有巴金森氏
病的4大特征:
1.Tremor
2.Bradykinesia
3.Postural instability
4.Rigidity
如果诊断正确,药物治疗没准可以让老人重新独立行走.
至于其他5个药估计是有回扣的,反正吃不死人,呵呵
在网上替人猜病是不是像写侦探小说? |
|
