w*********r
发帖数: 42116 | 1 在一个很窄的距离范围内，非常完美。远了、近了，都看不清东西。上了白妞眼医的当
了。普通的也就200美元一年，保险报销150；multifocal的要340美元一年，也只报销
150美元。不过白妞眼医给我了个链接，新客户可以有100美元rebate。 |
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l*h
发帖数: 4124 | 2 let me clarify a little bit.
Letterer-Siwe was first described close to a hundred years ago. the use of "
Letterer－Siwe" has changed several times over the time. at this time, most
physicians use it to describe a certain clinical presentation of Langerhans
cell histiocytosis (ie. infantile multifocal multisystem type ). but some
use it as a synonym of Langerhans cell histiocytosis.
first, the diagnosis of Langerhans cell histiocytosis must be confirmed.
assuming it is the correct diagnosis,
seco... 阅读全帖 |
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l*f
发帖数: 26 | 3 上周我妈妈在家里突然休克，送到了Duke University Hospital。biopsy确诊是
multifocal glioblastoma (多位置胶质瘤）Stage 4。总共三个，左边两个，右边一个
。外科大夫认为不适宜做手术，建议传统放化疗。因为我妈是短期visit没有保险，大
夫建议回国，说是国内外没有区别。急求建议
我们目前有三个打算：
1. 回北京（应该可以马上进肿瘤或者天坛医院）做放疗，看看中医，然后再根据情况
回美国化疗，和家人在一起，因为我是独子；
2. 留在Duke。Duke估计放疗在10 - 15万美金，药品6000 - 8000每月；但是Duke大夫
似乎认为这里能做的北京都能做；
3. 去其他医院，比如Boston。不知道这里是否有更好的治疗方法。另外是否对没有保
险的外国老人有些优惠。
4. 参与Clinical Trial，但是multifocal studies很少，联系了还没有回音。
多谢建议。如需要我可以发片子。我妈妈人十分善良，住院六天所有的护士医生都很喜
欢她。看到她目前的状态十分心疼。我已经决定停止工作半年，陪她尝试一切可能的治
疗。先... 阅读全帖 |
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t****o
发帖数: 342 | 4
春大侠也来捧场，多谢, 上次指点的预激综合征还历历在目，请有空的时候再多给讲arrythmia,谢拉～
这里是记下的答案，没有桥正过拼写，如果有错，还请大家指出，一起改正
1. What labs will you order to confirm the arrhythmia?
EKG, CXR-if with SOB
2. Name all the supraventricular tachycardia
sinus tachycardia, A fibrillation, A flutter, multifocal atrial tachycardia, atrioventricular reentrant tachycardia, atrioventricular reciprocating tachycardia, paroxysmal atrial tachycardia
3. Which of these tachycardia is associated with irregular rhythm?
multifocal atrial tachycardia, A |
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R*******t
发帖数: 367 | 5 There are multifocal severe stenosis of LAD and RCA. There are also disease
involving the left circ. I am not an interventional cardiologist, but in
interventional radiology, one of the contraindications for vascular stents
placement is multifocal stenosis, which doesn't respond well with stents or
angioplasty. With three-vessel CAD, bypass is not a bad option. |
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i********r
发帖数: 12113 | 6 是不是选错了镜片？看得清远处看不清近处，你是不是应该选progressive或
multifocal的镜片？ |
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i********r
发帖数: 12113 | 7 是不是选错了镜片？看得清远处看不清近处，你是不是应该选progressive或
multifocal的镜片？ |
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x********2
发帖数: 3 | 9 １. OK镜对于青少年主要有两大优点：
a. 暂时改变角膜形状，降低（消除）近视度数，以便达到日间较为满意的裸眼视力。
这个优势是很多家长选择OK镜的主要原因之一。
b. 控制近视度数的发展，随机和非随机的临床试验显示OK镜平均对近视的控制效果比
较框架镜对照减缓５０％左右。
由于角膜优越的弹性，OK镜停戴后近视度数至少会回到治疗前的基线，至于对近视的控
制有无反弹，目前没有足够的临床资料能用于回答这个问题。但基于绝大部分青少年近
视的发展很大程度上是因为近距离用眼强度过度，而不是genetically pre-programmed
process, 在高强度用眼的阶段（也就是近视快速发展的高风险阶段）之后停戴OK镜而
导致的反弹性的近视快速增长是不太可能的。
2. 至于OK镜的费用，第一年因为验配程序的复杂性，费用较高（$1500-1900), 但之后
的复诊和镜片更换费用大致在$500左右，而且都是在保险支付之前。而且可以使用FSA
。另外还要考虑其它矫正手段的相对成本，一副质量，设计都好的框架镜一般在保险之
外都有约$200左右的额外支出。
3. OK镜的适应人群：
a. 治疗前... 阅读全帖 |
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s**a
发帖数: 1995 | 10 我五月觉得膝盖后面疼，去看医生orthopedic surgeon, x光后说有磨损，疼痛是关节
液泄漏，压迫造成的。
医生让停止骑车，去做了6周物理治疗，有改善，但有时候还是疼。
本周做了个MRI,没找出的毛病部分就不写了，毛病部分如下：
There is multifocal thinking of the patellofemoral articular cartilage with
mild subchondral edema in the torcula region of the distal femur. There are
mild patellar osteophytes. The articular cartilage in the lateral
femorotibial compartment is intact.
There is no stress fracture or osteonecrosis, there is a small Baker's cyst.
医生告诉我以后不要骑自行车了，我42岁。当然，偶尔周末玩一玩可以，每天通勤就不
要搞了。
版上学... 阅读全帖 |
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l*******e
发帖数: 3584 | 11 来自主题: TrustInJesus版 - 仿生发明 Contact Lenses of the Future Inspired by Gecko Eyes
壁虎眼睛与未来隐形眼镜
(image via: jurvetson)
Feet aren’t the only part of gecko anatomy that’s got engineers excited.
Scientists have discovered that geckos have a series of distinct
concentric zones in their eyes that make it possible for them to see
colors at night, an ability few other creatures have. These zones have
different refractive powers, giving geckos a multifocal optical system
that allows light of different wavelengths to focus on the retin... 阅读全帖 |
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W******g
发帖数: 143 | 12 Caveats regarding Cardioversion*
• Electrical cardioversion is much less effective in
treating arrhythmias caused by increased automaticity (e.g., digitalis-
induced tachycardia, catecholamine-induced arrhythmia, multifocal AT).[5]
• Patients presenting with AF or atrial flutter lasting
longer than 36–48 hr are at risk for stroke from embolized thrombus
originating in the left atrium. Studies have shown that patients are often
unaware of the onset of AF, and |
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s******t
发帖数: 579 | 13 age? PMH? SH? SxH? VS?
Progressive multifocal leukoencephalopathy? Just a wild guess. |
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V**y
发帖数: 788 | 14 外行，瞎猜一个。。
Progressive multifocal leukoencephalopathy (PML)
involved. |
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g******p
发帖数: 111 | 15 Update:
I attended an webinar by NCCN on adjuvant therapy for NSCLC pts and asked the case. The presenter is leaning towards using adjuvant chemo therapy. I am still collecting more openion on this. My mom will have first first follow up CT in Aug. I guess (guess only) if obvious disease progression were seen, chemo should be used. I still have the hope that if she can rest well and build up her immuine system, she will be able to keep the cancer in check.
Also I put together my mom's diagnosis ... 阅读全帖 |
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u*******8
发帖数: 497 | 16 瞳距（Pupillary Distance）参数，一般是配镜的时候eye tech（验光技师）给输入。
眼科医生的Rx上面，值提供诊断结果，不测量瞳距。
Near Add = Near Addition=Add,是一个意思。Near=近处。
ADD = ADD POWER (Sometimes referred to as SEG POWER)- It is additional plus
power in the lower portion of a multifocal lens (progressive, bifocal, or
trifocal) that is required for near vision
非专业来讲的话，就是用来看近的度数（俗称“老花”），也就是说这位患者在看近处
东西的时候，还需要矫正。左右眼老花度数150.
这样的镜片，价格不便宜啊。还是回国去配吧。 |
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r**********n
发帖数: 9 | 17 Sorry for the sad news about your lovely baby.
ATRT的预后非常差，是肯定的。
如果你想尝试St. Jude or Boston，您可以直接与他们联系。复制并翻译所有的医疗记
录。如果他们接受你的宝宝，通常你需要提前支付作为一个国际病人。St. Jude 是研
究医院，可能对美国人免费。不知对国际病人如何。
因为它是ATRT，你要想清楚你花代价是想要什么结果。
以下转自UpToDate:
Atypical teratoid/rhabdoid tumors — CNS atypical teratoid/rhabdoid tumors (
ATRTs) are highly malignant tumors primarily occurring in young children
less than three years old [91]. Histologically, ATRTs are characterized by
rhabdoid cells and are similar to that of other small ro... 阅读全帖 |
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L******r
发帖数: 522 | 18 Elan是我们公司的客户之一。他们的问题主要是两个，首先是bapineuzumab的二期临床
结果不理想，让大家对基于amyloid机理的药物信心严重不足，风向已经转到tau去了。
个人感觉在当前大形势下，除非三期效果很好（可能性很小），否这这个药很难批。这
个坏消息让Elan的股票从29号的33。75跌倒30号的19。63。
第二个问题是新的关于Tysabri（natalizumab)的坏消息。在2004-2005的时候，因为这
个药的副作用，Elan几乎破产，只是后来检查了所以活着的用过的病人，没发现新的
progressive multifocal leukoencephalopathy （PML)病例，Elan才活过来。祸不单
行，现在又发现了两例，Elan股票31号从20跌倒了10。几天时间，损失了60%多。
所以想抄底的要小心了，Alzheimer's的机理现在谁都不确定，做那种药是高风险的干
活，目前看来，Elan成功可能性很低。
一直对Elan印象不错，他们的nanocrystal技术是真正实用化的nano技术，比那些瞎胡
吹的强多了。他们其他一些formulation |
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a*****8
发帖数: 2115 | 19 Sorry, can only type english at work.
Brentuximab vedotin was granted accelerated approval by FDA for the
treatment of patients with Hodgkin lymphoma after failure of autologous
hematopoietic cell transplantation (HCT) or after failure of at least two
prior multi-agent chemotherapy regimens in patients who are not candidates
for HCT. Phase II clinic trial is only on 100 patients. Without looking at
the trial it self along with PHASE III, it is really hard to tell the
efficacy. Based on the abstr... 阅读全帖 |
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R*******t
发帖数: 367 | 20 有一半以上的乳癌都是multicentric/multifocal disease，做了lumpectomy应该结合
chemoradiation，可以降低死亡率。有些做了mastectomy的，可以避免放疗。 |
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b******a
发帖数: 704 | 21 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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C****a
发帖数: 1639 | 22 The biotechnology giant’s first-quarter profits beat expectations on growth
of its multiple sclerosis drug Tysabri, and at the same time the company
gave important new data on its oral multiple sclerosis drug BG-12.
Biogen said the drug cut relapses 49% after two years, compared to placebo,
with an annual relapse reduction rate of 53%. It also reduced the
progression of disability by 38%. In comparison, Teva Pharmaceutical
Industries (TEVA) last week said its oral multiple sclerosis drug reduced... 阅读全帖 |
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y*****l
发帖数: 5997 | 23 22 Hot Drugs Facing FDA Approval in 2012
By Adam Feuerstein 11/29/11 - 08:55 AM EST
BOSTON (TheStreet) -- Here's your first look at the biotech and
pharmaceutical companies with pending FDA drug approval decisions in 2012.
The calendar on the following pages captures nearly two-dozen U.S.
regulatory events -- FDA drug approvals and advisory panels -- expected
between December 2011 and July 2012. As every savvy biotech investor and
trader knows, the volatility in biotech and drug stocks ramps sig... 阅读全帖 |
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m****g
发帖数: 530 | 24 针对多发性硬化症(multiple sclerosis, MS)开发的新的免疫疗法容易引起致命性的感
染。例如，那他珠单抗
(Natalizumab)疗法会降低大脑的免疫监视作用，导致进行性多灶性白质脑病(
progressive multifocal
leukoencephalopathy, PML)，PML是一种典型的致命性病毒性脑炎。Prof. Ralf Gold
和Dr. Werner Wenning 利用血浆
治疗法(plasmapheresis)排除这种活性药品从而达到成功清除大脑中感染的病毒的目的。
关于这种治疗方法的研究报告，已经发表在《New England Journal of Medicine》杂
志上。
那他珠单抗是一种用于治疗复发多发性硬化症的单克隆抗体。该抗体能够结合到白细胞
表面的特定区域，从而降低白细胞
结合并穿越炎症组织血管壁的能力，因此，这种抗体抑制了白细胞攻击髓鞘引起的破坏
性影响，但白细胞具有攻击外来物
质(如病毒、细菌等)的能力，因此，该药物的缺点在于降低了大脑的免疫防御能力。
血浆治疗法的目的是除去JC病毒，重建患者的免疫系统。那他珠单抗在人 |
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