l**********n
发帖数: 60 | 1 As indicated in the title, several reviewers are needed to review a
manuscript: Metformin is not associated with lactic acidosis in diabetic
patients undergoing coronary artery bypass graft surgery: A case control
study.
The journal is BMC Pharmacology & Toxicology (IF 2.3), please let me know if
you are interested. I would prefer experts with expertise in the related
area.
Thank you. |
|
l******e
发帖数: 14 | 2 Good tip! I thought met acidosis plus resp alkalosis first, so my initial
impression was to rule out ASA toxicity.
Now with met alkalosis, it becomes interesting.
So, if ever AG is increased, we have to calculate delta-delta, which equals
to delta AG/delta bicarb. if delta-delta is between 1-2, it's only AG met
acidosis; less than 1, then AG and non-AG met acidosis at the same time;
greater than 2, it's AG meta acidosis and met alkalosis.
Since this patient presented with dizziness, being hypote |
|
l*****n
发帖数: 81 | 3 when you decide it's metabolic acidosis, the right next step is use winter
formula as Soaplover said to see whether there is superimposed respiratory
component
1.5x HCO3 +8 = calculated compensatory CO2
Compare the real CO2 to compensatory CO2, if significantly greater, then
metabolic acidosis plus respiratory acidosis, if less, then metabolic
acidosis plus respiratory alkalosis |
|
f****o
发帖数: 2770 | 4 http://www.gastrojournal.org/article/S0016-5085(06)00735-9/abst
疗效文献原文
可以下载pdf
Histologic improvement occurred in 55% (68/124) of entecavir-treated vs 28%
(32/116) of lamivudine-treated patients (P < .0001). More patients on
entecavir than lamivudine achieved the composite end point: 55% (77/141) vs
4% (6/145), respectively (P < .0001). Mean change from baseline in HBV DNA
was -5.11 log(10) copies/mL for entecavir-treated patients and -0.48 log(10)
copies/mL for lamivudine-treated patients (P < ... 阅读全帖 |
|
s******n
发帖数: 65 | 5 The patient with PH 7.24 PO2 100, PCO2 38, HCO 17,
a Metabolic acidosis,
b Metabolic acidosis+respiratory acidosis
Any one knows the formula?
Many thanks |
|
h*****i
发帖数: 40 | 6 The client with hyperemesis gravidarum is at risk for developing:
1.
Respiratory alkalosis without dehydration
2.
Metabolic acidosis with dehydration
3.
Respiratory acidosis without dehydration
4.
Metabolic alkalosis with dehydration
正确答案是
2
我记得呕吐是会造成metabolic alkalosis，为什么会是acidosis呢。
谢谢回答 |
|
发帖数: 1 | 7 首先你可以问问以前进入这个program的前辈，他们经历过的会有最直接的信息，以及
面试的流程。因为这些要求学校和学校之间有着非常大的不同。
说说我的经历，我三周前也经历了面试，其中一个program就是分两边部分面试，一部
分是和school administration group的人面试，另一部分是和CRNAs,也就是来自各个
医院将来可能成为你preceptor以及clinical coordinator的人面试。school
administration的面试大多千篇一律，谈谈理想，聊聊人生，按照政治正确的标准对话
夹杂一点个人感情色彩，不能太生硬，网络上的问题都差不多。最关键的就是下一部分
，这部分负责clinical 的人大多非常聪明，他们会在测试你专业知识的基础上测试你
的抗压能力以及应变能力，根据你的回答能看出逻辑上的不通以及破绽，会有角色play
good cop负责鼓励安抚你,会有角色play bad cop as well, trying to intimidate
you,这时候就要沉住气。这个部分，差不多是决定我们能否进去的关键。
我拿到的scenario是... 阅读全帖 |
|
发帖数: 1 | 8 首先你可以问问以前进入这个program的前辈，他们经历过的会有最直接的信息，以及
面试的流程。因为这些要求学校和学校之间有着非常大的不同。
说说我的经历，我三周前也经历了面试，其中一个program就是分两边部分面试，一部
分是和school administration group的人面试，另一部分是和CRNAs,也就是来自各个
医院将来可能成为你preceptor以及clinical coordinator的人面试。school
administration的面试大多千篇一律，谈谈理想，聊聊人生，按照政治正确的标准对话
夹杂一点个人感情色彩，不能太生硬，网络上的问题都差不多。最关键的就是下一部分
，这部分负责clinical 的人大多非常聪明，他们会在测试你专业知识的基础上测试你
的抗压能力以及应变能力，根据你的回答能看出逻辑上的不通以及破绽，会有角色play
good cop负责鼓励安抚你,会有角色play bad cop as well, trying to intimidate
you,这时候就要沉住气。这个部分，差不多是决定我们能否进去的关键。
我拿到的scenario是... 阅读全帖 |
|
N******t
发帖数: 16051 | 9 这个理论叫做“acid-ash hypothesis”，说大量动物蛋白的摄入会导致体内pH变酸，
需要分解骨骼提取钙质来中和
事实上，近期的几篇meta－analysis都不支持这种观点。我摘抄最近一篇review的
abstract：
"Milk and dairy products neither produce acid upon metabolism nor cause
metabolic acidosis, and systemic pH is not influenced by diet. Observations
of higher dairy product intake in countries with prevalent osteoporosis do
not hold when urban environments are compared, likely due to physical labor
in rural locations. "
"Measurement of an acidic pH urine does not reflect metaboli... 阅读全帖 |
|
H********g
发帖数: 43926 | 10 1%对大多数人来说问题不是很大。尤其是如果在几百几千年里慢慢增加到1%，大部分人
可能就适应了。少数人当然是会不适应的。于是造成了新的内需。
Carbon dioxide content in fresh air (averaged between sea-level and 10 kPa
level, i.e., about 30 km (19 mi) altitude) varies between 0.036% (360 ppm)
and 0.041% (410 ppm), depending on the location.[93][clarification needed]
CO2 is an asphyxiant gas and not classified as toxic or harmful in
accordance with Globally Harmonized System of Classification and Labelling
of Chemicals standards of United Nations Economic Commission f... 阅读全帖 |
|
w*****s
发帖数: 230 | 11 附件是主治大夫的reasoning(email回复，红字)， 他的水平我们还是很佩服的，因为
他已开始猜了个病就和我们宝宝症状非常一致，可惜后来发现不是；而且他不是代谢病
专家。
问题是坚持宝宝不吃长链脂肪酸的奶粉后，他奇迹般地改善了；完全出乎医生们的预料
。我感觉医生列的是常见的代谢病，而我们感觉宝宝吃长链脂肪酸似乎是慢性中毒，大
概需要一个月左右才能体现出来。因为过程很慢，我们怀疑很多方法查不出来。
我们最大的问题是如果是这种病怎么查？不能确认的话他一辈子吃饭都受影响，基本也
就很难出门时间长一点了。尤其是他的肝已经在要换的边缘。医生们现在改口说他的病
程都是偶然，可我们不能同意。为什么每次都是长链吃一段时间就得病，尤其是这次停
了鸡蛋后马上改善。。
谢谢大家。 （下面是文字，可惜设置不成红色）
Q: Our biggest concern is the reason of his liver damage.
A: The biopsy shows severe fibrotic changes and tells us that this is not a
liver that ... 阅读全帖 |
|
W******g
发帖数: 143 | 12 echnique
If time permits, metabolic abnormalities such as hypokalemia and
hypomagnesemia should be corrected before attempting cardioversion. At a
minimum, hypoxia should be corrected with supplemental oxygen. If a patient
has metabolic acidosis, compensatory hyperventilation after endotracheal
intubation may be indicated prior to cardioversion. Respiratory acidosis
should always be treated prior to the use of sedative drugs. |
|
b****o
发帖数: 169 | 13 there is a question saying a patient with an acute asthma attack, whose
arterial blood gas on 50% oxygen reveals pH of 7.34, PCO2 of 38 mm/Hg, PO2
of 55mm/Hg and bicarbonate of 20mEq/L. I just wondering how come a asthmatic
patien can have a metabolic acidosis? i thought it is supposed to be
respiratory acidosis because of the retention of CO2. |
|
s*******r
发帖数: 174 | 14 First u got it is met acidosis because hco is 17, then u calculate
compensation by winter fomular co2 should be 33
with adequate compensation. Ur real co2 is 38, so u got the conclusion that
there is also res acidosis. |
|
m*****5
发帖数: 438 | 15 The answer is A. This is a case of anion and non anion gap metabolic
acidosis (winters formula 1.5 x 11 + 8) For a bicarbonate of 11 the pCo2
should be around 25 but it is lower (19) so this is not a simple DKA. Second
the patient is unresponsive which could be due to severe metabolic acidosis
so the first treatment should be focused on reversing it as soon as
possible, hence the administration of bicarbonate. |
|
m*****5
发帖数: 438 | 16
我认为答案b不正确。B is not correct because the treatment of DKA is never
insulin and glucose, it is insulin and saline. Secondly the question is
asking for immediate treatment which is A (bicarbonate). Of course later
on you will give them saline and insulin but that will take time to
correct the acidosis. Second this is not a simple acidosis from DKA
because pCO2 compensation is more than the loss of bicarbonate which means
that there is some acid present in the body which cannot be accounted for
by t |
|
i********9
发帖数: 12 | 17 题就是题嘛，值得argue的地方很多，没有chem7，没有vitals。在real world 至少要
知道有没有pulse才能make
decision嘛。we need to know electrolytes for anion gap, otherwise just by
Abg number, this could be non ag
metabolic acidosis, this could be rta. But if you go over the answers, they
r all about dka management. B is still the
best answer, assuming this patient does have pulse. That abg, He has
respiratory alkalosis on top of ag acidosis,
assuming there is a gap.
|
|
f****i
发帖数: 129 | 18 Hi RICU, I have a question: in respiratory acidosis, can metatolic
compensation overcompensate to a ph greater than 7.4?
or overcompensation can change a primary acidosis state (<7.4) to a
alkalosis satae(>7.4), or vise versa？
higher
or |
|
d******u
发帖数: 10 | 19 谢谢各位大拿指导，非常非常有帮助。这是一个真实的病例，我们下周要见病人，导师
让先自己分析一下病历。
The current blood glucose was obtained in BMP lab work. Thus, I suppose it
is fasting BG. Pt checks his BG sporadically, and reports no symptomatic
hypoglycemic episodes in last visit.
Still some questions I am not clear:
Why is Lantus better than Levemir? Anion Gap is 15, but I don’t have his pH
. Is it metabolic acidosis? If yes, Metformin should be discontinued, since
it is contraindicated in metabolic acidosis.
If both FBG and postprandial B... 阅读全帖 |
|
J******f
发帖数: 355 | 20 如果是手术后药物造成的RESPIRATORY DEPRESSION，进而产生ACUTE RESPIRATORY
ACIDOSIS， 体味和深呼吸的作用非常有限，应该要上呼吸机的；
如果是上呼吸道手术造成大量的EXCRETION，应该要SUCTION；
而且ACUTE RESPIRATORY ACIDOSIS基本算是MEDICAL EMERGENCY了，应该要MEDICAL
INTERVENTION， NURSING INTERVENTION 作用有限。
以上是我的二分钱。希望楼主贴答案和RATIONAL。
fowler's position，然后鼓励深呼吸。 |
|
a******a
发帖数: 57 | 21 My guess is: mixed metabolic acidosis (anion gap) and metabolic alkalosis,
his anion gap is more than 30,high anion gap, in the setting of urine/blood
ketone levels high, and drinking history, metabolic acidosis likely exists;
he also had nause/vomitting,and volume contraction, this would lead to
contraction alkalosis, indicated by hypokalemia
Management for this pt:
admit to ICU or sub-acute ward with adequate nursing support
large bore peripheral IV
check CBC, LFT+PT/INR+bilirubin
abdominal ul... 阅读全帖 |
|
N*G
发帖数: 217 | 22 Thanks againusa, your comments reminded me the appropriate way to think of
acid-base balance. My last ICU rotation was long time ago.
It is mixed metabolic acidosis (high AG), metabolic alkalosis and maybe
respiratory acidosis, since respiratory compensation is not appropriate? |
|
a******a
发帖数: 57 | 23 My guess is: mixed metabolic acidosis (anion gap) and metabolic alkalosis,
his anion gap is more than 30,high anion gap, in the setting of urine/blood
ketone levels high, and drinking history, metabolic acidosis likely exists;
he also had nause/vomitting,and volume contraction, this would lead to
contraction alkalosis, indicated by hypokalemia
Management for this pt:
admit to ICU or sub-acute ward with adequate nursing support
large bore peripheral IV
check CBC, LFT+PT/INR+bilirubin
abdominal ul... 阅读全帖 |
|
N*G
发帖数: 217 | 24 Thanks againusa, your comments reminded me the appropriate way to think of
acid-base balance. My last ICU rotation was long time ago.
It is mixed metabolic acidosis (high AG), metabolic alkalosis and maybe
respiratory acidosis, since respiratory compensation is not appropriate? |
|
w*****s
发帖数: 230 | 25 【 以下文字转载自 Biology 讨论区 】
发信人: wwwjobs (minimouse), 信区: Biology
标 题: 请看看附件图片文字，建议我们能做什么呢？
发信站: BBS 未名空间站 (Thu Jan 16 12:24:03 2014, 美东)
附件是主治大夫的reasoning(email回复，红字)， 他的水平我们还是很佩服的，因为
他已开始猜了个病就和我们宝宝症状非常一致，可惜后来发现不是；而且他不是代谢病
专家。
问题是坚持宝宝不吃长链脂肪酸的奶粉后，他奇迹般地改善了；完全出乎医生们的预料
。我感觉医生列的是常见的代谢病，而我们感觉宝宝吃长链脂肪酸似乎是慢性中毒，大
概需要一个月左右才能体现出来。因为过程很慢，我们怀疑很多方法查不出来。
我们最大的问题是如果是这种病怎么查？不能确认的话他一辈子吃饭都受影响，基本也
就很难出门时间长一点了。尤其是他的肝已经在要换的边缘。医生们现在改口说他的病
程都是偶然，可我们不能同意。为什么每次都是长链吃一段时间就得病，尤其是这次停
了鸡蛋后马上改善。。
谢谢大家。 （下面是文字，可惜设置不成红色）
Q: Our big... 阅读全帖 |
|
g******t
发帖数: 18158 | 26 paper在这里：
http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.p
The Role of Inbreeding in the Extinction of a European Royal Dynasty
Gonzalo Alvarez mail, Francisco C. Ceballos, Celsa Quinteiro
Abstract
The kings of the Spanish Habsburg dynasty (1516–1700) frequently married
close relatives in such a way that uncle-niece, first cousins and other
consanguineous unions were prevalent in that dynasty. In the historical
literature, it has been suggested that inbreeding was a major cause
re... 阅读全帖 |
|
S*******l
发帖数: 4637 | 27 大量使用糖皮质激素抑制免疫反应，是正确的治疗手段，但是未必能纠正过来。
cytokine storm就是免疫系统on hyper drive, 疯狂释放各种 cytokines, cytokines
平时要做的一件事儿是增加毛细血管通透性，让免疫细胞穿过去进入感染部位战斗。
这个过程的副作用就是大量损失血容量，低血压，器官灌流不足，缺氧代谢废物无法带
走，无氧呼吸增加，lactic acidosis, 还会trigger DIC, 就是弥漫性凝血，或者阻塞
血管，或者凝血功能丧失，是个恶性循环，最后多器官衰竭死亡。
也是肺积水的原因，肺泡里满是液体，SARS病人某种意义上是被淹死的。
凶险无比。
老年人最怕肺炎。 |
|
f******I
发帖数: 769 | 28
insulin is the oldest hypoglycemic agent, and in theory the most potent,
when you give patient enough insulin, you will eventually reach normal
glycemic level, also note that it is the only naturally occuring agent in
our system thus there is no limiting dosage and you don't have to worry
about the side effects from synthetic agents such lactic acidosis as you see
with metformin or heart failure with actos/avandia and such,
i think that people with type ii dm often starts with oral agent first |
|
c*****r
发帖数: 50 | 29 either ADEM( LP should tell the result) or MELAS( lactic acid in the serum
or CSF should help).
ADEM:Acute Disseminated Encephalomyelitis
MELAS: encephalomyopathy, lactic acidosis, and stroke-like episodes |
|
a**********2
发帖数: 3726 | 30 Let's see how you put here: "一天早晨我妈起床上厕所，不知怎么就摔倒在床边，
短暂昏迷。我爸随后扶她去了医院。诊断是脑梗"--- How was it diagnosed? MRI? If
MRI said so, then it is stroke. If not, then where did you hear that word?
I am sure that no doctor will make that diagnosis without imaging studies.
"这次住院又作了核磁共振，和一两年前比较，并无大变化，但脑梗的诊断不变"---
from what you described here, MRI was at least done this time, and you also
mentioned that compared with 1-2 years ago, that means MRI was done even in
the first time, then if it showed up in MRI, then... 阅读全帖 |
|
l*****y
发帖数: 5737 | 31 ☆─────────────────────────────────────☆
MakingWaves (making waves) 于 (Mon Dec 31 14:28:31 2012, 美东) 提到:
今年我妈住了两次院。现在我看， 好像都不是非住院不可的毛病。但医院从利益出发
，轻易建议住院, 过度治疗， 病人结果适得其反。
第一次是年初。一天早晨我妈起床上厕所，不知怎么就摔倒在床边，短暂昏迷。我爸随
后扶她去了医院。诊断是脑梗，收住院，点滴稀释血液的药， 同时点滴所谓有营养功
能的中药制剂。最多的时候，一天里输液有七种药品。我妈本来血压还不大高，输了几
天液，血压就高上去了， 腿走路都没劲了。她以前做过核磁共振， 当时大夫说，那结
果，不要说是六十多岁的人的，就算是四十多岁的人，都算正常。这次住院又作了核磁
共振，和一两年前比较，并无大变化，但脑梗的诊断不变。每次我妈抱怨不舒服，大夫
就再给加一种药输液。后来我妈实在受不了了，说，“走着进的医院， 住了几天，反
倒不能走路了”。终于在两个多星期后坚持出院。回家后， 不用那些药， 血压又正常
了，人有劲了, 也没再摔过... 阅读全帖 |
|
W********t
发帖数: 8514 | 32 清肠实验发现，从肠道中清除宿便后体重下降1-15公斤。看来，清肠行动，刻不容缓
数字显示：现代人，尤其是都市人的排便量与20年前相比下降20%左右。我们的肠道正承受着前所未有的宿便带来的压力。清肠实验发现，从肠道中清除宿便后体重下降1-15公斤。看来，清肠行动，刻不容缓。
真相一：现代人的消化速度超级慢！ 人吃进的食物经过消化道到排泄大约需要8~12小时，但discovery频道曾报导，与以前的人相比，现代人的消化速度只有十分之一，过去人类8~12小时就能消化掉的食物，在现代人缺乏纤维素及少吃蔬果的状况下，竟然需要80~120个钟头。你在马桶上嗯嗯出来的东西，竟然是3天前吃的东西，可见体内的废物会存在相当久的时间，宿便积贮良久之下，会产生许多毒素，对人体产生危害。
真相二：每天嗯嗯也不够 不要以为你每天嗯嗯，体内就没有宿便了！这是绝对错误的想法，根据医学报导，不论胖瘦，每个人体内都有宿便，这些嗯嗯都无声无息囤积在你的大肠小肠里。正常人体内有3~6㎏的宿便，肥胖、便秘者体内则有7~11㎏的宿便。
女性朋友请想想，妳45kg的曼妙身材中，竟然有６kg的宿便占去妳的体重，这是何等可怕的事。
... 阅读全帖 |
|
M*****g
发帖数: 116 | 33 MARK
正承受着前所未有的宿便带来的压力。清肠实验发现，从肠道中清除宿便后体重下降1-
15公斤。看来，清肠行动，刻不容缓。
小时，但discovery频道曾报导，与以前的人相比，现代人的消化速度只有十分之一，
过去人类8~12小时就能消化掉的食物，在现代人缺乏纤维素及少吃蔬果的状况下，竟然
需要80~120个钟头。你在马桶上嗯嗯出来的东西，竟然是3天前吃的东西，可见体内的
废物会存在相当久的时间，宿便积贮良久之下，会产生许多毒素，对人体产生危害。
的想法，根据医学报导，不论胖瘦，每个人体内都有宿便，这些嗯嗯都无声无息囤积在
你的大肠小肠里。正常人体内有3~6㎏的宿便，肥胖、便秘者体内则有7~11㎏的宿便。
可怕的事。
是无法真正吸收到，宿便不常排出或有便秘的成员，
了最大的效果了。
的化学毒素会污染血液，进而逐渐循环全身，终致造成酸毒症(acidosis)，同时会加重
肝、肾、皮肤三大排毒器官的负担。常疲劳、脚底痛、感觉睡不饱的成员，或许成因就
是 宿便 先生造成的哦！ |
|
A**A
发帖数: 3392 | 34 还有这个，这样的说法很中肯：
http://www.mayoclinic.com/health/honey/NS_patient-honey/DSECTIO
Evidence
These uses have been tested in humans or animals. Safety and effectiveness
have not always been proven. Some of these conditions are potentially
serious, and should be evaluated by a qualified healthcare provider.
Burns
Early evidence suggests that honey may reduce burn-healing time. Additional
study is needed to make a firm recommendation. C
Dermatitis (dandruff)
The evidence supporting the use of honey ... 阅读全帖 |
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v*********9
发帖数: 2457 | 35 那我直接copy过来吧。。。。。声明我只是copy不是作者哈。。。
清肠实验发现，从肠道中清除宿便后体重下降1-15公斤。看来，清肠行动，刻不容缓
数字显示：现代人，尤其是都市人的排便量与20年前相比下降20%左右。我们的肠道正
承受着前所未有的宿便带来的压力。清肠实验发现，从肠道中清除宿便后体重下降1-15
公斤。看来，清肠行动，刻不容缓。 真相一：现代人的消化速度超级慢！ 人吃进的食
物经过消化道到排泄大约需要8~12小时，但discovery频道曾报导，与以前的人相比，
现代人的消化速度只有十分之一，过去人类8~12小时就能消化掉的食物，在现代人缺乏
纤维素及少吃蔬果的状况下，竟然需要80~120个钟头。你在马桶上嗯嗯出来的东西，竟
然是3天前吃的东西，可见体内的废物会存在相当久的时间，宿便积贮良久之下，会产
生许多毒素，对人体产生危害。 真相二：每天嗯嗯也不够 不要以为你每天嗯嗯，体内
就没有宿便了！这是绝对错误的想法，根据医学报导，不论胖瘦，每个人体内都有宿便
，这些嗯嗯都无声无息囤积在你的大肠小肠里。正常人体内有3~6㎏的宿便，肥胖、便
秘者体内则有7~11㎏的宿便。女性朋... 阅读全帖 |
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g*2
发帖数: 658 | 36 Zan strong stable psychiatric selfcontrol. you must be very well prepared.
Maybe there was a bit metabolic acidosis at the end. Everyone who survived
and reached the final line in such a condition was a hero.
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l******k
发帖数: 27533 | 37 所以你妈妈一共得了lactic acidosis, stroke, bacteremia? 你说的细菌培养真是血
液源？你妈妈这病情也太凶险了！糖尿病导致和加重了所有病情，以后要严格控制血糖
呀！
如果还用着呼吸机，就得还在ICU
不过感染好转，neuro signs也在恢复就是最大的喜讯啦，恭喜 |
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q**x
发帖数: 1636 | 38 Material Safety Data Sheet
Sulfuric Acid
ACC# 22350
Section 1 - Chemical Product and Company Identification
MSDS Name: Sulfuric Acid
Catalog Numbers: S71211SC, S71826, S79200, S80213, S80213-1, A298 212,
A298212, A300 212, A300 225LB, A300 500, A300 612GAL, A300 700LB, A300212,
A300225LB, A300500, A300612GAL, A300700LB, A300C 212, A300C212, A300C212001,
A300C212002, A300C212003, A300C212004, A300C212005, A300C212006,
A300C212007, A300C212008, A300C212009, A300C212010, A300C212LC, A300FP 500,
A30... 阅读全帖 |
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q**x
发帖数: 1636 | 39 Material Safety Data Sheet
Sulfuric Acid
ACC# 22350
Section 1 - Chemical Product and Company Identification
MSDS Name: Sulfuric Acid
Catalog Numbers: S71211SC, S71826, S79200, S80213, S80213-1, A298 212,
A298212, A300 212, A300 225LB, A300 500, A300 612GAL, A300 700LB, A300212,
A300225LB, A300500, A300612GAL, A300700LB, A300C 212, A300C212, A300C212001,
A300C212002, A300C212003, A300C212004, A300C212005, A300C212006,
A300C212007, A300C212008, A300C212009, A300C212010, A300C212LC, A300FP 500,
A30... 阅读全帖 |
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k*******i
发帖数: 5067 | 40 我很抱歉， 我几天忙儿子， 没有来看这边。 LA 版上有人告诉我， 说pets 有人找我
的时候， 我还很奇怪， 我还问找我干什么， 是买房子（我绝对不是agent） 还是看
狗。
CRF: chronic renal failure, is the most common renal disorder in dogs and
cats, especially in aged dogs and cats.It is defined as long-standing
primary renal failure. Renal function remains relatively stable for weeks to
months but has a tendency to deteriorate over time. 猫更多于狗。
非常重要的一点： 这是一种irreversible disease.
CRF 的引发原因可以有很多。 长期肺气肿， 肾脏肿瘤或者癌症， FIP，polycystic
kidney disease， ARF， 这些最终可以引发CRF。 一旦开始了CRF， 其实... 阅读全帖 |
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l**********1
发帖数: 5204 | 41 En
温习一下 其十一年前的豪言 啊
中国科学：显著的发展和严峻的挑战
——历史演变和现状比较
于2001年12月4日 1st version
饶毅
本文在简要回顾中国科学史的基础上，介绍一些近年研究的内容，肯定中国
科学令人乐观的进步，并讨论可能的意义。同时也指出，中国优秀论文总量仍不
到世界的百分之一，低于中国经济在世界所占的百分比、也不能适应中国持续发
展的要求。中国科学的规模需要相当程度的扩大、质量有待进一步提高。中国科
技还存在面临许多问题和挑战。
中国科学历史上的优秀例子
一个国家科学研究状况可以近似地由发表论文的情况所反映。以下，本文主
要从生命科学的研究来讨论中国科学的情况，一方面这是我有一定判断力的领域，
另一方面生命科学是科学技术最重要的组成部分之一，可以反映科学主流。讨论
中国论文发表情况前，先谈两个背景：中国科学的历史情况，优秀科学和著名杂
志的关系。
奠定中国生命科学研究是二、三十年代协和医学院生理系林可胜和生化系吴
宪。他们不仅自己研究出色，而且培养和带领了其他研究者。林可胜在胃肠道生
理和神经生理有优秀工作。1942年，他在中国当选为美国科学院外籍院士，是... 阅读全帖 |
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l****z
发帖数: 29846 | 42 By THOMAS M. BURTON
WASHINGTON—The Food and Drug Administration is acting to stop U.S. sales of
nearly two dozen products marketed as diabetes treatments that the agency
said are illegal and can be ineffective, counterfeit or dangerous.
The federal agency sent warning letters to the companies involved and said
it can follow up by seizing the products, enjoining their sale and even
criminally prosecuting companies whose officials fail to take corrective
action.
The products include dietary supple... 阅读全帖 |
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z****a
发帖数: 150 | 43 ☆─────────────────────────────────────☆
scrub2008 (jobsmac) 于 (Sat Aug 2 14:42:21 2008) 提到:
What type of pleural effusion is transudate with low PH, glucose and high
LDH?
☆─────────────────────────────────────☆
adeno (天夺其魄) 于 (Sat Aug 2 16:02:25 2008) 提到:
Sounds like an oxymoron :)
Maybe in patients with severe acidosis, hypoglycemia and hemolysis?
☆─────────────────────────────────────☆
adeno (天夺其魄) 于 (Sat Aug 2 16:37:09 2008) 提到:
pleural inflammation causes exudate instead o |
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a**e
发帖数: 5094 | 44 我在那个fellow那里已经有案底了
前两天刚转过去一个病人，anion gap metabolic acidosis，病人又是mental
retardation,不会complain,medical ICU fellow 来看了病人，觉得没那么重，不该转
过去，还是救了我的那个attending,坚持让他们把病人收走。交班的时候我让medical
ICU的intern一定要做腹部CT,没人理我。。。第二天一早，听说MICU急火火的让我们那
个attending会诊，病人 end up intubated,两个dilated sluggish pupil,后来发现
massive mesenteric artery thrombosis+necrotizing pancreatitis
这次medical ICU 的fellow 半梦半醒中还不忘问了我一句，你是前两天把xxx转过来的
那个resident吧？？？ |
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H****J
发帖数: 22 | 45 anion gap metabolic acidosis with respiratory alkalosis compensation |
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s*******r
发帖数: 174 | 46 when there is a gap, we always want to calculate deltaAG, in this case, he
has a gap of 22, deltaAG+bicarb>expected, he also has met alkalosis. by
winter fomula, his co2 should be 35+-2 when compensated, his co2 is 30 now,
so he has rep alkalosis. with a normal PH, he has AG met acidosis, resp
alkalosis and met alkalosis. |
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W******g
发帖数: 143 | 47 Good, Have a wonderful weekend. By the way, Is it interesting?
I give that. Always look for the cause of AG Met acidosis.
Do you guys need another case? |
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o**h
发帖数: 55 | 48 A MAOi taker presents in ER with hypertensive crisis after drinking.
Alert patient, Nifedipine.
Unconscious patient,Labetalol.
preventive therapy of cluster headache,: Cab
Viral agents are factors contributing to the development of RA
To confirm urine in a urine leak: measuring the creatinine level.
In winter, intermittent headache, joint pain, nausea
next step in mx: checking arterial blood gas.
renal tubular acidosis
type I: low potassiun
type II: maybe hypophosphatemia
type IV: high potassium |
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g*****y
发帖数: 4 | 49 a - metabolic acidosis b/c PH<7.35, HCO3<22,PCO2 normal (33-45). |
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s******n
发帖数: 65 | 50 is it possible respiratory acidosis because PH is so low |
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