g*2
发帖数: 658 | 1 刚刚把堆积了几个星期的nejm翻看了一下，居然在11月底的那期case discussion就是
讲得这个病
http://www.nejm.org/doi/full/10.1056/NEJMcpc1103565
Case 36-2011 — A 93-Year-Old Woman with Shortness of Breath and Chest Pain
Presentation of Case
Dr. Pooja Agrawal (Emergency Medicine): A 93-year-old woman was seen in the
emergency department at this hospital because of chest pain and shortness of
breath.
The patient had been in her usual state of health, with hypertension and
chronic renal insufficiency, until the morning of admission, wh... 阅读全帖 |
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n*******c
发帖数: 501 | 2 I wonder if they have ruled out cardiogenic syncope. The patient has a
strong history of ischemic heart disease and had a CABG 2 years ago. How is
her LV function? If she has a poor LV function (say EF less than 40%) she is
at high risk of having ventricular arrhythmia which can present with
syncope or even sudden cardiac death. However, if posterior circulation
event is a concern, she will need a MRI+MRA. It does not convince me she had
a brain stem ischemic event with no other neurological si... 阅读全帖 |
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n*******c
发帖数: 501 | 3 sounds like a posterior circulation TIA/stroke.Is neurological exam all
normal? Any oculomotor and pupillary abnormalities (top of the basilar)?
I would do a MRI including DWI and MRA of brain and neck.
She will need an ECHO to exclude intracardial thrombus (as the source of
emboli) and assess LV function (for CHADS2 score in a new AF) , also to
cover causes of cardiogenic syncope.
confusion makes me think about postictal. I would do a EEG if the above is
not conclusive.
I assume the blood gluco... 阅读全帖 |
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R*******t
发帖数: 367 | 4 Cerebral MRA has pretty standard protocol in terms of imaging acquisition.
When I dictate a report, I always include the following:
Intracranial portion of internal carotids including petreous, clinoid and
siphon
Anterior cerebral arteries, A1 and A2
Acom and pcom, look carefully for aneurysms
Mcas, need to follow at least to trifurcation
Pcas, p1 and p2, if there is fetal origin of pcas
Basilar artery, vertebral, superior cerebellar arteries, pica and Aica.
These arteries should be steadily see... 阅读全帖 |
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n*******c
发帖数: 501 | 5 sounds like a posterior circulation TIA/stroke.Is neurological exam all
normal? Any oculomotor and pupillary abnormalities (top of the basilar)?
I would do a MRI including DWI and MRA of brain and neck.
She will need an ECHO to exclude intracardial thrombus (as the source of
emboli) and assess LV function (for CHADS2 score in a new AF) , also to
cover causes of cardiogenic syncope.
confusion makes me think about postictal. I would do a EEG if the above is
not conclusive.
I assume the blood gluco... 阅读全帖 |
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R*******t
发帖数: 367 | 6 Cerebral MRA has pretty standard protocol in terms of imaging acquisition.
When I dictate a report, I always include the following:
Intracranial portion of internal carotids including petreous, clinoid and
siphon
Anterior cerebral arteries, A1 and A2
Acom and pcom, look carefully for aneurysms
Mcas, need to follow at least to trifurcation
Pcas, p1 and p2, if there is fetal origin of pcas
Basilar artery, vertebral, superior cerebellar arteries, pica and Aica.
These arteries should be steadily see... 阅读全帖 |
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G**i
发帖数: 99 | 9 The dentist has right treatment.
space maintainer is used to keep space for permanent teeth eruption at 11
years old. If did not use space maintainer, the 1st molar (most posterior
teeth) will move forward either tipping or bodily movement to block the
eruption of 2nd premolar. It is very difficult to move 1st molar distally at
year 11 or 12. Your child will need long term orthodontic treatment.
no side effects, but have to clean very well to keep oral hygiene.
拔牙是唯一的办法? yes. this infection is ... 阅读全帖 |
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g*****d
发帖数: 991 | 10 Try this one.
3. A 75-year-old man presents with pain in both legs for the past six
months. He says that the pain has limited markedly his ability to walk. He
must sit down after walking a block. Stopping is not sufficient to decrease
the pain. At times, just standing causes his calves to ache, and he notices
tingling in both feet.
He has a 10-year history of systolic hypertension for which he has been
taking chlorthalidone. He has also been on warfarin and digoxin for a known
atrial fibrilla... 阅读全帖 |
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g*****d
发帖数: 991 | 11 4. A healthy 78-year-old man, who is still working, comes for a
consultation because he is "just not feeling well." He has "weakness"
associated with dyspnea occuring unpredictable. Episodes last from a few
seconds to several minutes. He has never had syncope. During the last 2-3
years, he has had 8-10 episodes of typical angina on very severe effort. He
weighs 235 pounds, has been treated for hypertension for many years with "
good control," and has troublesome arthritis in his right shoulde... 阅读全帖 |
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x********0
发帖数: 190 | 12 1. There is slight reversal of lordosis at the L1-L2 level and possibly
some very subtle dextroscoliotic curvature of the lumbar spine. Correlation
with plain film scoliotic series may be helpful as clinically indicated.
2. There is borderline congenital narrowing of the central canal along
the course of the mid to distal lumbar spine, however with no significant
central stenosis at any level .
3. At L5-S1 there is mild posterior annular disc bulging/diffuse endplate
spurring with slig... 阅读全帖 |
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s*******y
发帖数: 46535 | 13 一位朋友，65岁了，最近经常腰背疼，做了MRI，结果如下。我们大概对照wikipedia看
了一下，但是也不知道多少算是跟年龄有关的。请教一下情况有多严重
referring diagnosis: evaluate for herniated disc
technique: multislice multiweighted, 1.5 Teslah
comparison: none
findings:
alignment: no subluxations, there is lumbar levoscoliosis
multilevel degenerative loss of dis aignal and height
vertebral bodies: no compression fractures
L5-S1: within normal limits
L4-5: disc bulge and broad posterior disc protrusion, facet arthrosis and
redundant ligamentum flava produce marked... 阅读全帖 |
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s*******y
发帖数: 46535 | 14 一位朋友，65岁了，最近经常腰背疼，做了MRI，结果如下。我们大概对照wikipedia看
了一下，但是也不知道多少算是跟年龄有关的。请教一下情况有多严重
referring diagnosis: evaluate for herniated disc
technique: multislice multiweighted, 1.5 Teslah
comparison: none
findings:
alignment: no subluxations, there is lumbar levoscoliosis
multilevel degenerative loss of dis aignal and height
vertebral bodies: no compression fractures
L5-S1: within normal limits
L4-5: disc bulge and broad posterior disc protrusion, facet arthrosis and
redundant ligamentum flava produce marked... 阅读全帖 |
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M***D
发帖数: 249 | 15 I don't think 太太的头得枕着老公的脖子睡, because of the relatively fixed
position of axillary nerve at posterior cord and at deltoid, any downward
subluxation of proximal humerus or traction force or blunt trauma may lead
to axillary nerve injury. (Steinmann and Moran 2001, J Am Acad Orthop Surg 9 |
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k***m
发帖数: 30 | 16 Hi, sorry I could not type chinese on my computer.
I would suggest an ophthalmologist visit ( not optometrist).
It's hard to tell the diagnosis just from what you said in your post. Could
be posterior viteous detachment, which is more common and more benign. But
could be macular disease, less likely but more serious (edema, or hole, but
highly unlikely macular degeneration as you mentioned, unless mom is 75+).
Does not sounds like carotid problem, don't do ultra sound yet, unless your
eye doctor... 阅读全帖 |
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t******g
发帖数: 335 | 17 上周洗牙之后，牙医建议我做filling，并给了treatment case的单子。内容如下：
Teeth: 28,29,30,19,20,21 Code: D2391 Resin composite-1s, posterior
Teeth: 6 and 11 Code: D2330 Resin-one surface, anterior
他跟我说了一堆，我很多术语太懂，模模糊糊听了个大概。好像是说我以上几颗牙与牙
龈链接的部分有缝隙，说可能是磨牙或者刷牙过猛造成的。
想请教一下：这个filling究竟是一个怎样的手术？
我猜可能与我刷牙过猛有关（我刷牙习惯一直不好，容易造成局部牙龈磨损？）
另外再想请教一下：有没有必要去做这个手术？如果我从此以后改变刷牙习惯，这些缝
隙会变小甚至消失吗？
非常感谢！ |
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s******w
发帖数: 80 | 18 请教各位大神，国内心脏彩超的描述，我自己结合google翻译，是否准确？
右房右室增大，左房左室大小范围正常；各瓣膜回声及开放尚好；房间隔与左室后壁厚
度正常，略成通向运动，搏动好；房间隔中部连续性中断，可见回声失落约9mm. 主肺
动脉内径未见异常。PDE, CDFI可见房间隔水平左向右分流，二尖瓣瓣口血流E峰大于A
峰及二尖瓣、三尖瓣反流征象。CW估测肺动脉收缩压约为30mm Hg.
Right atrium and right ventricle enlargement, left atrium left ventricle
size within normal range; the echo and opening of valves are still OK;
interatrial septum and posterior left ventricle thickness normal, slightly
into the movement, good pulse; interrupted central continuity of the
interatrial sept... 阅读全帖 |
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j*****6
发帖数: 3 | 19 Re+包子
我是：系统生物学＋神经电生理
涉及脑区域：posterior parietal lobe, frontal lobe, ... |
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j*****6
发帖数: 3 | 20 Re+包子
我是：系统生物学＋神经电生理
涉及脑区域：posterior parietal lobe, frontal lobe, ... |
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R*****s
发帖数: 41236 | 21 Achilles Tendinitis
What It Is Tenderness in your lower calf near your heel that usually strikes
when you push off your toes
You're at Risk Men with a BMI of 25 or higher (a man who is 5'10" and weighs
175 pounds, for example) who run a nine-minute-per-mile pace or faster
Why The Achilles absorbs several times your body weight with each stride. A
faster pace and additional body weight put even more stress on this tendon.
Prevent It Strengthen your calf muscles (with your toes on a step, lower an... 阅读全帖 |
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l********k
发帖数: 613 | 22 大致看了下着篇paper，我不是学统计的，大家讨论一下。
我的理解是因为他这个model没有办法拿到所有的数据（这个model的设计导致了
missing data的必然发生），所以他没有data去estimate他需要的Prior distribution
parameters。所以他用了standard的distributions去generate了一个完全non-
informative的priors。这里他选用InvGamma(1,1)是因为这个是经常用到的normal分布
的non-informative prior distribution。不知道怎么解释为什么选择alpha, beta都
是1，可能这是最简单的选择吧。
同样也没有理解他选择generalized beta(1,1)的原因。假定了这个分布，他然后用了
Gibbs sampler去sample了符合GenBeta的分布的点，用这些点去estimate covariances.
所以我的理解是这些prior并没有任何informative的东西，最后的Posterior还是主要
靠算likelihood，P(X... 阅读全帖 |
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y*****d
发帖数: 82 | 23 1. Bayes Theorem to find posterior conditional probability;
2. many ways - do they ask for the one w/ min computational/communication
costs?
3. estimation of d=2*sum(x_i)/n
the |
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l*******s
发帖数: 1258 | 24 第二题。能不能有额外的机器？基本思路是1k台各自排序，然后用堆排序。但是总是要
有一台额外的机器用在第二步merge 1k台机器的排序结果放那个heap。另外，如前面所
言，有没有问communication cost？
第三题。感觉可以用Bayesian方法，先给d一个prior distribution，最好是conjugate
，然后根据observation来求d的posterior distribution |
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T*****u
发帖数: 7103 | 25 kfold不是这么用的吧。。。如果你这10个model parameters有很大不同，就不是挑哪
个cherry的问题，而是你对这个model有多少信心的问题。大概可以理解成posterior
distribution。 |
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d******e
发帖数: 7844 | 28 他讲的就是Maximum Likelihood和Bayesian Estimator的基本思想和基本区别。
一个是在是求最大化参数Likelihood。
至于说用Gradient Ascent，用Newton。Stochastic做，Batch做不过都是手段罢了。
一个是对Posterior做积分。
至于如何Sampling，是Gibbs Sampling, 还是更general的MH之类的，也只是手段罢了。
呵呵，你这是要Challenge我么？ |
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d******e
发帖数: 7844 | 29 他讲的就是Maximum Likelihood和Bayesian Estimator的基本思想和基本区别。
一个是在是求最大化参数Likelihood。
至于说用Gradient Ascent，用Newton。Stochastic做，Batch做不过都是手段罢了。
一个是对Posterior做积分。
至于如何Sampling，是Gibbs Sampling, 还是更general的MH之类的，也只是手段罢了。
呵呵，你这是要Challenge我么？ |
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B****n
发帖数: 11290 | 30 貝氏定理怎麼能說和Bayesian兩碼事呢
如果仔細看一下Bayes' formula就會發現 其實就是先給prior distribution 有了Data
後透過Bayes' formula算出posterior distribution 這正是Bayesian在幹的事 |
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y********g
发帖数: 81 | 31 随便选，比如高斯。sigma大，explore区域广泛，但rejection rate高；sigma小，
explore区域窄，但acceptance rate高。需要选择中间值，有篇paper专门讲理论的
optimal值是多少。
最优化的方案是猜测一个离你的真实posterior最近的分布，用这个猜测的分布作为你
的proposal。当然实战当中比较难猜。 |
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z*****4
发帖数: 45 | 32 借贵宝地请教：
我试图将数据拟合到一个模型中: Signal = a*exp(-R1*t)+b*exp(-R2*t).要拟合的参
数是R1，R2，a和b。 R1和R2更重要。有12个数据点: 12个t,对应12个Signal。我想用
贝叶斯概率理论来求R1，R2，a和b。 我在看贝叶斯分析的逻辑回归模型: https://www
.mathworks.com/help/stats/examples/bayesian-analysis-for-a-logistic-
regression-model.html。 但是，我还没想出如何写the prior distribution, the
posterior distribution, or maximum likelihood for my question。 这个网页也可
能是相关的: https://www.mathworks.com/help/stats/examples/curve-fitting-and-
distribution-fitting.html。
有人可以教我贝叶斯方法的实现数据拟合么，或是分享Matlab cod... 阅读全帖 |
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b******m
发帖数: 1451 | 33 【 以下文字转载自 Medicine 讨论区 】
发信人: tsiaojian (三宝太监), 信区: Medicine
标 题: 牙科FAQ（草稿）
发信站: BBS 未名空间站 (Tue Feb 24 19:35:39 2009)
准备慢慢写，欢迎补充 :-）
1. 看牙保险给报销么?
参见具体policy。健康保险如无明文提到exception，一般可以认为不报。看病之前，自学一下保险手册的关键条款（有生命危险或疼得天昏地暗者除外）。
2. 看牙咋省钱？
有保险的考虑适当拖延。到下一年可以用新报销额度。
自费买dental insurance：一般premium几百/年，一年最多报销两千，外加
waiting period，所以不一定合算。临时报佛脚的情况就不要考虑了。
dental discount plan：在参加计划的诊所可以立刻打折。比如Aetna Advantage Dental。
收入确实低的，在本地找免费或low cost诊所。这些地方可能有eligibility要求，很多只提供有限服务。
去附近的dental sc... 阅读全帖 |
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b*******o
发帖数: 1784 | 34 VCUG的确比较折腾。听着是可以考虑以后再作如果再次感染的话。male infant就是担
心posterior urethral valve，所以一般建议首次UTI就做VCUG。不过不急，看看cfu，
看看leukocyte esterase, nitrites.
9
CSF |
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