f*****t
发帖数: 901 | 1 支架的例子正好是反过来。
我是这个领域的，国内动不动就建议人做支架，因为回扣高。这里谨慎得多。有好几个
父亲的同事在国内做个CT就建议支架，包括去301和安贞这样的好医院，我建议他们有
条件的过来检查，结果两个过来，一个stenosis 35%， 一个45%，远不到做支架的标准
。这边医生说不理解中国的诊断依据。 |
|
W*******n
发帖数: 4140 | 2 Limin Wang
136-09 59th Ave
Flushing, NY 11355
Oct. 1, 2019, Tue
State of New York
Workers’ Compensation Board
PO Box 5205
Binghamton, NY 13902-5205
WCB Case #: G2029240
WC Insurance Carrier Case #: 18D48F512440
Date of Injuries: Jan. 16, 2018
Employer: B.Q. Wide Auto Body Parts Supply, Inc.; KSI Trading Corp; TriNet/
Strategic Outsourcing Inc.
Stated Insurance Carrier: Indemnity Insurance (Co) of North America
Third Party Administrator: Cannon Cochran Management Services, Inc. (CCMSI)
Re: Rebut ... 阅读全帖 |
|
a***k
发帖数: 1038 | 3 Cause of death:
Cardiorespiratory arrest
Pneumonia
Aortic stenosis
Diastolic congestive heart failure
Contributing conditions : coronavirus
: 如果你人不住在美国，相信这个属于无知。
: indicates
: the
|
|
t**x
发帖数: 20965 | 4 Here's a (partial) list of all the pre-existing conditions the GOP bill may
not cover
感觉常见病都包了
Acne
Acromegaly
AIDS or ARC
Alzheimer's Disease
Amyotrophic Lateral Sclerosis
Anemia (Aplastic, Cooley's, Hemolytic, Mediterranean or Sickle Cell)
Anxiety
Aortic or Mitral Valve Stenosis
Arteriosclerosis
Arteritis
Asbestosis
Asthma
Bipolar disease
Cancer
Cardiomyopathy
Cerebral Palsy (infantile)
Chronic Obstructive Pulmonary Disease
Cirrhosis of the Liver
Coagulation Defects
Congestive Heart Failure
Cy... 阅读全帖 |
|
b****b
发帖数: 199 | 5 Diseases related with heart or blood vessels are complicated. For anything
more than primary and simple conditions such as hyperlipidemia or hypertension
should be treated under doctors' close attention. Because complications and
comorbidities are very common. For example of your case, is the artery
stenosis of the kindey or of carotid (颈动脉)? Your father should have
hypertension and how severe it is? Does your father have atherosclerosis (动脉
粥样硬化) also? How about some kidney related symptoms? |
|
E******r
发帖数: 40 | 6 你可以查询：
rheumatic heart disease (风湿心脏病)
mitral valve stenosis
mitral valve regurgitation
heart valvular replacement
第二，第三个是风湿心脏病最常见的现象，第四个是瓣膜更换。如果你妈妈年纪较高，可
以看看仿生瓣膜(bioprosthesis)有关的信息。
四
多
很
我
加 |
|
f******I
发帖数: 769 | 7
if you are really interested, you could sign up a trial(free) membership at
new england journal of medicine, in may of this year(2007) there is a pretty
good debate regarding what kind of patients would need/benefit from back
surgery for lumbar stenosis, there is also a pretty good video explaining
about spondylolithesis and herniated disc and corresponding surgical
procedures,
or if you could teach me how to post picture files i could see if i could
download some of the pics and post them for |
|
f******I
发帖数: 769 | 8
.
ace inhibitor could cause angioedema which could be deadly, also could
worsen renal function in patients with renal artery stenosis, comparing to
those, dry cough is really a minor side effects, |
|
f******I
发帖数: 769 | 9
left heart cath is the gold standard test of choice as far as diagnosing
coronary disease, stress test could have either false positive or negative
results, not very sure about CT scan, it might have less contrast comparing
to heart cath but you can't perform any intervention when you just do CT
scan,
depends on which cardiologist you talk to,
generally speaking, when you put in a stent, it's a foreign body and there
is significant risk of in-stent re-stenosis, so for bare metal stent you
need |
|
gq
发帖数: 321 | 10 based on your stressed myocarcia study, you have multiple coronary artery
stenosis..
stent placement is a choice但时间久了支架也会再狭窄..
given your age, a contrast CT with 3D reconstruction may be suggested
to rule out some anatomic variances..
go and discuss with a cardiac specialist.
and
inferolateral |
|
f******I
发帖数: 769 | 11
dizziness and poor balance might not be from cervical spine stenosis,
if it's VBI then physical therapy would not help |
|
j****i
发帖数: 496 | 12 my mom:
59 y/o female, history of high blood pressure (170/80 w/o medication), CT
found arteriosclerotic lesions w/ a unilateral 50% carotid artery stenosis
on the right side. currently taking aspirin & lopressor. should she
consider lacipil as her first line agent for hypertension instead?
also, what are the early signs of ischemic stroke? any home emergency
treatment to minimize the damage once symptoms occur?
i understand many things in life are irreversible. my heart is broken when
seeing |
|
m****a
发帖数: 98 | 13 per your description, he has indication for 心脏搭桥手术. PTCA is not good
for him because of widespread stenosis. |
|
m****a
发帖数: 98 | 14 left anterior descending artery is one of the arteries often occluded. 50%
stenosis can be treated by PTCA, no bypass surgery needed.but some docs may
choose conservative therapy, so it depends on your doc. |
|
t*****t
发帖数: 10 | 15 大家好，
我腰酸背痛已经快一个月了，有蛋白尿。胃部有轻微溃疡，在服药中。
背痛主要在腰部稍微偏上的部位，髋部最近也开始疼了，主要是早上起床时。
感觉腰部和背部是那种比较僵硬的疼痛。在深呼吸的时候，感到腰部前后（两侧）都非
常疼。
肾超声正常。另外感觉右腿像是坐骨神经痛。
做了MRI，结论是：straightening of the lordosis. Mild L4-L5 and L5-S1 Disc
bulges. No significant stenosis,normal conus.
医生让我做physical therapy，主要就是电刺激腰背部，做一些背飞这样的动作。上周
感觉好多了。周末又不行了。我从网上查了一下，感觉很像僵直性脊柱炎？
请问一下版上的大牛有什么建议，可以做什么按摩穴位之类的来促进康复么？每天早上
背痛醒感觉太难受了。
万分感谢 |
|
c********e
发帖数: 496 | 16 I heard many stories like this, three stents for coronary heart disease.
by pass/CABG is indicated in the treatment of multiple lesions (including 3)
.
the most I've heard is 7, imagine 7 stents in one heart, with one year re-
stenosis rate for one stent is 10-20% (3% for rapamycin eluting stent), what
's the total.
totally a disaster. |
|
c********e
发帖数: 496 | 17 first make sure the stroke is ischemic instead of hemorrhagic.
then try to identify the etiology, since some of them are curable or
treatable, run echocardiography (if embolus found, then warfarin) or carotid
doppler (if stenosis, CEA). If the ischemia comes from thrombosis or
anthersclerosis, then aspirin is DOC. |
|
g*****j
发帖数: 1211 | 18 脚麻 should be taken seriously. The symptom you described could be caused
by spinal stenosis, a narrowing of spinal canal thus impinging on the spinal
cord.
It does not matter which school of medicine you believe, your mom need a
good diagnostic exam, preferably by MRI. After that, whether conservative
treatment or surgical treatment is dependent on the degree of compression,
because what you do not want is permanent spinal cord damage which is
irreversible. |
|
g*****j
发帖数: 1211 | 19 Well, apparently you had the right work up. The original ECG should
inferior ischemia (an obstruction of blood flow) at one point. It is
important to exam the coronary artery direct, which you did through CT
angiogram. The question is why you had the ischemia in the first place.
There could be many explanations, such as vasospasm, a transient stenosis
which luckily resolved spontaneously or many others including panic attack (
unlikely though to an extent of ECG changes). It will be difficu... 阅读全帖 |
|
p*****0
发帖数: 16 | 20 Please help with the translation of the following. We are medical illiterate
. Many thanks in advance.
Initial unenhanced axial CT images of the abdomen and pelvis were obtained
from above the diaphragm through the public symphysis. The patient was
hydrated and scans were obtained after administration of IV contrast timed
to optimize imaging in the corticomedullary and urographic phase. Sagittal
and coronal images were derived from the data set.
The kidneys enhance an excrete contrast symmetrica... 阅读全帖 |
|
y*****g
发帖数: 193 | 21 Dizziness/presyncope can be divided into cardiovasular source and non
cardiovascular source.Cardiovascular causes include heartblocks, dysrthymias
,aortic stenosis,cardiomyopathy,so on....
Noncardiovasuclar causes include vasovagal reflex failure, systemic
orthostatic hypotension and neurogenic orthostatic hypotension(OH)..
If you don't have cardiac history, go back to noncardiogenic reasons. As
your MD said, 10% of pts can't find causes at all with these symptoms.
Hotbath will cause vasodilatio... 阅读全帖 |
|
y*****g
发帖数: 193 | 22 possible carotid artery stenosis? check dupler study of carotid.
If hypotension is present, low blood pressure with narrowed cerebral vessels
or narrowed carotid artereis possibly leads to hypoperfussion for her brain
. There is a medication which can increase blood pressure if needed. Also
eating salty food could also increase blood pressure.
Is she anemia? and why does she have hypotension at the first place? |
|
y*****g
发帖数: 193 | 23 possible carotid artery stenosis? check dupler study of carotid.
If hypotension is present, low blood pressure with narrowed cerebral vessels
or narrowed carotid artereis possibly leads to hypoperfussion for her brain
. There is a medication which can increase blood pressure if needed. Also
eating salty food could also increase blood pressure.
Is she anemia? and why does she have hypotension at the first place? |
|
a**********2
发帖数: 3726 | 24 Stent for the one with 75% stenosis.
Others no need for anything. Also consider other comobidities such as
diabetes, hypertension, etc. Get second opinion if possible. |
|
l*h
发帖数: 4124 | 25 the enlargement of pulmonary artery and its branches is significant and also
quite long. it cannot be explained by post-stenosis changes.
the next step should be evaluation of pulmonary artery pressure or pulmonary
wedge pressure. if the pressure isn't too high, the surgery will be simple.
if it is too high, the surgery can be very difficult. |
|
l*h
发帖数: 4124 | 26 the MRI you described doesn't explain his symptoms. there are a few
possibilities (listed in the likelihood from higher to lower):
1. lumbar spinal stenosis seems able to explain every symptom he has, but it
was not shown on MRI you described. Another possibility is that arteries
supplying lumbar level nerve roots are abnormal. In non-invasive
examinations, CT/MR angiogram might help diagnosis in the latter case.
2. his symptoms are not at the spinal cord. they are caused by a combination
of ins... 阅读全帖 |
|
h***f
发帖数: 162 | 27 Are you sure this is a heart attack? 35 is very young to have a heart attack
. Chances are your husband had an arrhythmia. Given his age, unless he has a
history of mitral stenosis or regurgitation secondary to rheumatic fever, I
don't think he has atrial fibrillation. He probably has supraventricular
tachycardia, although without an EKG I can't tell you what kind (AVNRT, AVRT
, MAT, atrial flutter, etc). If your husband's arrhythmia cannot be
controlled, he may undergo an ablation procedure and... 阅读全帖 |
|
l*h
发帖数: 4124 | 28 i am wondering what was done, or what was attempted right after the
discovery of her condition when she was half year old. at that time, there
might have been a chance for corrective surgery.
apparently when she was 3 yo, the surgery was palliative, not corrective,
likely because the right side pressure was already too high for corrective
surgery. all the efforts afterwards were to reduce right side pressure,
including Glenn.
the best chance is still to do something about the pulmonary artery st... 阅读全帖 |
|
q*********8
发帖数: 81 | 29 多谢LMH， 朋友说三岁前由于医疗水平和当时的经济问题没做任何手术，现在上海医院
推荐的也是pulmonary artery stenosis。 以你个人经验，这种手术在国内和美国做效
果差别大么？他女儿好像不能坐飞机，来美国也只有坐船。不过朋友什么都愿意试，只
要能把女儿治好。。。 |
|
z*******6
发帖数: 353 | 30 Symptomatic cerebrovascular dz+ >=70% stenosis ---- surgical correction
Otherwise aspirin + statin |
|
i****o
发帖数: 30 | 31 谢谢你的回复。他一出生发现就是重度的，第二天做完球囊扩张以后变为轻度，但是1
个半月的时候复查又变为重度了，现在不知道是需要在做一次扩张手术呢，还是开胸。
宝宝太小，我们期待尽量不要做开胸手术。 |
|
S****a
发帖数: 2568 | 32 复查在变严重，不乐观。只能跟负责的医生讨论，听取他们的建议。
1
，所 |
|
b***p
发帖数: 1398 | 33 depends on the annulus size, it is possible to implant sapien3 20mm thv
during the open heart surgery. the s3 can be further expanded as the infant
grows, which could minimize the number of open heart surgeries.
is
gradient |
|
m*******g
发帖数: 3044 | 34 FINDINGS:
The lumbar spine is in satisfactory alignment. Height of the vertebral
bodies is maintained.
T12-L1: Unremarkable.
L1-2: Unremarkable.
L2-3: Unremarkable.
L3-4: There is a mild bulge of the L3-4 annulus without visible focal
herniation or stenosis.
L4-5: There is a moderate bulge of the L4-5 annulus. Mild hypertrophy is
present of the ligamentum flavum. Dimensions of the lumbar canal at the
lower limits of normal. The AP dimension of the thecal sac measures 8 mm.
L5-S1: Unremarkable.
I... 阅读全帖 |
|
h*******3
发帖数: 327 | 35 在parenting看到你的贴子, 到这里来回一下...
我们家的小人从出生第一天就发现有杂音, 当天做了X-Ray, ECHO, 没什么问题. 二周
后在儿医的坚持下到儿童医院心脏专科又做了ECHO和心电图, 发现她有Pulmonary
Artery Stenosis, 第三周做了cath, 接下来就是很多follow up, 一个月大, 三个月大
, 半岁, 一岁, 等等, 前几次每次都有ECHO和心电图, 一岁的只有心电图, 总的来说一
切都好, 我们下一次复查是二周岁.
每次检查, 小朋友都是醒着的. 有时侯她会闹, technician就会让爸爸或妈妈横抱着她
做ECHO, 或者在床上搂着她做. 医院从来没用过什么药. 做心电图就更简单了, 直接让
坐在我们的腿上. 也许因为医院是儿童医院, 所以更耐心些?
话说回来, 这个镇定剂我不清楚, 但是我们三周大做cath是全麻的, 花了一小时左右,
当时再不愿意, 也是个孰轻孰重的选择. 小朋友现在17个月了, 活泼好动的, 所以MM也
不要太担心...
BLESS一个... |
|
l******i
发帖数: 73 | 36 你好。我是写这个贴子的LZ的朋友，也同样在为这个孩子奔忙。我手上译了一份英文的
病历。麻烦你问一下医生。人工二尖瓣叫mitral valve。病历如下：
English Medical Record:
Name: Qianrui Su Gender: female Birthday 2009-6-9
1. Congenital heart disease was found 35 days after the birth (CAVC,
complete atrioventricular canal), and she was treated by radical surgery of
CAVC at Shanghai Children’s Medical Centre on 2009-9-21. Echocardiography
after the surgery shows that ventricular septum and atrical septum are both
well repaired without shunt. Mitral valve is a li... 阅读全帖 |
|
l******i
发帖数: 73 | 37 您好。我是LZ的朋友，也同样为这个孩子在奔忙。我手上有翻译的病历如下：
English Medical Record:
Name: Qianrui Su Gender: female Birthday 2009-6-9
1. Congenital heart disease was found 35 days after the birth (CAVC,
complete atrioventricular canal), and she was treated by radical surgery of
CAVC at Shanghai Children’s Medical Centre on 2009-9-21. Echocardiography
after the surgery shows that ventricular septum and atrical septum are both
well repaired without shunt. Mitral valve is a little narrow and mitral and
tricuspid valv... 阅读全帖 |
|
x*l
发帖数: 178 | 38 还没有生，看了一些母乳喂养的书，做了些笔记摘要，和大家分享。
Signs of a Good Latch
• Baby’s lips curled outward and firmly applied to your breast.
• If you pull slightly on your baby’s lower lip while he is
suckling, you should see that his tongue is curled up on each side and
cupped around your breast, forming a trough to the back of his mouth. A
large area of his tongue should be in direct contact with the underside of
your breast, massaging it in a wavelike motion that brings the milk into his
mouth with... 阅读全帖 |
|
i*****y
发帖数: 188 | 39 if your baby spits up almost after every meal, there is a chance of pylorus
stenosis (my baby had it).
If less often it might be reflux |
|
w******y
发帖数: 4871 | 40 以前做过检查吧，把那些个什么renal artery stenosis之类的能引起HTN的病都给排除
掉了吧？
以前难道没有看过PCP吗？他们refer你去high risk OB可能预约不会等那么长时间。
你以前没有看过OB,对于OB来说你是位新病人，OB可以给你预约或不给你预约sometimes
it is based on ur insurance situation. 血压很高再有点症状的话，应该马上去急
诊。
俺们科就是很严重的哮喘发作的病人头一次自己打电话来预约，基本上都是一到两个月
以后才能排的上appointment ,一般前台都会告诉病人得follow up with their PCP or
go to ER if it is an emergency. 那时候病人还没在俺们诊所看过病，俺们对这个
病人没有liability的。 |
|
l**p
发帖数: 328 | 41 lzmm,我家宝宝也是从20天左右开始吐奶，越来越厉害
一周以后诊断出是幽门狭窄pyloric stenosis,马上做了手术
看你描述的症状有些相似，我不是想吓唬你，但是希望你引起重视
上网查查看，和儿医多沟通 |
|
p********5
发帖数: 7433 | 42 我本人如果遇上，会选择生下。我是个赌徒，从来只看最好的一面。但是，每个人决定
，我们只有祝福与理解。
****努南氏症是1963年由小兒科醫師Dr Jacquline Noonan 首次提出並闡述。
主要是特殊心臟缺損、身材短小及罕見的臉部特徵，屬於一種多發性先天異常症候群。
目前尚無產前檢查可確診，但可在懷孕早期經由超音波掃描瞭解是否有心臟異常，約50
%的患者有PTPN Type11的基因缺陷，發生率為1/1,000 ~1/2,500出生新生兒。
疾病簡介
此症個案外觀像透納氏症患者，具有個子矮、八字眉、內眥贅皮、後髮緣低、脖子短、
蹼狀頸、手肘外翻、隱睪症、青春期延遲等表徵，但不同之處在於透納氏症個案為染色
體數目少了一條X所致，而努南氏症候群則為基因變異所造成，因此此症的發生不分性
別、男女生都可能發生，且半數以上個案伴隨有先天性心臟病（肺動脈狹窄較常見），
部分則有輕度智能不足的問題。
臨床表徵：
1. 蹼狀頸 Webbing of the neck
2. 漏斗胸 Pectus excavatum
3. 厚且低位或不正常外形的耳朵 Thick, low-set or abno... 阅读全帖 |
|
|
w***e
发帖数: 269 | 44 projectile vomit in a baby could mean pyloric stenosis, just like this one. |
|
M**6
发帖数: 308 | 45 同事刚生完小孩没多久，今天跟我说他小孩前两天刚做的手术。我问怎么回事说是这个
病。大致就是胃和肠之间的通道闭塞了，胃部无法排空，吃的奶全吐出来了。不是天生
的，是一个月左右发展出来的。一开始他们以为就是吐奶，后来发展到吐血（棕色的奶
）才去医院拍X光。马上就手术了。说还好发现的早，否则小孩脱水或者营养不良的话
，还要等情况改善才能手术。给我看照片，肚脐上面一圈手术的疤痕。才一个多月的小
孩，听的我眼泪都下来了。好可怜，家长也不容易。都是新爸新妈，小孩吐奶肯定都以
为是reflux，谁会想到这么严重。据说大概千分之二的小孩会得这个病。虽然不是那么
常见，发上来给大家提个醒。 |
|
h******e
发帖数: 152 | 46 只能pat pat您
一切听医生的， 该做手术就要做，大部分先心病，不治疗，只能进一步加重。
现在要做的，就是选择相信医生。实在不放心，再咨询下两三个新生儿心脏专科医生，
如果诊疗方案类似，妈妈就不要在犹豫了。 |
|
s*******b
发帖数: 1012 | 47 Update: Gone
------------------------------------
攒485 RP
key word：Stent placement， internal jugular vein stenosis， case report
有兴趣的请站内，附简单背景 (no guarantee) |
|
G***Y
发帖数: 9698 | 48 医生警告：纽约市空气污染严重或致命
发布于 2015-03-05,周四 17:55
【侨报纽约网报道】纽约大学( NYU)医学院的研究人员称，仅仅是吸入纽约市的空
气就可以导致动脉硬化，从而增加中风的风险。我们是否可以认为在大城市中生存的秘
诀就是不要呼吸。
据纽约邮报报道，纽约大学兰贡医学中心(NYU Langone Medical Center)的心脏病
专家乔纳森· 纽曼(Jonathan Newman)说： “经过我们的研究证实，空气污染是造成
心血管疾病的一个重要的危险因素。”
“该研究表明一个人为患心血管疾病的风险不仅与他们的遗传基因，健康的行为，
以及生活方式的选择相关，在一定程度上还将取决于在我们所生活的世界和我们所呼吸
的空气。”
纽曼曾是一篇名为《空气颗粒物污染与颈动脉狭窄(Particulate Air Pollution
and Carotid Artery Stenosis)》的主要作者，该篇论文讨论的重点就是纽约，新州和
康州的空气质量。
研究主要集中在30万个居民区，以其家居邮政编码为单位，并已美国环境保护机构
(US Environmen... 阅读全帖 |
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k**1
发帖数: 1955 | 49 应该是椎管狭窄,spinal stenosis.
急性期卧床, 不用治疗, 治了也没用. 我和我朋友都得过, 3-6月后自愈.
Here is good information on 腰腿痛 from 养生堂, 2012 年2月25日和26日. 你在
百度上搜一下即可. 这是一个院士做的, 比较靠谱. |
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G***G
发帖数: 16778 | 50 现在有如下这些胃癌数据参数。老板让挖掘。我不知道挖掘什么。
有经验的请指点一下，这些临床数据中可以挖掘些什么？
how to do clinical analysis based on clinical data?
maybe this is a big question.
let's give an example. suppose we have the 200 gastric patients' data like
the following. What kind of analysis should be done? what parameters should
be focused
and what parameters should be ignored?
Classification by age
hospital days
Postoperation hospital day
Family history
Biopsy before surgery
Operation duration(min)
Surgeon
Anesthesia
Volume of blood tr... 阅读全帖 |
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