blike

(is this the part where I rig the vote like all good presidents do?)

What the hell inspired your name?

Good suggestion, thanks!

It's kind of funny when you come to the realization that all those hours you sunk into world of warcraft (or your favorite MMO) are simply to increase a number on your screen. Getting that next level is like trying to score your next crack hit -- you'll do anything to get there, and when you do it's not as good as you thought it was going to be, but the next will undoubtedly be better!

I caught a few segments of it last night. I thought it was pretty funny.

Glad to see you guys back!

For those of you who follow medicine, an important and controversial trial was just published in the New England Journal of Medicine this month (actually gets published in print tomorrow). This is one of those landmark studies that will be talked about for years in the medical community, particularly amongst cardiologists and internists. Rosuvastatin to Prevent Vascular Events in Men and Women with Elevated C-Reactive Protein N Engl J Med 2008 359: 2195-220, available online free from the NEJM. The NEJM has also opened up a comment section titled "The JUPITER Trial: Will You Change Your Practice?" available until Nov. 26th online here. There are some insightful comments posted.

Bro.

Pangloss didn't comment on the film, he asked what sets it apart from other documentaries that "the other side" puts out. Can you show me a few examples?

The progression of fungal pneumonia varies depending on the organism. Organisms like histoplasmosis and blastomycosis are endemic to certain regions (ohio river valley and lower mississippi river respectively), but infection with these organisms is relatively rare. Often times infections are subclinical and self-limiting. Asymptomatic non-immunocompromised patients aren't even treated usually. If the infection is systemic or the patient is experiencing symptoms, the infection is usually treated with an oral antifungal -- itraconazole and amphotericin B are typical examples. Itraconazole is tolerated pretty well, sometimes patients have a bit of diarrhea. It's also slightly hepatotoxic, so you might see a bump in the liver enzymes. Amphotericin B has a bigger side-effect profile which you can look up if you're interested. There are different formulations that try and minimize the side-effects. Generally the medications work very well. Usually the only time you see a fungus really someone a lot of trouble is in the immunocompromised (cryptococcus and aspergillis especially). For the record I'm a 4th year medical student.

Not sure if this belongs in the maths forum, so one of the mods will have to clean up after me if it doesn't. On another forum I'm involved with a discussion of random functions. One poster is arguing that if you take any random process or function and add it to a non-random process or function, that your end result is still random. Is this true? If not, can it be shown in some sort of proof that this is not the case?

You are correct in your understanding that MRSA is resistent to some antibiotics. It's actually a misnomer that MRSA is resistant to all antibiotics, or even most antibiotics. MRSA stands for methicillin resistant Staphylococcus (short "staph") areus. Thus, any staphylococcus aureus culture which is resistant to methicillin is classified as MRSA. However, many MRSA strains are susceptible to doxycycline, clindamycin, linezolid, TMP-SMZ, and even flouroquinolones. The susceptibilities often depend on whether or not the MRSA is community acquired or hospital acquired. In medicine we often use the word chronic as an adjective to describe a disease that is slow to develop. Patients who develop MRSA pneumonia will develop symptoms very quickly because MRSA is evokes such a strong immune response. It is not considered a chronic disease because the disease has a rapid onset and patients will get sick enough to present to the hospital (or their primary care physician) seeking treatment. Patients don't walk around in the community with a MRSA abscess in their lungs. However, the fungal organisms I mentioned earlier often do have a slow onset of disease and a longer clinical course. Patients can walk around in the community with these pneumonias and have very minor or even absent symptoms.

Work hard and apply broadly. Don't overestimate yourself, but don't underestimate yourself either. Remember to have a life, too. Your activities will certainly be much more limited in medical school and you'll wish you had spent more time doing the things you love. Admissions committees are looking for people who have balanced a life and academics. And don't knock DOs -- same classes, same work, same rotations, same practice rights, same legal standard of practice. If it's not your thing it's not your thing, but no need to be disrespectful. Good luck to you!

As to your specific questions: #1 - It's hard to give a very detailed description without a more macro and micro picture. What you're seeing in that picture looks like some sort of suppurative chronic pneumonia. The alveolar walls are thickened and the alveolar space, which should normally be filled with air, is filled with neutrophils. What you see in the upper left corner of the picture is most likely an arteriole filled with RBCs, however without a closer picture I can't be certain. #2 One poster above mentioned MRSA as a chronic pneumonia -- this is not correct. MRSA will almost certainly present acutely. M. tuberculosis is the classic bacterial cause of chronic pneumonia, however other bacteria such as Actinomyces israelii, and Nocardia can also cause a chronic pneumonia. Fungi can also cause chronic pneumonia -- blastomycosis and coccidiomycosis are the typical examples.

There's also the delayed choice quantum eraser.

I can move part of this discussion to another thread, if you guys would prefer. Just let me know via PM.

..works for me

Test

WINNAR - A+ would read again.

Could also be retinal detachment, which is an opthalmologic emergency and can lead to permanent blindness. But hey, you're the expert.

A big thanks to dave and cap'n refsmmat -- they worked hard today getting it set up so fast. This was probably the smoothest transition we've ever had.

Classic Klaynos.

All the medical syndromes that are named after their discoverer really get on my nerves. I'd much rather they stick to the traditional the latin naming scheme. Maybe it's because as a student it's very tedious to try and remember which disease is which person. There is actually a push to prefer the latin names in medical education, but the problem is that the older generation of physicians know and reference many syndromes by their colloquial name. For example, Von Hippel-Lindau (often shortened to VHL) is more appropriately named cerebelloretinal hemangioblastomatosis. That could be shortened to CRHB or something, and it makes far more sense and is much easier to remember than trying to remember which disease Von Hippel-Lindau is.