Perfusion MRI Puns

40M. I’ve been having some chest ache, palpitations and PVCs. I’ve done an echo and 7 day holter monitoring and now my cardiologist would like me to have an MRI Stress Perfusion test. I’m terrified. Has anyone ever had one?

Please explain it this was r/ELI5

I'm currently reading a 2004 study on brain regions crucial for orchestrating language where they used diffusion and perfusion weighed MRI, but the paper does not go into much detail on how these work. Could anyone shed some light into these methods? Thank you in advance!

http://www.ncbi.nlm.nih.gov/pubmed/16641420

I'm beginning to be convinced that the main cause of the lung and chest related symptoms are related to blood vessel damage. This would explain my low DLCO score (75% of predicted), while every other PFT and CT scan looks normal. I'm having a xenon MRI soon to show more information about lung perfusion.

Does anybody have any information on improvement of DLCO scores, or know if the blood vessels and capillaries in the lungs can heal from damage? Any thoughts or comments are appreciated!

Happy Sunday everyone.

I hope you're all well, and excited for the second instalment in the case discussion series!

As with the last one ( Case Series #1 - Confusion, Chemotherapy and Diarrhoea : JuniorDoctorsUK (reddit.com) ), this is a real case, but with a few details changed for the sake of anonymity. This one has more of a liver flavour to it, and one I was involved with in my specialty capacity rather than as the general medical registrar; whilst some of the finer points will not be relevant to your personal practice unless you also look after a lot of livers, there are some broad strokes which are definitely applicable to general medicine, and aspects of practice and discussion which are worth highlighting.

I have taken feedback onboard from the last time around, and I will try and keep to a timeline (which I will update as we go along).

As before, please don't make a new top-level comment, but instead reply to one of mine so that we can keep discussion organised.

Without further ado, onto the case!

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A 49 year old woman is brought to A&E by her concerned daughter. It is 0300am. The daughter has brought her to hospital because she's very worried; over the past two days, she has developed obvious jaundice, diarrhoea and become confused.

There's not much else to be gleaned in a collateral history. The daughter tells you that the patient has lost some weight recently, but that she has been well up until 2 or 3 days ago, with no apparent signs of being unwell.

This woman has a PMHx of HTN and diet-controlled T2DM, and four years ago was told she had a “fatty liver”, but there’s no history of anything more significant than that. As far as the daughter is aware, she is a social drinker, and will drink maybe once or twice a month, and would have “maybe three or four” glasses of wine at each of those occasions. She is an ex-smoker, having quit 5 years ago after being a 40/day smoker most of her life.

Her vital signs are as follows:

O/E:

Overtly jaundiced

Normal central cap refill, prolonged peripheral cap refill of 4s

Normal cardiac examination

Normal respiratory examination, barring obvious tachypnoea

Mildly distended abdomen, no clearly appreciable ascites. Diffusely mildly tender.

Metabolic flap present

Dependent oedema in ankles and elbows

Furt

Hello again and happy 2022. Below is our most recent report & appointment with an internal medicine specialist. We are on a waiting list for a neuro consult and have a follow-up with his vet in a few weeks for a potential soar tooth his vet wanted us to keep an eye on during his annual check-up last August. Since his appointment transcribed below:

1. He has had only one episode of erratic behavior
2. He has been on the Rx diet both dry and wet
3. Still has drooling episodes a few times a week
4. Still has a grinding sound from his mouth while eating wet food exclusively
5. Has been drinking more water last week but has returned to normal
6. Still avoids old litter boxes but will use a new one that is not enclosed (tray style)
7. Has not been on any listed medications since early November

History: Thank you for referring [cat's name]; is a 10-year-old, neutered male, DSH who presents to the Internal Medicine Department for new patient consultation. [cat's name] was originally sick at the end of August. He had dilated eyes, appeared very skittish and painful, and would not eat for 3 days. He was originally treated for a URI but he was still worsening 3 days later he was brought back into the vet clinic where he was diagnosed with a UTI and his antibiotics were changed. They had to spoon-feed him food and water for a while as he would not eat. Now he is doing better but every now and then he will act like he sees something, has dilated pupils, a wide-based low stance, and urinate on the floor. He has also been inappropriately defecating outside of the litterbox. His owner noted he did vomit stomach bile this morning. His owner notes that he did have an issue with grinding his teeth and drooling but that has been resolved currently but tends to return within one to two weeks. His owner thinks his eyesight appears worse in dark or dim lighting. His is still has personality changes such as hissing and growling occasionally which is very unlike him. Their other cat in the home passed away at the beginning of October from presumed cancer. Blood work performed 9/21/21 was normal (CBC/chem/T4). Blood work 9/1/21 CBC WNL Chem ALT 244, glob 5.4. Current Medications/Supplements: oral Buprenorphine to be used as needed (have not been used in a while) Diets/Treats: Fancy Feast Preventatives (Flea/Tick/Heartworm): none Environment (Yard/Daycare/Indoor/Outdoor): Indoor only Physical Examination: T: not obtained P: 180 R: 40 WT: 5.11kg BCS: 5/9 EENT: No ocular dischar

Every post is open to criticism, but only posts of sufficient quality are allowed. Anyway, here's my first for the subreddit: related to dissociation, though non-pharmacological points will be mentioned in a later post as well as the special case of cannabis-induced dissociative disorders.

Dissociation has an effect on mental presence both with reduced feeling of being in reality and of being oneself, and also with a clouding of consciousness which is popularly known as brain fog. The integrative system of the brain is known as the salience network (SN), and its function of switching between introspective cognition via the default mode network (DMN) and focussed cognition via the central executive network (CEN) is tightly controlled by neuronal excitability; the CEN itself can utilise subsystems that concentrate on self-reference via the DMN and perception via the dorsal attention network (DAN) that in turn is modulated by the stimuli-filtering of the SN. It's clear that dissociation would result from inferior connectivity of the SN compared to the DMN with the CEN (i.e. focus is then directed on the internal aspect of mind and not stimuli processing, which reduces feelings of embodiment), and relatedly superior connectivity of the DMN instead of the CEN with the SN (i.e. mind-wandering is accepted over concentration). In other words, there's a stronger association of focus to introspective processes, with impaired overall focus at that - on a basic level, you're more in your own world via disembodiment and one where it's disorganised via weaker concentration.

Neuronal excitability can be understood as the propensity for action potentials to fire, which requires a sufficient build-up of positive charge within the firing neuron. So, substances that increase charge within the neuron increase neuronal excitability - let's call this process "go" - and substances that decrease this charge decrease neuronal excitability - let's call this one "stop". Substances that increase neuronal excitability through increasing net "go" increase activity and connectivity throughout the triple-network model, but without sufficient "stop" the CEN network especially loses fidelity through a decreased signal:noise ratio (as a result of threshold signals being amplified by "go" and not being limited by "stop") and the DMN network is strengthened as inhibitory control regulating DMN-related processes like daydreaming is decreased - and so the SN shifts towards promoting DMN activ

I don't want to step on anybody's toes here, but the amount of non-dad jokes here in this subreddit really annoys me. First of all, dad jokes CAN be NSFW, it clearly says so in the sub rules. Secondly, it doesn't automatically make it a dad joke if it's from a conversation between you and your child. Most importantly, the jokes that your CHILDREN tell YOU are not dad jokes. The point of a dad joke is that it's so cheesy only a dad who's trying to be funny would make such a joke. That's it. They are stupid plays on words, lame puns and so on. There has to be a clever pun or wordplay for it to be considered a dad joke.

Again, to all the fellow dads, I apologise if I'm sounding too harsh. But I just needed to get it off my chest.

Rashod Bateman suffers a grade II adductor strain on 8/10/2021. This is moderate tearing of one of the groin muscles (in his case, it's the adductor longus). Common injury in sports and usually happens with fast cutting or lateral movements. This is confirmed by examination to the region where the training staff sees local swelling and pain with palpation. An MRI will later be used (8/10/2021 at 6pm) to rule out sports hernia.

At the time I'm writing this, he is just resting and allowing the natural healing process to begin. This starts with inflammation in the region. Blood cells like neutrophils and macrophages are at the injury site cleaning up damaged tissue. Besides controlling pain, the training staff, (AT's, PT's) know that there isn't too much to be done besides control pain through the use of thermal modalities and maybe some H-Wave.
Bateman will be seen on crutches over the next few days. This will cause much panic around training camp and some speculation from the media about this being a serious, season ending injury. Fear not. This is jut an extra precaution to take stress off the injured area and allow for continued healing.

Continued pain modulating modalities and manual treatments are used for the remainder of the week. Rashod works with the training staff and watches camp from the sidelines. They are working on maintaining ROM through the knee, ankle and trunk. Careful to avoid overstretching of the adductor longus.

On Saturday 8/14/2021 Rashod is on the bike to perfuse the injured tissue with fresh blood to speed up healing. He works on low load squats through a pain free range of motion. He is discomfort, but not terrible. Mentally, he is starting to feel better. "Maybe I'll be able to make it week 1"

Starting on Monday 8/16/2021, Rashod is working on proprioceptive drills to facilitate neuromuscular control of the muscle group in question without straining it. He's doing very well in his rehab efforts. He still has discomfort with walking, but he can walk without a limp and/or crutches for the first time since the injury.

Rehab efforts are slowly progressed over the following 2 weeks. Rashod is still not running with the team, but he is catching passes to keep his hand-eye coordination in sync. He is now using some load from front squats and walking lungs. Still not ballistic movements like cutting, sprinting or jumping.

On 9/6/2021, he enters the final phase of rehab. He is on the slide board, run

The doctor says it terminal.

Alot of great jokes get posted here! However just because you have a joke, doesn't mean it's a dad joke.

THIS IS NOT ABOUT NSFW, THIS IS ABOUT LONG JOKES, BLONDE JOKES, SEXUAL JOKES, KNOCK KNOCK JOKES, POLITICAL JOKES, ETC BEING POSTED IN A DAD JOKE SUB

Try telling these sexual jokes that get posted here, to your kid and see how your spouse likes it.. if that goes well, Try telling one of your friends kid about your sex life being like Coca cola, first it was normal, than light and now zero , and see if the parents are OK with you telling their kid the "dad joke"

I'm not even referencing the NSFW, I'm saying Dad jokes are corny, and sometimes painful, not sexual

So check out r/jokes for all types of jokes

r/unclejokes for dirty jokes

r/3amjokes for real weird and alot of OC

r/cleandadjokes If your really sick of seeing not dad jokes in r/dadjokes

Punchline !

Edit: this is not a post about NSFW , This is about jokes, knock knock jokes, blonde jokes, political jokes etc being posted in a dad joke sub

Edit 2: don't touch the thermostat

Do your worst!

https://www.yourbrainonporn.com/relevant-research-and-articles-about-the-studies/internet-video-game-addiction/internet-video-game-addiction-brain-studies/

Our current list of Internet addiction brain studies. Without exception, all studies have found addiction-related brain changes in Internet addicts. This review of the literature makes a compelling argument for Internet porn addiction as a sub-type of Internet addiction Neuroscience of Internet Pornography Addiction: A Review and Update (2015). The review also critiques two recent headline-grabbing EEG studies which purport to have "debunked" porn addiction. Also see the Current list of all the Brain Studies on Porn Users, and these reviews of the literature/commentaries on porn & sex addiction:

1. Cybersex Addiction (2015)

2. Sex Addiction as a Disease: Evidence for Assessment, Diagnosis, and Response to Critics (2015)

3. Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports (2016)

4. Should Compulsive Sexual Behavior be Considered an Addiction? (2016)

5. Compulsive Sexual Behaviour as a Behavioural Addiction: The Impact of the Internet and Other Issues (2016)

6. Neurobiological Basis of Hypersexuality (2016)

7. Searching for clarity in muddy water: future considerations for classifying compulsive sexual behavior as an addiction (2016)

8. Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports (2016)

9. Sexual Addiction chapter from Neurobiology of Addictions, Oxford Press (2016)

10

How the hell am I suppose to know when it’s raining in Sweden?

Mathematical puns makes me number

We told her she can lean on us for support. Although, we are going to have to change her driver's license, her height is going down by a foot. I don't want to go too far out on a limb here but it better not be a hack job.

Ants don’t even have the concept fathers, let alone a good dad joke. Keep r/ants out of my r/dadjokes.

But no, seriously. I understand rule 7 is great to have intelligent discussion, but sometimes it feels like 1 in 10 posts here is someone getting upset about the jokes on this sub. Let the mods deal with it, they regulate the sub.

They were cooked in Greece.

I'm surprised it hasn't decade.

He lost May

Now that I listen to albums, I hardly ever leave the house.

Two muffins are in an oven, one muffin looks at the other and says "is it just me, or is it hot in here?"

Then the other muffin says "AHH, TALKING MUFFIN!!!"

Don't you know a good pun is its own reword?

For context I'm a Refuse Driver (Garbage man) & today I was on food waste. After I'd tipped I was checking the wagon for any defects when I spotted a lone pea balanced on the lifts.

I said "hey look, an escaPEA"

No one near me but it didn't half make me laugh for a good hour or so!

Edit: I can't believe how much this has blown up. Thank you everyone I've had a blast reading through the replies 😂

It really does, I swear!

And now I’m cannelloni

Because she wanted to see the task manager.

But that’s comparing apples to oranges

And boy are my arms legs.

Put it on my bill

Heard they've been doing some shady business.

but then I remembered it was ground this morning.

Edit: Thank you guys for the awards, they're much nicer than the cardboard sleeve I've been using and reassures me that my jokes aren't stale

Edit 2: I have already been made aware that Men In Black 3 has told a version of this joke before. If the joke is not new to you, please enjoy any of the single origin puns in the comments