Cass

These sort of articles pop up every few months and make people hopeful for a cure, but this is sadly unlikely to ever be a viable one.

Stem cell transplantation is a standard treatment for several blood cancers, but will almost certainly never be a standard HIV treatment for anyone except patients who need a transplantation anyway, for one single reason: with modern medicine, living with transplanted stem cells is significantly worse than living with HIV.

With modern meds, HIV patients can have a normal life expectancy and live basically normal lives.

You know how in traditional organ transplantation, your own immune cells will attack and often destroy the transplanted organ? In stem cell transplantation, your transplanted immune cells will attack every single organ in your body. Look up "graft versus host disease."

After stem cell donation, most patients will have to take immuno-suppressants that a have significantly worse side effects than modern HIV meds do, often for the rest of their lives - and that's the lucky ones, where the meds will successfully treat the graft versus host disease. One of the more gruesome sights I've seen in my medical career was a lady with a severe graft versus host skin reaction that her doctors couldn't get under control despite massive doses of immuno-suppressants. Eventually large parts of her skin peeled off in strips, like something out of a horror movie. Then she died of pneumonia from the immuno-suppressants.

This is an extreme example, of course, and many people live perfectly ordinary lives after stem cell transplantation, but the failure more is both more likely and more gruesome than the one for antiviral HIV treatment.

Oh, and I phrased that badly, but he didn't drink a ton of tea at the hospital. The hot water for tea comes in limited amounts from those samovar type things, and he didn't want to use too much of it, so he only drank 2-3 cups per day.

We were all burningly curious whether the liver failure would come back if he resumed his normal green tea consumption, especially him (very "try everything, you only live once" type of personality; see also, consumption of mysterious Peruvian rain forest drugs), thus proving whether the tea was the culprit or not, but for ethical reasons I had to caution him against experimenting on the only liver he had, and he reluctantly agreed he wasn't THAT curious. Therefore, the cause of his liver failure will never be fully and conclusively proven to be green tea.

Oh, certainly, there's nothing to prove it was the green tea. We did rule out any other cause of liver failure we possibly could, but there's nothing to say we didn't miss something. But green tea in high doses IS a known cause of liver failure (admittedly, not known to us at the time, but there's case studies on pubmed I found once I started searching), so it remained the most likely cause after eliminating anything else plausible apart from the good old doctor standby of "sometimes shit just happens, shrug emoji" also known as "idiopathic."

He didn't drink 4-5 Liters at the hospital, just a few (two or three) small cups per day. We'd asked about alcohol and drug consumption, but didn't think to ask about his normal food and drink consumption beyond asking for possible sources of infection (asking about any potential spoiled food or exotic meats he might have consumed.) In retrospect, certainly a big oversight in this case!

The most House (the TV show)-like case that ever happened in my medical career was the case of the patient with liver failure due to green tea intoxication.

A young man presented in our hospital with acute liver failure. He'd just spent a month traveling through the rain forests of Brazil, Colombia and Peru. During his trip, he'd consumed unknown drugs in a Peruvian shaman ceremony and had unprotected sex with a Peruvian sex worker.

We tested him for everything obvious. He didn't test positive for any known drugs or any obvious drug-related toxins. He didn't have HIV. He didn't have hepatitis A, B, or C. He didn't have EBV, he didn't have CMV, he didn't have Dengue Fever, he didn't have Yellow Fever, he didn't have Malaria. He didn't have any sign of autoimmune conditions.

We called the institute for tropical diseases. We tested him for tropical diseases we'd never even heard of. He didn't have those. He didn't have Syphilis. He didn't have Gonorrhea. He didn't have liver cancer, or any other discernible cancers.

We called the institute for tropical diseases again. They started researching. We tested him for diseases the experts for tropical diseases hadn't even heard of. He had none of those, either.

His liver, which had started failing for no discernible reason, now stopped failing, for equally indiscernible reason. We started planning his discharge.

We had a nice final discussion. He really appreciated how hard we'd tried, he said, and he really appreciated how kind everyone had been, and sorry again about the unprotected sex with sex workers thing, that was effing stupid in retrospect. He said he was looking forward to getting home and detoxing from all this. He said he didn't think the green tea we had on the ward (cheap, shit, comes in bags, unlikely to have ever encountered a tea plant in real life) did anything much, detox-wise, and anyway he'd feel bad emptying our hot water carafe all the time.

Um. How much green tea do you drink, I asked him.

4 to 5 liters per day, he said.

I googled "green tea liver failure," with some vague memory that sometimes tea gets contaminated during the drying process and maybe he'd caught a bad batch? Turns out, green tea just... causes liver failures, occasionally, in higher doses. Probably due to the anti-oxidants.

You live and you learn.

The patient went home and limited his green tea consumption to no more than a cup per day. He checked in with me a year later, because I'd asked him for an update, and his liver was doing perfectly fine and had never failed him again.

That's a bizarre line of thought to me. If you build an expensive structure for fortification, you don't usually get to the interior design and then go "Oh fuck it, this extra safety measure wouldn't cost anything, but if they've got this far we might as well surrender, so let's not bother."

Going by that logic, the president's bunker under the pentagon would've been built without a lock. After all, people don't usually have to physically drag a country's leader out of their locked bunker, right? By the time anyone's knocking on that door, usually the war is lost and the country has surrendered.

And yet, if you're designing for defense, why NOT take such a cheap and easy countermeasure as putting a lock on the door or choosing the more defensible way to spiral your staircase? You might want to buy a few more minutes to negotiate in a desperate situation; you might want at least the option of taking that futile last stand; you might be facing not an invading army but a single lunatic with a sword who snuck past the outer guards.

The phrasing of this question seems meant to imply that because one explanation doesn't satisfy you (better diagnosis), it must be the other (vaccines). This sets up a false dichotomy, though--there's no reason it would have to be one or the other.

We know vaccines aren't the cause, because large-scale studies have been done that show that autism rates aren't higher in vaccinated children. This leaves us with basically every other possible cause, including not just better diagnostics (I personally find that explanation highly plausible), but also changes in nutrition, effects of some sort of virus, pollution, microplastics and everything else under the sun that's changed in the last decades.

I assume they're referring to the over a billion people living in China. Whether China is a place you'd want to live depends entirely on your personal cirumstances, of course.

Most wheelchair users are either elderly or suffering from some other deteriorating condition associated with pain, overall weakness, or instability, and will therefore likely not be able to use these. (Note that even in the promotional images, people are using crutches to balance in addition to the exo-skeletons.)

The classic "strong above the waist, paralyzed from the waist down" image of a wheelchair user that people might have from eg the paralympics is the minority.

Not in Germany, they don't. Barmer is a "gesetzliche Krankenkasse"/public insurance, which means most of their members' premiums are legally limited to a certain percentage of their members' income, and while they can and do raise their premiums occasionally, that's always a topic of political debate and needs a better justification than "a very small percentage of our members need expensive exo-skeletons now."

They have no ability to raise premiums on specific members with high healthcare costs.

This isn't meant for heli-skiers who go out with a few thousand bucks of equipment. None of the average hikers I know own a satellite phone, plenty of them like to hike alone, and an hour of walking into the woods (hardly a strenuous hike) will frequently land you somewhere with patchy service (and this is in a country with perfectly well-functioning infrastructure, not the middle of the Rocky Mountains.)

I'm sure this is going to lead to a few spectacular, high-profile rescues, but I'd bet the average use case is going to be "saved me three hours of crawling through the woods on a broken ankle to get back to the last place I had cell service."

In areas so remote that modern medical treatments aren't available at all, people do often still grow their own medical plants.

If lack of finances is an issue, growing your own herb garden certainly isn't the solution. These plants aren't going to replace a $500 shot of insulin. At best you could maybe replace the occasional aspirin, dramamine, or buscopan, all of which are available over the counter at price points much lower than what it would cost to even buy a bag of quality seeds, never mind soil, fertilizer, and the garden to plant it all in. (Or the time and labor to plant and tend it).

That's already true of most sports, though. There's plenty of mechanical constructs that can move faster than the fastest human. The challenge is to be the fastest human using nothing but a human body, not to outrun a car or a boat (or even a humanoid running robot, which I assume we could build at this point, if anyone was interested in putting enough money behind it.)

The fun thing about art criticism, and the reason I firmly believe in the "death of the author" school of critique, is that even the choices an artist made in the face of constraints, or as a snap decision at three am, often do carry some meaning, and not always one the artist themselves recognize, either.

Presumably they could've gone out and gotten more green. They could've transitioned to bright blue, or purple, or yellow. But they looked at the piece done in grey, and instead of going "Yikes, that's way more bleak than I thought it would be, I'm gonna buy some more green and redo this," they seem to be satisfied with the final piece.

And that means that interpretations that find meaning in the color choice aren't necessarily invalid just because the artist wasn't consciously thinking about what they were doing when they ran out of green at 3 am. Or, for that matter, that an interpretation of an art piece can't be valid just because it's counter to what the artist themselves had in mind.

I've used a bunch of different pillows (cherry stone, wheat, etc) and found that, while the initial heat is great and feels better than a hot water bottle, they only stay properly hot for about five to seven minutes. Once when I had a bad back pain day, I put the microwave next to the bed so I could keep a constant reheating cycle going.

Is there an easy way to make this work for a non-programmer, i.e. without installing a whole python environment? I'm less interested in cloning specific voices than in getting a high-quality text-to-speech program that'll read me arbitrary Mandarin input, which it seems like this should be able to do.

A diagnosis of anxiety is usually not an out but the beginning of the hard work of improvement. The generally accepted treatment for anxiety is therapy that will encourage you to put yourself into manageable but challenging situations where you can practice overcoming your fears, while finding and rooting out the mental fallacies that those fears are originating from.

No competent medical professional would've told you "You have anxiety, so go sit at home neglecting your social life." That's the OPPOSITE of what people with anxiety should be doing.

The article mentions that one patient has an unexplained brain injury comparable to that caused by the shockwave of an explosion. I'm sure the embassy isn't going to release this info to the press, but I'd really like to know what kind of injury we're talking about here, whether it's something that could just occur spontaneously (I mean, if we're talking intracerebral bleeding, that does just happen sometimes), and if it's been tested for or seen in anyone else complaining of these symptoms.

There's a HUGE difference between "some people are getting unexplained headaches and brainfog" (yeah, so are half my patients right now, during this time of unprecedented stress) and "some people are getting unexplained brain bleeds" (YIKES)

I'm a successful 33 year old adult in a career ideally suited to the way my brain works, so I was VERY skeptical about whether it would make any difference to my life to get diagnosed or go on meds. Now that I have, I can confidently say that it was a total game-changer and I wish my parents had gotten this done for me when I was a kid. It would've made so many things so much easier.

I currently only use my meds (specifinally, Vyvanse) once per week, because I don't love the side effects and I can manage fine without most of the time. On that one day per week, I do everything that my brain chemistry usually makes difficult, which is mostly paperwork and cleaning.

The difference it's made is HUGE. I went through a whole grieving process when I realized how much easier I could've had it all along. I can sit down, spend four hours doing my taxes, and then be done (and then realize the bathroom needs cleaning, and also do that), instead of sitting down, getting a snack, doing ten minutes of taxes, cuddling with the cat, starting a conversation, going on hacker news, doing ten minutes of taxes, going on hacker news, and finally finishing the taxes ten hours later at a quarter to midnight.

It's also made a huge difference to accept that some things are simply symptoms, and not signs that I'm a disorganized failure who'd too stupid to manage daily life. It's also helped to live with people who know and accept this about me, and who know that although I'm very good at managing my symptoms, sometimes things go wrong.

Yes, sometimes everyone is mildly inconvenienced because we were about to leave and now I have to go on a ten-minute WHERE IS MY WALLET tear through the house. It's fine! Sometimes, we're mildly inconvenienced because my girlfriend's insulin pumped is clogged and she needs to spend ten mins fussing with the catheter. These are things that happen when you have a chronic health condition, and no reason for anyone to get upset or berate anyone else. Accepting that has made me a much happier person.

I like this scavengers idea. How far is it to Cairo, and what's unemployment like after Corona killed the tourism industy? Unlock all the containers, tell people you're paying them fifteen bucks an hour to come unload, AND they get to keep whatever they can carry off. How many people can you fit on that ship at once?

There's plenty of political views so toxic and harmful they don't deserve civility.

An easy litmus test: are you advocating harm to a person for merely existing in the world, living with the skin color and sexuality they were born with, or making choices that don't harm anyone else? Then I have no interest in hearing your toxic and hateful opinion and I sure hope you'll be afraid to voice it around me.

It's a great thing to have political discussions and to try to see all sides of a topic. Your willingness to see the other side's points should stop at the point where the other side is actively trying harm people for the crime of existing in this world. (See also: antisemitism, homophobia, transphobia, racism.)

The theory I've heard is that to breed a deadly plague, you need to live in close contact with animals. A well-adapted virus won't usually kill its host, so most deadly viruses jump over from the animal hosts they adapted to. Europe has lots of animals that can be domesticated (Chickens, dogs, cats, pigs, cows, etc) while the animals in Africa and the Americas mostly were the kind you can't domesticate. (Apart from Llamas.)

That's why most deadly plagues came from Europe back then, and now tend to come from places where people still live in very close contact with their lifestock or with wild animals.

The Cueva de los Verdes, a famous cave on Lanzarote, was named after the Verdes family and contains nothing green. (Well worth seeing if you ever get a chance to go.)

The math on this doesn't add up because your career doesn't just have to finance your retirement, it also has to finance the decades of your life before that.

Sure, if you had 150k at age 18 and weren't going to need another cent until you turn 65, you could drop that money in the stock market and wait for riches to come to you. But as it is, you're going to need some kind of job. And while there's a few pleasant careers available without college these days (software engineering being one of them), for most jobs that aren't heavy physical labor or minimum wage drudgery, you're going to need that college degree.

I wouldn't be surprised if you're actually quite a good pick for the floor wax commercial demographic. Now you, specifically, may not have waxable floors or an interest in floor maintenance, but the more interesting questions is, how many people who look similar to you to an algorithm do?

Let's assume renters don't generally wax their floors, and cheap shitty floors don't need waxing. So we're looking for people likely to own a home nice enough too have wooden floors worth maintaining. You could probably do worse than to show that commercial to "highly-educated people with children, working in fields adjacent to software engineering."

They suggest treating only 5-7% of the blood, which is 250 - 350 ml. It's still going to be an elaborate procedure, but a lot less so than hemodialysis, which moves much larger volumes of blood. You wouldn't even need a large-bore catheter, and keeping the blood pressure stable would be far less of a concern, so you probably don't have to do it 1:1.

My Bavarian hospital is on there as yellow. I'm currently sitting in the empty urgent care clinic and just had a chat with the nurse from the almost empty emergency room about the fact that both the COVID-19 ward and the ICU are far from capacity. Not really sure why we're yellow, to be honest.

Speaking as a physician who's been handed a lot of respirators from ever more dodgy sources, how do I tell whether I'm given a counterfeit N95?

Can't you get your doctor to give you a note that you have to work from home for now for medical reasons? It seems that in most EU countries, your employer would be forced to respect that. If they refuse, get a sick note and stay home, there's no reason to put everyone's lives at risk by getting infected at work and spreading it through your commute.