racer983

joined 1 year ago
[–] [email protected] 5 points 1 year ago (1 children)

Lucille: How's my son? Doctor: He's going to be all right. Lindsay Funke: Finally some good news from this guy. Doctor: That's a great attitude. I got to tell you, if I was getting this news, I don't know that I'd take it this well. Lucille: But you said he was all right. Doctor: Yes, he's lost his left hand. So he's going to be "all right." Lucille: [Jumping on the doctor] You son of a bitch! I hate this doctor!

My favorite running gag, love the literal doctor

[–] [email protected] 2 points 1 year ago

Looks like this drug has multiple on going trials. Here is a phase II/III trial ongoing that's probably the direct successor to the trial in the article. It's currently recruiting, they expect to be done some time in 2025.

https://classic.clinicaltrials.gov/ct2/show/NCT05723562

Clinicaltrials.gov makes it really easy to find pretty much any trial.

[–] [email protected] 2 points 1 year ago

As the article points out prion diseases are still extremely rare. There's also no proof yet that the deer prion can make a jump and cause disease in humans. I rationally know this, and yet having seen prion disease before in person, I irrationally (rationally?) avoid venison now just in case.

[–] [email protected] 6 points 1 year ago

Subsequent encounter means you're seeing the doctor again for the same problem. So if you got sucked into a jet engine and lived somehow you'd probably be seeing the doctor a bunch of times, and the second doctor visit and all later visits would be encoded as "subsequent encounter"

I love weird icd 10 codes, my favorite is V91.07, burn due to water-skis on fire. Like has that ever actually happened? If so please post link, I must know.

[–] [email protected] 4 points 1 year ago

I've never heard of urgent care requiring referral from a pcp, that wouldn't make any sense as the whole point of urgent care is being seen more urgently than your primary physician can accommodate. And seeing people who don't have a primary physician and keeping them out of the ed if not necessary. I would ask your insurance for that policy in writing, that can't be right. And if it is it should be reported to that state insurance commission because that's totally asinine. I mean never underestimate the dumbness of insurance companies but I think something might be being lost in translation here.

[–] [email protected] 3 points 1 year ago

Please don't do this, it is dangerous and could potentially make the whole situation much worse, costing you more money in the end. This is a CVS minute clinic/insurance interaction thing, CVS wants just really simple complaints that they can address in a very brief amount of time. Insurance companies don't consider a male UTI a simple complaint for some reasons I address in a comment above. A real urgent care will have no issues billing insurance for this issue.

[–] [email protected] 4 points 1 year ago* (last edited 1 year ago)

Yeah it's a minute clinic thing, and probably to do with how much insurance companies are willing to pay for such a short visit in that care setting. A real urgent care would absolutely be able to see them for this, and should have no trouble billing insurance. CVS wants low hanging fruit easy to address complaints only.

[–] [email protected] 31 points 1 year ago* (last edited 1 year ago) (9 children)

This is mildly infuriating, I can give you a little more context though if you're interested. I don't know exactly about contracts between insurance companies and CVS so I can't speak to that definitely. Probably something related to how much insurance is willing to pay minute clinic for such a short visit, and what things are feasible to address in such a short visit (hence CVS only allowing certain complaints).

I think this is something to do with the concept of "uncomplicated" vs "complicated" uti. Complicated utis are when there's an increased danger of serious complications from a uti or increased likelihood of failing a typical antibiotic therapy. Utis in men are much much rarer than women, and are considered to be an automatic "complicated" uti by many. The greater length of the urethra in men helps prevent bacteria from being able to travel up to the bladder, whereas in women the short distance allows for this to happen much more frequently. So when a male has a UTI there is a much greater chance there will be complicating factors like prostate issues, structural problems, kidney stones, kidney infection, catheter use, atypical bacteria, etc. If you look more into their info on utis, they also state if they suspect any of those things, even in women, they won't treat it and will just refer you to someone else, probably the Ed or a real urgent care clinic. Since the odds of that are much greater in men, they probably aren't allowed to have longer appointments in minute clinic based on what insurance will pay for what they're providing, they just decided to not see that at all in minute clinic. Looks like they do see men for sexually transmitted infections though, which are actually the most common cause of utis in young men, so if that's a concern looks like they would be able to see people for that.

But I totally agree with you, fuck insurance companies in general.

 

Archive link: https://archive.ph/rYlvQ

I think this would be an interesting article for discussion. Some of these articles in popular media I feel adopt an overly hostile tone toward doctors and assume the worst of a situation. Part of this is the necessity of health care privacy laws that prevent us from getting all sides of a story which could shed more light on a situation.

I think it also ignores the huge flipside problem of this, confidently telling someone they have a diagnosis even though you shouldn't and they don't. For instance I often see someone who's been referred to me and told confidently they have a deadly disease or a genetic disease, told everyone in their life they have this, joined online support groups, and made big life choices based on that info, but they actually don't have the disease. And the information the diagnosis was based on was nowhere near confident enough to say so. It was right to seek further evaluation and there may have been some abnormality, but even if the diagnosis should be mentioned as a possibility, the patient shouldn't have been told they definitely have this thing yet because the certainty was just not there. Anyway, I think there's lots of interesting aspects of this article to think about.

[–] [email protected] 3 points 1 year ago

My donations lately have been focused a lot on the LGBT community. Things like lambda legal, local LGBT advocacy groups, and community health efforts. While discrimination from society as a whole and the health system in particular have been leading to worse health outcomes for, well since forever basically, this recent backsliding, especially rampant hate towards Trans individuals and laws preventing them from getting health care has been especially worrying for me.

[–] [email protected] 1 points 1 year ago* (last edited 1 year ago)

I agree with this. The area of medicine I'm most involved in has had a crazy rate of new medications approved and innovations with a giant pipeline of possibilities on the way. The article focuses on crispr a lot, which is cool and always get the headlines, but I think in the nearer term oligonucleotide therapies or even viral vector gene therapies are already here. Oligonucleotide therapies use rna to affect gene expression, usually decreasing it. Theoretically it can be used in any toxic gain of function mutation, which covers a lot of genetic diseases. It's not really a question of do we have the ability to treat genetic diseases anymore, it's more getting all the time, money, expertise, and prerequisite natural history work done on the sheer number of them so these tolls can be tested in all these diseases and brought to patients.

The importance of high quality natural history studies and biomarker development cannot be overstated too. When you design a clinical trial you need to know how many patients need to be in it and how long it needs to run, or else you might accidentally throw out a treatment that works by designing the trial incorrectly. Natural history studies are where you get that information. Biomarkers can help provide more sensitive measures of change so you can more quickly figure out if a treatment has potential or not (ideally followed up by proving efficacy with clinical measures too).

The availablity of the these tools for making new treatments but limited resources for testing them is also leading to ethical issues and inequality. For instance there have been a number of "N of 1" trials where treatments were made specifically for a particular patient. I hope that benefit would then flow to other patients eventually too, but it does raise a lot of questions.

[–] [email protected] 1 points 1 year ago

Yet another disastrous effect of restricting abortion access. The many harms from restricting reproductive care need to keep being hammered on in the media. Thanks for posting this.

 

A fascinating condition. You can walk away, come back ten minutes later and have the exact conversation in the exact same way even down to the person's vocal intonations. It is uncanny. Truly gives you existential "oh my god I'm a meat computer" thoughts if you ever see it for yourself.

Luckily if someone gets this they are back to normal in less the a day, and it's uncommon to have multiple episodes.

[–] [email protected] 2 points 1 year ago* (last edited 1 year ago)

Yes there is. Scroll to the bottom of mander.xyz and you'll see a link for "instances." This will show you both who we're federated with and if any instances have been blocked. I don't think any are blocked at the moment. If mander were to defederate from an instance you would not be able to make posts there with your mander account. You'd have to make an account with that instance or a different instance that does federate with them. So I can post to beehaw from this account, but not if I had an account on the lemmy.world instance since beehaw defederated them. I personally hope that an export or sync subscriptions feature will eventually be made to make it easy to get new accounts up to speed in case there's a defederation event.

Edit: oh and one stipulation, if a instance defederated us, but we didn't defederate them, you could still make posts to it (and it wouldn't show up in our block list), but this wouldn't get sent to the "real" thread and would only be visible to other people on mander. We also would no longer get new posts or comments on those. So like right after beehaw defederated from lemmy.world there was for a brief time some ghost comments that only people from lemmy.world could see.

Also if we did defederate from an instance, and a person from that instance posted to a different instance that we did federate with, you still wouldn't be able to see their comments from your mander account. Basically defederation is hitting block for everyone on this instance to everyone and every post on that instance. If I'm wrong in any of this please correct me, I'm new on this too. But basically defederation is messy so probably best reserved for extraordinary circumstances.

 

I've always found sleep paralysis fascinating, having had it a few times myself it's much less scary if you know what's going on. I think there's lots of good research out there on the mechanisms of the paralysis, but would love to see more work done on some of the even more bizarre features, like the tendency to hallucinate a shadowy figure in the room with you.

 

Before there was long covid there was Encephalitis lethargica or the sleeping sickness, vanishing around 1927 as mysteriously as it appeared alongside Spanish flu epidemic. Many individuals afterwards suffered from severe parkinsonism, prisoners in their own body and barely able to move for years until the drug L-dopa was found to "unlock" them many years later in the 1960s. Made famous of course in Oliver Sack's book "Awakenings." Also featured prominently in the Sandman comics. The exact cause of the illness still uncertain to this day, though evidence exists for multiple theories.

 

I found this server via the join lemmy site and really like it, but noticed the communities here don't appear on https://browse.feddit.de/ which seems to be the way most people are finding communities across other instances. I was wondering if that was deliberate, and if not how to get the mander.xyz communities listed so that those at other instances who are interested in the communities here might able to find them and participate.

 

How are those out there who grade essays or teach writing skills planning on dealing with the monumental advances in easily accessible ai language models this year?

 

Republicans racing to gut programs that help keep the government budget balanced and others that actually massively benefit their own districts. Highlights of the article include $375 million alone spent by the pharmaceutical industry lobbying to try and kill provisions to allow the government to negotiate drug prices.

 

Another gene therapy for a deadly genetic neuromuscular disease, this time Duchenne muscular dystrophy, is nearing potential fda approval with a final decision expected this week. The scientific advisory panel narrowly voted in favor 8-6, but like in many fields currently the tension between early approvals on the basis of biomarkers and how that might effect the ability of researchers to obtain definitive measures of clinical efficacy in phase 3 trials remains.

New trial results have been seen at conferences and likely will be published publicly as well soon, previous small trial published here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7296461/

 
 

Cited NYT article here for those who have access and would like more details: An Inside Job https://www.nytimes.com/interactive/2023/06/16/world/europe/ukraine-kakhovka-dam-collapse.html?smid=nytcore-android-share

 

From the history of pretty crazy self experimentation in medicine, a doctor has a cutaneous branch of his own radial nerve surgically cut. He then meticulously documents the progress of nerve regrowth, initial total numbness followed by neuropathic pain, and a partial return of sensation over time

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