Neurologist

joined 3 months ago
[–] [email protected] 3 points 17 hours ago

I mean there’s a lot of ways to interpret it that’s for sure. But if you look at the entire response that quote is located in, it’s in the beginning of the debate when he’s really nervous and kind of all over the place. He somehow continues after that sentence talking about Trump crowd sizes. It’s almost gibberish to make any sense from his response there. But I think the message of it was something along the lines of Israel should defend itself against Iran and the US will support it in that endeavour.

[–] [email protected] 33 points 21 hours ago* (last edited 19 hours ago) (4 children)

If I was editing wikipedia and saw your statement I’d add these two tags:

[dubious claim: discuss] [citation needed]

I know you’re taking a quote from the debate but it seems really out of context. If I remember he was talking about Israel’s response to a potential Iranian attack.

Not the Israel-Palestinian conflict.

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

Well the problem is we know very little. So a movie like that would be complete guesswork.

You might enjoy the youtube channel “Stephan Milo” though. His videos are well sourced and have a lot of expert interviews. And he focuses on this kind of stuff.

[–] [email protected] 8 points 1 day ago* (last edited 1 day ago) (4 children)

Cool.

Title might be a bit clickbait though.

It’s oldest known representational art. Not oldest known art.

For example the carvings in the Blomos cave in South Africa are atleast 75’000 years old.

Edit: Thank you for editing the title! That’s pretty weird mistake by Nature I thought they had high standards. Well they have peer reviewed and approved some dodgy research in my field recently so maybe I should be more skeptical.

[–] [email protected] 2 points 3 days ago

It’s the cooking pot looking part of Ursa Major

[–] [email protected] 11 points 4 days ago* (last edited 4 days ago)

r/libertarian was mildly pro-Biden 4 years ago. I guess the astroturfing and corpofication of reddit have taken their toll.

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submitted 1 week ago* (last edited 1 week ago) by [email protected] to c/science
 

ELI12 TLDR: Decent accuracy was found ~80% when using these to differentiate between people with Long COVID versus people who had recovered. People with Long COVID tend to have high Artemin which is linked to nerve cell communication problems and the elevated levels found may provide a clue into the cognitive problems many of these patients have. High Galectin-9 levels (which were also found here) are often associated with immune issues such as overactivation, which seems to fit well with all the immune abnormalities we see in these patients.

Abstract: This study aimed to assess plasma galectin-9 (Gal-9) and artemin (ARTN) concentrations as potential biomarkers to differentiate individuals with Long COVID (LC) patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) from SARS-CoV-2 recovered (R) and healthy controls (HCs). Receiver operating characteristic (ROC) curve analysis determined a cut-off value of plasma Gal-9 and ARTN to differentiate LC patients from the R group and HCs in two independent cohorts. Positive correlations were observed between elevated plasma Gal-9 levels and inflammatory markers (e.g. SAA and IP-10), as well as sCD14 and I-FABP in LC patients. Gal-9 also exhibited a positive correlation with cognitive failure scores, suggesting its potential role in cognitive impairment in LC patients with ME/CFS. This study highlights plasma Gal-9 and/or ARTN as sensitive screening biomarkers for discriminating LC patients from controls. Notably, the elevation of LPS-binding protein in LC patients, as has been observed in HIV infected individuals, suggests microbial translocation. However, despite elevated Gal-9, we found a significant decline in ARTN levels in the plasma of people living with HIV (PLWH). Our study provides a novel and important role for Gal-9/ARTN in LC pathogenesis.

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

Oh I did that a while ago. I might take it again next weekend. Thank you for the share.

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

And patients with psychological issues tend to realise their issues are psychological in nature and vice versa. Although both have downstream effects. And in my above example. The psychological burden of thinking you have (having) a debilitating psychical illness but being disbelieved by your doctors must be enormous.

[–] [email protected] 2 points 1 week ago* (last edited 1 week ago) (3 children)

Yeah definitely. Really appreciate your sceptical of the psycho/functional stuff too. I find some schools of medicine have a big ego to assume anything we can’t figure out must be psychological and not that we just haven’t figured out what’s wrong yet.

It’s a common story in medicine. From peptic ulcer to lupus, illnesses thought to be psychosomatic or “hysteria” turning out to be genuine physical illnesses.

[–] [email protected] 2 points 2 weeks ago* (last edited 2 weeks ago) (5 children)

We do know it is multisystemic. We don’t know if it is mediated by the CNS. But there are some extensive neurological problems. From the latest long COVID research, the leading theory is that, (I’ll say this in vague terms because I don’t want to sound too concrete as this is all hypothesis). Is that the Immune System, specifically T-Cells and B-cells, along with the complement system start working weirdly, we start seeing depletions dysregulations and abnormalities, which don’t happen in people who recover normally from COVID.

Then we start seeing problems with oxidative stress, and biopsies show damaged mitochondria with numerous abnormalities. It is thought that the problem with the mitochondria, including the resulting increased oxidative stress, which we havn’t fully figured out. Starts causing neurological issues.

In that sense, the leading theories is that it is multisystemic and immune mediated, but we obviously can’t rule out centrally medicated as we are still in such an early stage of research.

I’m extremely curious what we’ll find out in the next couple decades :).

There’s also the possibility that “M.E.”. Just like the “waste-bucket diagnosis” it’s predecessor “CFS” was, is more than one disease. Which would explain the heterogenity and diverse symptom presentations. But what most leading researchers seem to think is that it can take a progressive form (through PEM, don’t have time to explain what PEM is but it’s a defining feature and it can lead to permanent worsening of the disease), which can cause it to start producing more symptoms and affecting more body systems.

BTW: I appreciate your curiousity and open-mindedness. Gives me some faith in the medical field. Most older colleagues who aren’t specialised in this they hear ME, CFS etc. and their mind goes oh like psychosomatic fibro type stuff and they refuse to read newer research because it’s a “waste of their time” or to genuinely listen to one of us explain. It’s quite shocking too see this kind of groupthink. The new fashion for these types of docs is to diagnose everything they can’t understand from weak limbs to seizures to M.E. type presentation as “Functional Neurological Disorder”, the literal DSM-5 successor of conversion disorder aka. hysteria. I’ve had a decent couple patients who ended up having rare-autoimmune diseases or even a simple MS type presentation, who lived multiple years with the FND misdiagnosis.

[–] [email protected] 2 points 2 weeks ago* (last edited 2 weeks ago) (7 children)

Yeah, it’s a strange one because it’s two different diseases in one.

Since the 1980s, a disease characterised by fatigue and mostly thought to be caused by psychological factors has been called “chronic fatigue syndrome”.

Since then, we (biomedical researchers) have found a far more specific disease within this broad category, often caused by viral infections, which we named Myalgic Encephalomyelitis, which is what an original outbreak was called in London, I believe.

Anyhow, M.E. has very strict diagnostic criteria, requires some features that don’t present in any other illnesses, and requires a substantial decrease in physical functioning (>50%). Here’s the International Consensus Criteria for example. Interestingly, some cases present without the “main symptom” of fatigue, as defined by chronic fatigue syndrome. Most chronic fatigue syndrome diagnosis criteria, such as the Oxford Criteria, require only unexplained disabling fatigue. For M.E. subgroups defined by strict criteria, we also have clear physical abnormalities present, which show it is a physical disease and not psychosomatic.

The problem arises because most of these discoveries were made in the past decade. So, nearly every trained doctor and medical professional who advises the government treats M.E. as a “psychosomatic fatigue disease,” which is really far from what it actually is. This has even led to a few high-profile cases of patients dying in care after being refused a feeding tube and dying of starvation, for example, since M.E. can cause fatal gastroparesis.

In practice, patients are often treated for psychosomatic fatigue and even blamed for their symptoms, which is far from the actual case. Unfortunately, most of the English-speaking world is quite behind on this. The Mayo Clinic Proceedings is decent, but the CDC, NHS, and NIH are still holding onto some outdated beliefs. The real push has come from Austrian and German-speaking medicine (including Dutch), where some major discoveries have been made recently.

We had a young patient tragically die in our care a couple of months ago; there seem to be some cases that are progressive.

It’s similar to fibromyalgia in that it includes a lot of symptoms, is of unclear aetiology, and has often been treated as psychosomatic in the past. But, in practice, they are quite different diseases, with fibromyalgia being characterised by high levels of pain and thought to be a pain processing disorder with “central amplification.” Meanwhile, M.E. is mostly characterised by severe functional disability, and we have found different immune abnormalities and depletions, as well as problems with mitochondria and increased clotting. As of now, we don’t know how this all fits together. Something I find interesting is the only drug that has had some positive clinical trial results is an AIDS drug. Although none are approved for the disease as of now.

 

Nearly 200 health professionals have written to the health secretary saying that patients with the illness are being left to ‘languish behind closed doors’

The Times (UK)

Doctors have said that NHS patients with myalgic encephalomyelitis (ME) risk starving to death because of unsafe and “unconscionable” standards of care. 

The letter calls for the government to take action to address the “serious patient safety concerns” for patients with ME, an illness which affects about 250,000 people in the UK.

More than 200 health professionals including GPs, hospital consultants and nurses have written to Wes Streeting, the health secretary, saying that patients with the illness are being left to “languish behind closed doors” because specialist NHS services to provide safe care “do not exist”.

ME, also known as chronic fatigue syndrome, is a complex neurological disorder that leads to symptoms including extreme exhaustion. Severe cases can be fatal, with patients bedridden and unable to eat or drink, but these patients currently “fall through the cracks” as there is no specialist NHS care provision. 

A letter signed by 202 doctors and NHS staff calls on ministers to convene an ME clinical task force providing “emergency specialist guidance in cases where patients are hospitalised”, as well as to commit to holding NHS trusts “accountable” for care.

They write: “There is little access to truly specialist ME care or treatment within the NHS and paradoxically, the sicker a patient is, the less care they receive.

“Even if doctors and healthcare professionals are knowledgeable and willing to treat patients, the infrastructure to provide safe and appropriate care does not exist.”

[…]

 

Background

A considerable number of patients who contracted SARS-CoV-2 are affected by persistent multi-systemic symptoms, referred to as Post-COVID Condition (PCC). Post-exertional malaise (PEM) has been recognized as one of the most frequent manifestations of PCC and is a diagnostic criterion of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Yet, its underlying pathomechanisms remain poorly elucidated.

Results

Upon physical activity, affected patients exhibit a reduced systemic oxygen extraction and oxidative phosphorylation capacity. Accumulating evidence suggests that these are mediated by dysfunctions in mitochondrial capacities and microcirculation that are maintained by latent immune activation, conjointly impairing peripheral bioenergetics. Aggravating deficits in tissue perfusion and oxygen utilization during activities cause exertional intolerance that are frequently accompanied by tachycardia, dyspnea, early cessation of activity and elicit downstream metabolic effects. The accumulation of molecules such as lactate, reactive oxygen species or prostaglandins might trigger local and systemic immune activation. Subsequent intensification of bioenergetic inflexibilities, muscular ionic disturbances and modulation of central nervous system functions can lead to an exacerbation of existing pathologies and symptoms

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🐊🐓🦖 (mander.xyz)
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If you’re confused: Birds are dinosaurs, crocodiles aren’t; note the “closest living relatives

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