oaktrout

I read the primary study and admittedly skimmed the very long article. So far as I can tell the takeaway is: after baby is 6 months old there are no observed downsides to sleep training, is that correct?

I guess I don't see the point of your psychiatrist trying to do an n of 1 study on you. Imagine that you has a pnemonia/cancer/whatever that was in remission halfway through treatment with antibiotics/chemotherapy/whatever. Would you want the doctor to stop the med just to make sure that it was the med that helping? What happens if your pneumonia/cancer/depression comes back and you suffer serious consequences? Put simply "if it ain't broke don't fix it". There is nothing to be gained from a n of 1 study aside from satisfying your intellectual curiosity.

Of course these studies should be done, but through a scientific trial, where the risk of remission can be balanced with potential gains to scientific knowledge.

Maybe a hot pocket isn't the best example (I couldn't eat 3 hot pockets per day either, I would probably feel sick). A hot pocket weights about 8oz, for reference the meat alone in a restaurant burger weighs about 5-8oz typically.

Some people are born with 12 fingers. 1700 per day is close the basal metabolic rate (laying in bed all day) for a thin adult male. It is less than 3 hot pockets per day, very few people gain weight eating that much.

I would be curious to hear what you suggest should have been done differently.

You state "Nonetheless, clinicians should be more vocal about it", more vocal about what? That it is not always easy to tease out whether it's medication or lifestyle changes that improve your depression? How would that help?

Separately, you started and antidepressants and had an improvement in your depression. Could the antidepressant have given you the impetus to make the positive lifestyle changes you allude to?

For those who don't want to read the article, the highlights for me were: 1) esketamine may not work as well as ketamine and 2) esketsmine was invented to make pharm companies money because they couldn't do it with ketamine.

I agree. One has to ask: what is worse for the environment, a car that pollutes more but lasts 400k miles or a car that pollutes less but only lasts 200k. The cost and environmental affects of manufacturing aren't zero.

Yes, this has been shown in other populations already. I think the highlight of this study is that it worked in South Asians also, as some might question if genetics/ culture play a particular role. This adds to the evidence that weight loss works for diabetes in all ethnicities.

Most doctors know how to heal people with type 2 diabetes, at least if you catch it early enough. It is well known that if you lose weight and eat a healthy diet the insulin resistance is reversible (some others in this thread have provided citations showing this).

Simply put fat worsens insulin resistance. The mechanism is complex, basically fat causes inflammation that causes cells to not respond appropriately to insulin. This leads to elevated blood glucose and all the effects of diabetes. Remove the fat, decrease inflammation, improve insulin resistance.

Well, she was unlocking small pigeon holes so that they could read the labels (reveal the mystery inside), clearly she will do gastroenterology or gynecology.

So you agree with me then, I was replying to a post that said "no one".

"no one said it would fall off the earth immediately, that it would cease to function right now"

Quite a few people said that it would crash essentially immediately.

I know a lot of doctors and medical students, for the vast majority prestige is not a primary motivator, not sure why you think its the prestige motivating everyone.

Knowing these people, I also get the feeling that if pay were worse / debt was higher they would have pursued alternate careers. If your goal is to make more physicians you don't want to make the job less desirable. There are already paid residency positions that go unfilled every year (not because there arent enough students, but because the students dont want them). I don't know why you think people would pursue positions that they have to pay for.

To your other point on the intense competition: If half the people currently applying to medical school quit applying the quality of your average future doctor would drop.

If you've spent on average ~200K for medical school, how willing will you be to pay to work for 3 to 8 more years before you get a paycheck? Resident doctors already make less than nurses with 4 year undergraduate degrees.

This makes sense. Albuminuria is heavily associated with poor vascular health and in particular diabetes (diabetics get urinary screening for microalbuminuria). Poor vascular health --> poor brain blood flow --> dementia.

Also, no surprise that chronic kidney disease patients have higher rates of dementia.

You need a healthy body if you want to have a healthy mind.

Consider the magnitude of the immune response. In someone with pre-existing immunity the virus may replicate relatively little before being killed. Compare this to getting the vaccine, where your body will be flooded with spike protein whether you have previous immunity or not.

I am cringing so hard imaging someone injecting something intraperitoneally. Good luck missing your intestines.

I on the other hand went to public school and would send my children to one. Anecdotally, some of the most successful people I know went to public school, many of which had parents that could easily afford to send them to private school.

It looks like the term "privilege" was used in the 1200s, and even earlier in Latin, so restricting its use to male white privilege in the 2000s seems silly to me.

Most times when this happens its because the patient doesn't have these goals clearly documented, in my experiences hospitals are willing to follow the wishes of the patient. If the patients wishes aren't clearly documented that's when it gets tricky.

That might be understandable, but I'm a lazy skeptic and don't want to make your argument for you. You made the claim, why must I support it?

If I find a meta analysis that agrees with your claim, but has obvious methodological flaws you could simply say "you picked the wrong one" or "that wasn't one of the limited domains of application".

I did as you asked anyway, in my pubmed search 5 out of the top 10 results are by the same author and are published in the journal "Homeopathy". I have no doubt there are many positive studies in that journal, just as there are many true sasquatch sightings in "Sasquatch Magazine".

Please share one of these meta-analyses.

Just because something doesn't pop up in the original trials doesn't mean it's not real, that's why they do post-marketing studies.

Also the mechanism makes sense, women's period timing is notoriously sensitive to threats (critical illness, sickness, trauma).

I think calling cannabis bad or good is a false dichotomy. Sometimes peanuts kill children, that doesn't make peanuts "bad". Maybe cannabis causes schizophrenia in rare cases, does that make it "bad"?

In this specific case, the authors started him on a treatment for schizophrenia and he got better. Why continue him on this treatment if they thought it was simply the cannabis that caused it (as he would abstain from then on). Also, they increased his dose prior to discharge.

I'm not arguing that cannabis didn't cause his schizophrenia, just that this doesn't sound like cannabis induced psychosis, which is a different diagnosis with different prognosis.

Thanks, I searched for cannabis specifically which would explain why this didn't show up. I imagine much of the substance use auto amputations are in people who do things like PCP.

I have a feeling that these individuals (I could only find two in my pubmed search) were suffering from schizophrenia, not cannabis-induced psychosis. Maybe you could make the argument that the cannabis caused the schizophrenia, but that's still a different diagnosis.

In the case you link the guy had smoked weed for two years prior with no apparent issues. Yes his psychosis resolved after he stopped using cannabis, but he was also treated from that point onward with anti-psychotics (the kind you would treat schizophrenia with). It was probably the anti-psychotics, not the cannabis cessation that made him not psychotic.

Fair, I thought I was replying to the idea that old age must be miserable, but on re-reading I see that the poster I was replying to may have meant something else.

Still, smokers not wanting the last 20 do themselves a disservice by disabling themselves and their hopes of redemption. They often do not die sudden deaths that bring them respite, instead many spend years struggling for breath hooked to oxygen tanks. I think these initially rebellious smokers see themselves as going out in a blaze of glory, but COPD is anything but.

Probably not. Costs have come down immensely, most HN users could afford a butterfly if they wanted to play around with it.

Ultrasound has limited penetration for deeper tissues so you aren't going to see lung cancer with it (especially behind ribs), and overweight patients don't image as well, again because of limitations in imaging depth. Regardless of uptake it's not going to solve all our diagnostic challenges.

It also takes skill to know what you are seeing and to know how to find what you're looking for. Anyone could learn, but it's a time investment and physicians have limited time as is.

Still, it is becoming more popular and soon it won't be uncommon for your primary care doc to pull out the probe and see if your gallbladder is inflammed or if that abscess is going to be amenable to in office drainage.

Ahh yes, the evil big vegetable lobby is trying to undermine the good that has been done by poor old Philip Morris.