wathe
-
Posts
3,237 -
Joined
Content Type
Profiles
Forums
Events
Blogs
Classifieds
Store
Posts posted by wathe
-
-
2 minutes ago, TCB said:
I think I was a bit heated in my response on this thread last night. I broke my rule of not posting right after a 12 hour shift at work.
For me it seems that these claims are often coupled with the suggestion that any dr, who doesn’t immediately leap in and start using them, is automatically assumed to be part of a huge conspiracy to withhold the true cure. That is just so unjust. Everyone I work with is trying, and has been trying for months, to do everything we can to help. The insinuation that people in healthcare are deliberately keeping a “wonder drug” away from patients cuts to the quick.I’m trying to look at recent stuff about Ivermectin but finding it a bit difficult to sort through. Does anyone have a link to a recent Medcram about it?
You had the nerve to say what many of us are screaming in our heads.
HCP try very hard to keep the professional veneer intact. I think it's probably a good thing for the general public to get a peek behind the curtain sometimes. We're people. (And we're all going to have a certain amount of PTSD/burnout once this is over.)
-
6
-
1
-
-
Evidence summaries for hydroxychloroquine from UpToDate:
In particular, hydroxychloroquine has received considerable attention as an agent with possible antiviral activity, but trials have not suggested a clinical benefit for patients with COVID-19, including those managed in the outpatient setting [82,83]. Although some observational and unpublished anecdotal reports have suggested a clinical benefit of hydroxychloroquine, those are subject to a number of potential confounders [84], and randomized trials offer higher-quality evidence that hydroxychloroquine has no proven role for COVID-19. As an example, in an open-label trial including 293 patients with mild COVID-19 who did not warrant hospitalization, hydroxychloroquine administered within five days of symptom onset did not reduce viral levels at day 3 or 7 compared with no treatment [82]. In addition, there was no statistically significant reduction in hospitalization rates or time to symptom resolution. The rate of adverse effects, primarily gastrointestinal symptoms, were greater with hydroxychloroquine. (See "Coronavirus disease 2019 (COVID-19): Management in hospitalized adults", section on 'Hydroxychloroquine/chloroquine'.)
Hydroxychloroquine/chloroquine — We suggest not using hydroxychloroquine or chloroquine in hospitalized patients given the lack of clear benefit and potential for toxicity. In June 2020, the US FDA revoked its emergency use authorization for these agents in patients with severe COVID-19, noting that the known and potential benefits no longer outweighed the known and potential risks [87].
Both chloroquine and hydroxychloroquine may inhibit SARS-CoV-2 in vitro [88]. However, accumulating data from controlled trials suggest that they do not provide a clinical benefit for patients with COVID-19 [89-94]. In a randomized, blinded, placebo-controlled trial of 479 hospitalized patients with COVID-19, hydroxychloroquine did not improve 14-day clinical status or 28-day mortality (10.4 versus 10.6 percent; adjusted OR 1.07, 95% CI 0.54-2.09) compared with placebo; the trial was terminated early because of this lack of benefit [94]. Other large, open-label trials comparing various potential therapies with standard of care also terminated the hydroxychloroquine arms after failing to detect a mortality benefit or reduction in hospital stay [49,89]. In another open-label trial of hospitalized patients who required no or only low-flow oxygen supplementation (≤4 L/min), hydroxychloroquine (with or without azithromycin) did not improve clinical status at 15-day follow-up compared with standard of care [93]. Observational data are somewhat mixed and have methodologic limitations, but overall also suggest no benefit with hydroxychloroquine or chloroquine [95-100].
Studies have highlighted the potential toxicity of hydroxychloroquine or chloroquine [99,101]. One trial comparing two doses of chloroquine for COVID-19 was stopped early because of a higher mortality rate in the high-dose group [101]. QTc prolongation, arrhythmias, and other adverse effects associated with hydroxychloroquine and chloroquine are discussed in detail elsewhere. (See "Coronavirus disease 2019 (COVID-19): Arrhythmias and conduction system disease", section on 'Patients receiving QT-prolonging treatments' and "Antimalarial drugs in the treatment of rheumatic disease", section on 'Adverse effects' and "Methemoglobinemia", section on 'Dapsone and some antimalarials'.)
Bolding mine. Hydroxychloroquine is not a benign drug. One should not prescribe a drug with known toxicity in the absence of evidence of clear benefit. The evidence is not there. Prescribing this drug for covid is , given the current state of the evidence, likely to do more harm than good.
-
NIH on hydroxychloroquine:
There is good evidence to show that it is not effective in hospitalized patients.
-
3
-
-
This Bernie Sanders dolly pattern (Etsy) made me smile (I don't crochet. Maybe I should learn)
-
7
-
1
-
2
-
-
NIH most recent statement on Ivermectin.
The COVID-19 Treatment Guidelines Panel (the Panel) has determined that currently there are insufficient data to recommend either for or against the use of ivermectin for the treatment of COVID-19.
and
However, most of the studies reported to date had incomplete information and significant methodological limitations, which make it difficult to exclude common causes of bias.
The quality of the data regarding ivermectin is very poor.
-
6
-
2
-
-
Just now, wathe said:
This matches with what I am seeing on the ground in the ED: Fewer mental health presentations - fewer suicide attempts, fewer patient presenting with self-harming behaviours, fewer patients presenting in crisis.
Also, not related to mental health, many fewer pediatric patients (especially respiratory illness - notably less asthma, bronchiolitis, croup, flu etc), and fewer injuries in general. (With the notable exception of tobogganing injuries; those are off the charts this year.)
Meant to edit, but quoted by mistake. The decrease in mental health presentations has been especially notable for youth/young adults.
-
5
-
-
19 hours ago, kand said:
I don’t know the best thread for this, but Canada is another country reporting no increase in suicides since the pandemic, and they may actually have decreased:
(not to say a pandemic is a good way to decrease suicide rates, but these studies are reassuring that we aren’t seeing a double whammy of increased suicides on top of Covid deaths)
This matches with what I am seeing on the ground in the ED: Fewer mental health presentations - fewer suicide attempts, fewer patient presenting with self-harming behaviours, fewer patients presenting in crisis.
Also, not related to mental health, many fewer pediatric patients (especially respiratory illness - notably less asthma, bronchiolitis, croup, flu etc), and fewer injuries in general. (With the notable exception of tobogganing injuries; those are off the charts this year.)
-
10
-
-
21 hours ago, Ausmumof3 said:
I haven’t read this in depth but sounding very positive
In 4,159 patients proven to be diagnosed with COVID-19 using a PCR test, colchicine resulted in a 25% decrease in hospitalizations, a 50% decrease in the use of ventilation and a decrease in deaths by 44%. “It’s a major breakthrough,” says Dr Late.
Colchicine works to prevent the “major inflammatory storm” that affects the lungs and can send patients to hospital.
Im not sure if this is the other of the two drugs mentioned in the study further up thread? I know tocilizumab (spelling?!) was one. Maybe this was the other?
Edited to add - looks like this is completely different and can be given immediately on diagnosis not just in already hospitalised patients. Seems very promising.
Re colchicine: Interpret with caution. The data have not been published yet. The press release stated, "The study results have shown that colchicine has reduced by 21% the risk of death or hospitalizations in patients with COVID-19 compared to placebo. This result obtained for the global study population of 4488 patients approached statistical significance."
Meaning that the results were not statistically significant.
All that this press release tells us is that this drug holds promise and requires further study.
This article on the risks of science by press release sums it up nicely:
https://www.statnews.com/2021/01/23/colchicine-gout-drug-shows-promise-for-covid-19/
Also, colchicine is not a benign drug. The therapeutic index is narrow. There are serious toxicity risks, especially in patients with liver or kidney dysfunction.
ETA link to press release.
And to add: The numbers quoted are almost certainly relative risk numbers. Meaningless without context.
ETA again: Link to clinicaltrial.gov trial information, including inclusion/exclusion criteria (for inclusion must be at least age 40 and have at least one high risk condition.) I'm not sure that the results would be generalizable to the whole population even if the results were stat. sig.
-
2
-
3
-
-
3 hours ago, Melissa Louise said:
I don't know anything about Washington DC. Is there a displaced indigenous people who formerly lived on the land the city is now on? Please excuse my ignorance.
For example, I live on Gadigal land of the Eora nation. Acknowledgement of land is commonplace here, most events start with it, including in schools, and it's always puzzled me that this seems more of a Commonwealth thing?
You can safely assume that that there is a displaced indigenous people who formerly lived on the land of every city in North America.
ETA: the only exception to displaced would be extinct.
-
5
-
-
4 hours ago, Tanaqui said:
Are reusable bags really a vector for COVID, though? I mean, reusable clothes aren't, and god knows lots of people aren't rewashing their masks between uses....
Nope. It's theatre.
-
5
-
-
2 hours ago, Melissa Louise said:
Hey, culture question.
At civic events like this, do you guys do your own form of acknowledgement of country?
This is commonly done in Canada, referred to as Land Acknowledgement. No idea about the USA.
-
3
-
-
@Sneezyone and @YaelAldrich said it better than I did.
-
1
-
-
14 minutes ago, rainbird2 said:
I don't want to derail the thread, but I would like to ask...what is the best way to ask someone about their ethnicity? Or, is it never a good idea to ask? I ask because I am genuinely curious, I love knowing people's backgrounds, and I love learning about their culture.
We are a blended family of 6 different ethnicities. My husband and I attended a high school that we nicknamed the U.N. We often asked people's ethnic backgrounds because we needed to know if we should speak Mandarin or Cantonese in one house, or Gujarati or Punjabi, or Arabic or Swahili in another. It was no big deal.
What is acceptable these days?
I think a good general rule of thumb is just don't ask. Unless there is a good reason why you need to know (and there usually isn't). Or ask yourself if you would be asking this question if askee were white. Particularly in casual conversations with someone you've just met, or as small talk. Curiosity and interest are problematic - because, when you ask WAYF to satisfy curiosity and interest, you are doing this at the expense of othering the askee. In essence, you are demonstrating that the dominant group's curiosity is more important than the minority group's inclusion/comfort.
Situations within friendship groups where there is an ongoing relationship, and everyone is swapping origin stories are different.
-
5
-
4
-
-
Just now, mommyoffive said:
Very much agree. As a person who is of mixed race, I grew up with everyone asking me "What are you?" Adults still ask me this to this day. It is really offensive to me.
My kids get "What are you?". Their strategies for how they deal with this are evolving (and can be quite funny, in a tragic sort of way. And not always polite).
-
2
-
-
Microaggressions are so insidious because, individually, they seem so innocent. It's the cumulative effect of microaggression after micoraggresion over time that's damaging.
Asking "Where are you from?" really feels like an innocent question, doesn't it? And sometimes it's totally appropriate (like when meeting new people at a conference and everyone is actually from somewhere else). But when one is frequently the victim of being singled out with WAYF because of the way one looks, one develops the habit of reacting defensively to the question even when the context is innocent. It's a conditioned response.
-
11
-
-
42 minutes ago, Kinsa said:
Omg... are you serious??? 🤣
I said she was articulate to directly counter that I insinuated that she sounded drunk. So, "I didn't say she sounded drunk. She was articulate." Meaning, exactly, that she sounded the opposite of drunk. There was no, none, zip, microaggression in that statement.
But now I'm remembering why I took a very long leave of absence from this forum. My sanity might require it of me again.
I think "articulate" has become a loaded word when used to describe people who are Black.
It's racist when it's used to imply articulate for a Black person. And that's not at all how I think you meant it in this context. But that doesn't mean that it's not how a Black person (or other sensitized person) might hear it, or think maybe that's how you meant it. Because the word has been used so often as a micro-aggression that it's become loaded. It's probably best avoided, no matter how innocent the intent.
The other thing about microaggressions is that they don't have to be intentional. I think many of us commit microaggressions subconsciously (not saying that's what you did here, Kinsa) or are completely unaware that some of the things we say are microaggressive.
For example, "Where are you from?" is a loaded question in the Asian-Canadian community (implying that you look different, so you must be from somewhere else, and is often a kind of code for "what kind of Asian are you?"). The asker of the question thinks they are just curious and interested, and may not be consciously aware that what they are doing is othering the askee. The askee, who has been singled out with this question eleventy billion times, and has noted that the white people he's with don't get the same treatment, definitely feels this as a microaggression.
-
13
-
2
-
-
14 minutes ago, Laura Corin said:
We have a slow down in supply. They are having to make some alterations to the Pfizer plant that supplies the UK.
I think it's the same plant. Our supply comes from Belgium, I think.
-
1
-
-
3 minutes ago, popmom said:
You're in Canada? Has the entire country run out or is this local?
National supply disruption, sadly.
-
4
-
-
We have run out. My second dose has been postponed to who-knows-when (was supposed to be this weekend).
-
13
-
-
38 minutes ago, kiwik said:
It is interesting watching. It must have taken us about 90 years (1893 to 2980 something ?)after women got the vote to get our first woman PM so maybe next time. And yes I guess it was different this time with Vivid. 3 months seems a long time to me. There is just too much mischief to be done in those 3 months. Though I suppose your way avoids the not officially having a government between the election and the swearing in a few weeks later.
Great typo! I hope it won't take until 2980 before the USA elects a woman president, or for Canada to elect* a woman prime minister.
*We've had one female prime minister, but she assumed the role late mid-term after a male prime minister stepped down. And we don't directly elect our prime ministers. More correctly, I hope that it doesn't take until 2980 until a woman is the leader of the winning party in a Canadian federal election.
-
1 hour ago, kiwik said:
3 questions for US people.
1/ What is the reasoning behind it being such a public event?
2/why is there such a long gap between the election and change of government given you have a 2 party system?
3/ Why have you had 46 Presidents and no women yet?
Not an American (so take it for what it's worth):
1/ It's a republic's equivalent to a coronation, with all the pomp and circumstance to go with.
-
6
-
-
23 minutes ago, Tanaqui said:
Scarlett, almost always when people say "diabetes" they mean "diabetes mellitus". That just means there's sugar in the pee, because the pancreas doesn't function properly. The other diabetes is an utterly unrelated disease, diabetes insipidus. The pee tastes insipid, because the kidneys aren't functioning right. (Yes, I said tastes. That's how doctors used to roll, I guess!
It's a much less common condition than the other diabetes, and so normally the other one is just called "diabetes" and nobody says the mellitus part except if they're doctors, and then only on forms.
Yes. Both DM and DI historically presented with symptoms of polydipsia (excessive thirst) and polyuria (excessive urination). (They still do present this way, of course, but DM is often caught earlier now, before symptoms are florid). In DM, the urine is sweet/sugary (mellitus=honey/sweet) and in DI, the urine is most definitely not sweet. DM is common, and commonly refered to as simply diabetes. DI is rare, and has a completely different pathophysiology.
MD's here tend to abbreviate diabetes mellitus to "DM", specifying DM1 or DM2 to differentiate type one (historically called juvenile diabetes, then insulin-dependent diabetes, now DM1) from type two (historically adult-onset diabetes, then insulin-independent diabetes, now DM2).
-
2
-
1
-
-
28 minutes ago, myblessings4 said:
Acute posterior septal myocardial infarction, massive
Arteriosclerotic cardiovascular disease
Diabetes mellitus
Yes,this exactly.
Interval between onset and death (box to the right of cause of death: 1)15h (or some other number of hours, hard to read) , 2) UNDET = undetermined
-
1
-
1
-
-
3 minutes ago, MercyA said:
A short discussion on tiny little vs. little tiny: https://forum.wordreference.com/threads/little-tiny-vs-tiny-little.3487314/
From that link,
The more restrictive term usually comes first, further narrowing the subset. 'Thing' then 'little thing' then 'tiny little thing', because 'tiny' is littler than 'little'. 'Thing' then 'big thing' then 'great big thing', because 'great' is bigger than 'big'.Of course! So logical.......-
1
-
1
-
Personal covid experiences
in The Chat Board
Posted · Edited by wathe
.