Odd medication to complain about. Crbamazepine (Tegretol) was a highly used seizure/epilepsy medication 25 years ago, and to lesser extent, used for migraines or bipolar disorder. Now it is rarely used for any of these.
I'm puzzled why there is particular concern over a medicine that is rarely used any more. -- Josh
1) "new" study? Published 2015. Someone is just catching up on their reading, although why they'd read this...
2) psych testing and surveys via Amazon Mechanical Turk?
-- JS
It is a massive overstatement to say that birth defects are going to be prevented. Did anyone here read the article? I did. This is still in the realm of science and optimism and hypothesis.
1. researchers looked at genes in human family members of those with multiple congenital anomalies, found some genetic stuff, speculated genetic issues could have caused birth defects (and maybe miscarriages) and could be fixed by increased NAD (Niacin, Vit B3)
2. researches put the speculated problematic genes with CRISPR technology into mice.
3. supplementing mice with NAD (Niacin, a.k.a. B3) reduced birth defects
That's it. There are a lot of hypotheses and assumptions here, and not a single human miscarriage or birth defect has been prevented yet.
This article is great for forming hypotheses like "we oughtta test women/couples for these genes" or "we oughtta give pregnant women vit B3 supplements". But until we actually do these medical studies testing these ideas, we know nothing and have not advanced human health.
-- Josh (yes, I am a doctor and I practice obstetrics and I'm not recommending any additional supplementation with Vit B3 until we have outcomes evidence in humans)
Hi folks,
I am a primary care doctor. I have tons (literally) of obese patients with all the attendant consequences like diabetes, arthritis, sleep apnea, high blood pressure, poor circulation, and more.
I do not prescribe weight loss drugs, never have, doubt I ever will. Reasons are simple and obvious.
1) they don't work. They produce an insignificant amount of weight loss and do it only over the shortterm.
2) they have bad side effects. Along with the lack of benefit, they sure do harm people. Xenical causes such massive diarrhea as to cause fecal incontinence. Pooping your pants uncontrollably... do I need to explain any further why no one takes this med?
3) they have a LONG history of causing severe and unanticipated health damage. Heart valves with fenfluramine, addiction with amphetamines, etc.
4) they do nothing to change people's underlying weak efforts at diet, exercise, and fitness, which produce real health. When patients stop the drugs, they lose the (minimal) benefit, and they go back to being what they were before.
--JSt
Hi folks,
Nice to imagine that something about "orgo" is fruitful to the process of making doctors, but I disagree. Organic chemistry has NOTHING to do with day to day doctoring for probably 99.9% of us. I don't have to draw a molecule of penicillin or know anything about how it interacts with other molecules in order to use it for strep throat or syphilis.
We need in this day and age doctors who know science, probability, the human psyche, communication, and teamwork. But they don't need to know organic chemistry. And there are other fruitful ways to weed out those who can't hack it in med school.
I know because I am a physician and I teach medical students and resident physicians in New York.
--JSt
Hi.
Sorry that you are away from your son more than you prefer. Everyone here assumes it's divorce, but for all we know you work on a nuclear sub or a marine biology platform away from home for months at a time. Either way, you deserve our sympathies for having to be separated, and you deserve our support for wanting to stay close to your boy.
For me it was divorce around when our son turned 3. We had (and still have) shared custody with him living with each of us on certain days. But for practical reasons, he's with his mom more, so the issue of how to stay connected was most important for me.
In my experience, a child that young has a tough time staying focused and connected to a voice on a phone. A voice alone is somewhat of an abstraction. As you surely know already, kids are really concrete. My son at that age found it difficult to stay focused and pay attention on the phone. If he held the phone himself, he was as fascinated by the buttons and the neat sounds they made when pressed as he was to talk to me (or to talk to my ex when he was with me). And if an iPhone with shiny screen buttons, even more distracting. If my ex held the phone near him on speaker phone, usually as he took his evening bath, he'd stray in and out of paying attention. It's just hard at that age.
I gave my ex my old MacBook so that we could do Skype and/or Facetime (when latter came along). That helped a good amount. Voice plus video is a lot better. Matters not whether it's an iPod Touch or iPad or laptop. Clear audio plus video equals better likelihood of paying attention and staying connected.
My son is 8 now. We still do the same arrangement, wherever he is, he calls the other parent and tries to do video chat every night. Neither of us has gotten him his own phone, and I think it will stay that way at least another couple years. He uses my ex'es iPhone or laptop to call me or he uses my iPhone or laptop to call her. I think it's better that we parents maintain control of devices and not let him have a phone for his own, at least so far. He'd be overjoyed to have a smartphone, no doubt about it, but we know that less phones and screens and more friends and outdoors and diverse activities is better.
I hope you find a way to make a good connection.
Good luck,
-- Josh
My developer info as an iOS developer includes my Apple ID and my password. The same ID and password for my iTunes account which is connected to my credit card. If my name and email was compromised, I'm not terribly worried. If my password was compromised, then my credit card was compromised, and that's a problem.
--JSt
Win8 may not be all that bad.
But I only use it at work. And I'm not going to muck around with software add-ons and then screw something up and then call the I.T. help desk here at work begging for them to fix what I screwed up on their computer. I'm willing to try stuff out on the computer I own and maintain at home, my Mac laptop. But I'm not going to screw around with someone else's computer which I need to work for workplace productivity.
--JSt
Go back to the beginning of what made the IBM PC great. It was spreadsheets, databases, word processing, and boring financial programs. These were, and still are very much critical to businesses. These needs are not going away!
Correct. There will still be millions of users at work needing these applications. And Win7 runs them just fine. My medical organization still runs mostly XP (transitioning to Win7). If it ain't broke, no one will fix it for the sake of change itself. Change sucks. Only undertake it when necessary. What is essential or necessary for business on Win8? If you have no answer just like me, then I guess we know why Win8 is floundering.
--JSt
My workplace (medical) is all Windows, transitioning from XP to Win7. All of our key applications will not run on Win8. I am replacing an old Motion Computing tablet. It is not easy to shop for a Win7 computer, but that's what I did. Alternatives were buy a Win8 machine and hope it's downgradable or buy a native Win7 machine, and I went with the latter.
Home users have had a growing choice of platforms since iOS and Android arrived. But I figured workplace use would remain solidly Windows. Suspect it still will. But maybe companies will wait for Win9
--JSt
Bitcoin? Really? I thought news is information that someone cares about. 10 years from now people will chuckle or roll their eyes at the thought of Bitcoin. In 20 years, people will go "huh?"
--JSt
1) not required to report unexplained loss of consciousness like seizure or fainting to Dept Motor Vehicles in NY State. In fact, if I did so, I would be in violation of patient privacy
2) yes, a physician is a mandated reporter of child abuse, so are nurses, teachers, and several other professionals. You have a problem with that?
--JSt
I'm sorry about your friend. But you don't see the flip side of this.
If every tiny white dot lead to a massive investigation, we'd kill more patients. It goes like this. Every tiny questionable finding white dot would lead to big investigation with endoscopy (garden hose scope down your throat) with biopsies to get the truth about the terrifying "white dot". Every now and then the procedure and the anesthesia would lead to a patient breathing in mouth saliva or gastric juices and catching a wicked pneumonia, a few might die. Every now and then the biopsy would perforate the stomach and a few might die. Every now and then the biopsy would nick a blood vessel in the stomach causing massive bleeding, leading to emergency surgery, blood transfusions and blood bourne infections and transfusion reactions, surgical wound infections, and a few would die. Or the white dot would be further evaluated not by scope but by CT scan, and every 1100 CT scans cause 1 additional case of cancer from the high dose of radiation, and so a few people would die.
Get it? It takes experience and judgment to notice a tiny abnormality and decide whether it warrants further investigation. Mostly we get it right. Sometimes we get it wrong. But don't imagine that every white dot overlooked goes on to be bad just because it happened to someone you know, and that every white dot investigated improves the health of those lucky enough to not to be overlooked.
Again, same reason why you folks should not look at your records: you won't know what you're looking at and you won't be able to make useful sense of them to improve your health.
--JSt
Not quite true. Doctors are supposed to look for highest probability diagnoses and most dangerous diagnoses first. Common because that's probably the correct diagnosis, and dangerous ones because those cannot afford to be missed, even if they are less likely.
--JSt
this is so silly.
If you complain to me that you have explosive diarrhea, I write down "patient had explosive diarrhea". My medical notes are just that -- notes to help me remember and understand what I heard, what I examined, and the plans I made.
You people are a bit prudish if you think that explosive diarrhea is titilating to a physician. It is not. We deal with complaints of vaginal discharge, anal bleeding, coughs with nasty phlegm, rashes with putrid oozes, everything which can be vomited, and all manner of intimate stories from our patients over their sexual indiscretions, their substance abuse, their crushing sadness from social estrangement or divorce or death of a loved one, and everything else which causes suffering in the human condition.
As amazing as this is (and it IS friggin' amazing), remember that the human brain does this throw, catch, reposition, recalculate, and respond stuff effortlessly. Just play catch with a ball and your 5 year old child. Animals with pea-sized brains do it great, too!
-- Josh
Obama is taking mediocre expensive American medicine and getting it to more people. More expense. More mediocrity. More, frankly, crap. If he were really a liberal, he would have sought a govt based solution like single payor and been done with the atrocious 3rd party employer linked private insurance that we put up with now. But no, he gave in, compromised or caved at every turn, and thus we have more crap for more people when we could have had transformative change. Not a Democrat, not a liberal.
--JSt
Yeah, I guess bagging college works for the rare 1-in-a-billion future billionaire. But for everyone else, college is a place of great growth of knowledge, breadth of mind and experience, social maturation, and preparation for anything and everything. Yeah, college does not guarantee success. But not going to college virtually assures lack of success. Don't listen to this drivel.
--JSt
I'll help all you folks out who are insecure. I am an amateur software cobbler, able to make Hello World work only during full moons. I tip my hat to all of you, whether you are developers or engineers.
Cheers,
--JSt (fortunately, software tinkering is not my day job)
One reason I've heard cited that makes sense to me is that education, whether 2nd grade or second year of med school, is one of those human endeavors that requires person-to-person interactions that resists the general industrialization that occurs in so many other fields of work. You can't outsource classroom teaching. You can't replace a teacher the way you can replace secretaries with word processors and calendar apps and automated phone answering systems.
I don't know whether this idea stands up to scrutiny, tho'...
--JSt
"Why should college necessarily be a "fond personal experience"? You're there to learn, are you not?"
You're there to do a lot of things. Learn is one of them. But get real for a moment, nearly everything one learns in a college classroom one forgets within weeks, months, and certainly years. This is not cynicism, this is fact. If you take an Econ course or a Psychology course, months or years later former students can't recite lots of facts learned.
College is about learning facts, learning discipline, learning teamwork, learning about other people, broadening your mind, transitioning to being an adult. All the goals are important. For some certain goals will be more important than for others. For some, the stuff one learns will be highly aligned with the work they do in the workplace in 2, 5, and 20 years, for others the stuff they learn will have little to do with future work, and that's ok.
Anyway, with a broader view of what one could and should get from college, I think college can and should be a fond personal experience.
--JSt
Slashdot Mirror
Odd medication to complain about. Crbamazepine (Tegretol) was a highly used seizure/epilepsy medication 25 years ago, and to lesser extent, used for migraines or bipolar disorder. Now it is rarely used for any of these.
I'm puzzled why there is particular concern over a medicine that is rarely used any more.
-- Josh
1) "new" study? Published 2015. Someone is just catching up on their reading, although why they'd read this... 2) psych testing and surveys via Amazon Mechanical Turk? -- JS
It is a massive overstatement to say that birth defects are going to be prevented. Did anyone here read the article? I did. This is still in the realm of science and optimism and hypothesis. 1. researchers looked at genes in human family members of those with multiple congenital anomalies, found some genetic stuff, speculated genetic issues could have caused birth defects (and maybe miscarriages) and could be fixed by increased NAD (Niacin, Vit B3) 2. researches put the speculated problematic genes with CRISPR technology into mice. 3. supplementing mice with NAD (Niacin, a.k.a. B3) reduced birth defects That's it. There are a lot of hypotheses and assumptions here, and not a single human miscarriage or birth defect has been prevented yet. This article is great for forming hypotheses like "we oughtta test women/couples for these genes" or "we oughtta give pregnant women vit B3 supplements". But until we actually do these medical studies testing these ideas, we know nothing and have not advanced human health. -- Josh (yes, I am a doctor and I practice obstetrics and I'm not recommending any additional supplementation with Vit B3 until we have outcomes evidence in humans)
"Fail fast, fail frequently, fail cheap" I forget the book I read that in. --Josh
Hi folks, I am a primary care doctor. I have tons (literally) of obese patients with all the attendant consequences like diabetes, arthritis, sleep apnea, high blood pressure, poor circulation, and more. I do not prescribe weight loss drugs, never have, doubt I ever will. Reasons are simple and obvious. 1) they don't work. They produce an insignificant amount of weight loss and do it only over the shortterm. 2) they have bad side effects. Along with the lack of benefit, they sure do harm people. Xenical causes such massive diarrhea as to cause fecal incontinence. Pooping your pants uncontrollably... do I need to explain any further why no one takes this med? 3) they have a LONG history of causing severe and unanticipated health damage. Heart valves with fenfluramine, addiction with amphetamines, etc. 4) they do nothing to change people's underlying weak efforts at diet, exercise, and fitness, which produce real health. When patients stop the drugs, they lose the (minimal) benefit, and they go back to being what they were before. --JSt
Hi folks, Nice to imagine that something about "orgo" is fruitful to the process of making doctors, but I disagree. Organic chemistry has NOTHING to do with day to day doctoring for probably 99.9% of us. I don't have to draw a molecule of penicillin or know anything about how it interacts with other molecules in order to use it for strep throat or syphilis. We need in this day and age doctors who know science, probability, the human psyche, communication, and teamwork. But they don't need to know organic chemistry. And there are other fruitful ways to weed out those who can't hack it in med school. I know because I am a physician and I teach medical students and resident physicians in New York. --JSt
Hi. Sorry that you are away from your son more than you prefer. Everyone here assumes it's divorce, but for all we know you work on a nuclear sub or a marine biology platform away from home for months at a time. Either way, you deserve our sympathies for having to be separated, and you deserve our support for wanting to stay close to your boy. For me it was divorce around when our son turned 3. We had (and still have) shared custody with him living with each of us on certain days. But for practical reasons, he's with his mom more, so the issue of how to stay connected was most important for me. In my experience, a child that young has a tough time staying focused and connected to a voice on a phone. A voice alone is somewhat of an abstraction. As you surely know already, kids are really concrete. My son at that age found it difficult to stay focused and pay attention on the phone. If he held the phone himself, he was as fascinated by the buttons and the neat sounds they made when pressed as he was to talk to me (or to talk to my ex when he was with me). And if an iPhone with shiny screen buttons, even more distracting. If my ex held the phone near him on speaker phone, usually as he took his evening bath, he'd stray in and out of paying attention. It's just hard at that age. I gave my ex my old MacBook so that we could do Skype and/or Facetime (when latter came along). That helped a good amount. Voice plus video is a lot better. Matters not whether it's an iPod Touch or iPad or laptop. Clear audio plus video equals better likelihood of paying attention and staying connected. My son is 8 now. We still do the same arrangement, wherever he is, he calls the other parent and tries to do video chat every night. Neither of us has gotten him his own phone, and I think it will stay that way at least another couple years. He uses my ex'es iPhone or laptop to call me or he uses my iPhone or laptop to call her. I think it's better that we parents maintain control of devices and not let him have a phone for his own, at least so far. He'd be overjoyed to have a smartphone, no doubt about it, but we know that less phones and screens and more friends and outdoors and diverse activities is better. I hope you find a way to make a good connection. Good luck, -- Josh
My developer info as an iOS developer includes my Apple ID and my password. The same ID and password for my iTunes account which is connected to my credit card. If my name and email was compromised, I'm not terribly worried. If my password was compromised, then my credit card was compromised, and that's a problem. --JSt
Awesome set of skills and experiences. But must note that it weakens the presentation of them to misspell HIPAA
Win8 may not be all that bad. But I only use it at work. And I'm not going to muck around with software add-ons and then screw something up and then call the I.T. help desk here at work begging for them to fix what I screwed up on their computer. I'm willing to try stuff out on the computer I own and maintain at home, my Mac laptop. But I'm not going to screw around with someone else's computer which I need to work for workplace productivity. --JSt
Go back to the beginning of what made the IBM PC great. It was spreadsheets, databases, word processing, and boring financial programs. These were, and still are very much critical to businesses. These needs are not going away!
Correct. There will still be millions of users at work needing these applications. And Win7 runs them just fine. My medical organization still runs mostly XP (transitioning to Win7). If it ain't broke, no one will fix it for the sake of change itself. Change sucks. Only undertake it when necessary. What is essential or necessary for business on Win8? If you have no answer just like me, then I guess we know why Win8 is floundering. --JSt
My workplace (medical) is all Windows, transitioning from XP to Win7. All of our key applications will not run on Win8. I am replacing an old Motion Computing tablet. It is not easy to shop for a Win7 computer, but that's what I did. Alternatives were buy a Win8 machine and hope it's downgradable or buy a native Win7 machine, and I went with the latter. Home users have had a growing choice of platforms since iOS and Android arrived. But I figured workplace use would remain solidly Windows. Suspect it still will. But maybe companies will wait for Win9 --JSt
Bitcoin? Really? I thought news is information that someone cares about. 10 years from now people will chuckle or roll their eyes at the thought of Bitcoin. In 20 years, people will go "huh?" --JSt
1) not required to report unexplained loss of consciousness like seizure or fainting to Dept Motor Vehicles in NY State. In fact, if I did so, I would be in violation of patient privacy 2) yes, a physician is a mandated reporter of child abuse, so are nurses, teachers, and several other professionals. You have a problem with that? --JSt
I'm sorry about your friend. But you don't see the flip side of this. If every tiny white dot lead to a massive investigation, we'd kill more patients. It goes like this. Every tiny questionable finding white dot would lead to big investigation with endoscopy (garden hose scope down your throat) with biopsies to get the truth about the terrifying "white dot". Every now and then the procedure and the anesthesia would lead to a patient breathing in mouth saliva or gastric juices and catching a wicked pneumonia, a few might die. Every now and then the biopsy would perforate the stomach and a few might die. Every now and then the biopsy would nick a blood vessel in the stomach causing massive bleeding, leading to emergency surgery, blood transfusions and blood bourne infections and transfusion reactions, surgical wound infections, and a few would die. Or the white dot would be further evaluated not by scope but by CT scan, and every 1100 CT scans cause 1 additional case of cancer from the high dose of radiation, and so a few people would die. Get it? It takes experience and judgment to notice a tiny abnormality and decide whether it warrants further investigation. Mostly we get it right. Sometimes we get it wrong. But don't imagine that every white dot overlooked goes on to be bad just because it happened to someone you know, and that every white dot investigated improves the health of those lucky enough to not to be overlooked. Again, same reason why you folks should not look at your records: you won't know what you're looking at and you won't be able to make useful sense of them to improve your health. --JSt
Not quite true. Doctors are supposed to look for highest probability diagnoses and most dangerous diagnoses first. Common because that's probably the correct diagnosis, and dangerous ones because those cannot afford to be missed, even if they are less likely. --JSt
this is so silly. If you complain to me that you have explosive diarrhea, I write down "patient had explosive diarrhea". My medical notes are just that -- notes to help me remember and understand what I heard, what I examined, and the plans I made. You people are a bit prudish if you think that explosive diarrhea is titilating to a physician. It is not. We deal with complaints of vaginal discharge, anal bleeding, coughs with nasty phlegm, rashes with putrid oozes, everything which can be vomited, and all manner of intimate stories from our patients over their sexual indiscretions, their substance abuse, their crushing sadness from social estrangement or divorce or death of a loved one, and everything else which causes suffering in the human condition.
Doctors are deputized agents of the State? You need to go see your doctor for some psych meds to make those delusions stop haunting you...
Stuff you don't understand that only doctors understand like a zillion test results that to you might look concerning but to a doctor look fine
As amazing as this is (and it IS friggin' amazing), remember that the human brain does this throw, catch, reposition, recalculate, and respond stuff effortlessly. Just play catch with a ball and your 5 year old child. Animals with pea-sized brains do it great, too! -- Josh
Obama is taking mediocre expensive American medicine and getting it to more people. More expense. More mediocrity. More, frankly, crap. If he were really a liberal, he would have sought a govt based solution like single payor and been done with the atrocious 3rd party employer linked private insurance that we put up with now. But no, he gave in, compromised or caved at every turn, and thus we have more crap for more people when we could have had transformative change. Not a Democrat, not a liberal. --JSt
Yeah, I guess bagging college works for the rare 1-in-a-billion future billionaire. But for everyone else, college is a place of great growth of knowledge, breadth of mind and experience, social maturation, and preparation for anything and everything. Yeah, college does not guarantee success. But not going to college virtually assures lack of success. Don't listen to this drivel. --JSt
I'll help all you folks out who are insecure. I am an amateur software cobbler, able to make Hello World work only during full moons. I tip my hat to all of you, whether you are developers or engineers. Cheers, --JSt (fortunately, software tinkering is not my day job)
One reason I've heard cited that makes sense to me is that education, whether 2nd grade or second year of med school, is one of those human endeavors that requires person-to-person interactions that resists the general industrialization that occurs in so many other fields of work. You can't outsource classroom teaching. You can't replace a teacher the way you can replace secretaries with word processors and calendar apps and automated phone answering systems. I don't know whether this idea stands up to scrutiny, tho'... --JSt
"Why should college necessarily be a "fond personal experience"? You're there to learn, are you not?" You're there to do a lot of things. Learn is one of them. But get real for a moment, nearly everything one learns in a college classroom one forgets within weeks, months, and certainly years. This is not cynicism, this is fact. If you take an Econ course or a Psychology course, months or years later former students can't recite lots of facts learned. College is about learning facts, learning discipline, learning teamwork, learning about other people, broadening your mind, transitioning to being an adult. All the goals are important. For some certain goals will be more important than for others. For some, the stuff one learns will be highly aligned with the work they do in the workplace in 2, 5, and 20 years, for others the stuff they learn will have little to do with future work, and that's ok. Anyway, with a broader view of what one could and should get from college, I think college can and should be a fond personal experience. --JSt