but exactly where did I reference the Hopkins study? That one reportedly dealt with a putative parkinsons/MDMA link. No matter, there's plenty of research for you to peruse on MDMA, much of which deals with the Neuropharmacology of the drug. The Hopkins study is hardly representative of the entire body of literature on the subject.
As a heads up, Prozac use often tags people with seratonin imbalances. Seratonin is in the MDMA equation and intensifies positive and negative effects of the drug on these people
Excuse me... what? I'm not even sure what you're trying to say here... In the animal studies currently available, Prozac has not been shown to intensify the effects of MDMA... in fact, the opposite is true. The mechanism has even been elucidated. Prozac can reportedly intensify some neurotransmitter effects of other amphetamines, but I've never seen research to suggest that effect exists with ecstasy.
Lastly, ecstacy tablets bought on the street are almost never ever pure and are often cut with speed,cocaine,heroin,DXM (this causes major overheating),drano or other nasties which are responsible for ER visits, imho.
Street drugs are often misrepresented... a point I made in my initial post. Even so, it an incredible stretch to blame the deleterious effects of ecstasy on adulterants. The adulterants you mentioned are harmful, but that hardly evidence that ecstasy is harmless.
Alcohol in moderation seems to cause no ill effects, and can even have some benefits... the same cannot be said for MDMA and the other scheduled amphetamine
I think if you want to smoke, drink to excess, shoot-up, whatever... you are pretty much free to do so... all the above are widely available (some with legal penalties, some not). What I also believe, however, is that in making that conscious, informed, adult decision to indulge in such behavior, you should then absorb the costs for your habit, including purchase, medical costs, or even eventual detox.
It's fine with me if you want to shoot up... you're only hurting yourself... but I think it is morally wrong to attempt to force an uninvolved party to pay the price for another's stupidity.
Don't pitch Ecstasy like it's a harmless medication... it is not. (Disclaimer: I'm an ER physician, and I've treated ecstasy users)
Ecstasy (MDMA) is chemically related to the amphetamine family, and has many of the same effects. One of the side-effects of Ecstasy is hyperthermia... an elevation of body temperature that can lead to rhabdomyolysis (mass breakdown of muscle tissue, often leading to kidney failure), brain damage, and death.
Ecstasy acts primarily on the serotonergic and dopaminergic neurons in the CNS, and appears to irreversably harm the former (documented pathologically in animal studies, and observationally in humans). Interestingly, Prozac and some of the SSRI drugs seem to partially antagonize the effects of Ecstasy (but if you're planning on stopping your anti-depressant so you can get a better buzz on the weekend, you need serious help).
There's another problem: you never know what you're getting when you buy street drugs. Unless you have a degree in organic chemistry and are making your own (which can be done), it pays to be cautious.
Maybe you've taken ecstasy hundreds of times and had no problem... good for you. But ecstasy is not harmless... I've seen it go wrong, and it's not pretty.
Hyponatremia can be a problem, though rarely in a normal person (IIAD, BTW).
The most common scenario where I've seen symptomatic hyponatremia in a non-athlete is in a syndrome called SIADH (AKA: Syndrome of Inappropriate Anti-Diuretic Hormone). I've rarely seen it in psychiatric patients who compulsively drink massive quantities of fluids as part of their psychosis... Believe it or not, it's actually possible to drink enough water that you dilute out your electrolytes.
Anti-Diuretic Hormone is what determines the final concentration of your urine (ie. how much free water your kidneys scavenge from the filtrate in your kidneys)... it works in the kidney's distal tubules. Interestingly, ADH is inhibited by ethanol. Ever wonder how beer seems to go through you so quickly? Well, the answer is that it really doesn't... part of that massive urination is from the alcohol inhibiting ADH secretion, your kidneys start dumping free water, and you start peeing like a racehorse. The result? You get dehydrated; one of the major contributors to the discomfort of hangovers. Heh... a bag or two of IV fluids does wonders for a hangover.
Dilutional Hyponatremia is relatively easy to fix (obviously depending on severity)... just restrict fluid intake. In the case of SIADH, you also have to hunt for the cause... some lung cancers are notorious for secreting excess Anti-Diuretic Hormone.
Note that severe hyponatremia is life-threatening... you can have refractory seizures, coma, and profound mental status changes. Fixing it too quickly is also dangerous, and can cause a nasty (and permanent) condition called Central Pontine Myelinolysis... definitely not on the top-ten-diseases-to-have list.
Mr. Wright is it? I don't necessarily disagree with everything you wrote... your tone could use a bit of work.
I'd love to see you define 'state sponsors of terrorism', 'genocidal regimes' and (especially nice) 'rogue nations pursuing WMD'
Challenge accepted.
State Sponsor of Terrorism: Iran (also Syria) Genocidal Regime: Iraq, N. Korea (primarily against its own starving people) Rogue nation pursuing WMD: Iran, N. Korea, (also Syria)
You brought up a good point. Like you, I don't think the list should be only 3 countries long... there are plenty more I would add... but all in good time; we'll deal with the worst first.
just like going round the League of Nations was right?
The UN wasn't doing its job... somebody had to do it.
Good thing - because you're not.
Really? Perhaps you're a pacifist... I am not. I have no problem hunting and killing terrorists and their allies. In fact, I've personally taken part in/supported operations of exactly that type during my military service. To answer your unspoken question, yes... I sleep very well at night.
some poor British guy (web designer) who you held hostage for 2 years, tortured, starved, and beat, ritually.
So he says... I don't know the circumstances under which he was captured, and neither do you. As for his claims... I'm sure he has no axe to grind against his captors... If he innocent, I'm glad he was released. Yes, 2 years is a chunk out of his life he'll never get back, but at least he's free now... the system was slow, and certainly less than ideal, but it worked.
Hating America, and Americans, is increasingly easy these days. Because of fuckers like you. We know we shouldn't, but jesus, you're loud obnoxious pricks.
On the contrary, Mr. Wright... I've simply offered some reasoned counterpoint to some fairly over-the-top posts. I'm frankly surprised that you're so upset... that kind of vehemence in the face of this simple debate says something about you, sir.
don't fuck with the rest of the world
This may come as a surprise to you, but nothing would please most americans more than to simply be left alone. We didn't ask for this fight... but the Al-Queda have been targeting americans for over ten years, and it's time to deal with them, and the environment that's spawned them (radical islam and state terrorist sponsors).
Bush is the least qualified President we have ever had
After checking the Wikipedia... Kennedy - Bachelor's degree Carter - Bachelor's degree Reagan - Bachelor's degree Bush I - Bachelor's degree Clinton - Bachelors and JD Bush II - Bachelors and MBA
Least qualified? Not by comparison to some other recent presidents.
His ties to Enron alone are enough to want him out.
Much of the Enron shenanigans were ongoing before he even took office. Clinton had some ties also. Would that have made you impeach Clinton too, or only Bush?
Bush squandered the greatest chance for peace in our time by calling all of the world "Evil"
It was 3 countries, and those countries are either state sponsors of terrorism, genocidal regimes, or rogue nations pursuing WMD. If that's not evil, I'd love to see how you define "good."
say a big fuck you to the world
Kerry supported it... No, Bush got tired of UN corruption and inaction, and going around the UN was arguably the right thing to do. Check out the latest dirt on the UN's "Oil for Pala^H^H^H^H Food" program.
think of America as a "play by its own rules" bully
If those "rules" include reining in WMD proliferators and demolishing terrorist states, screw the opposition; The Right Thing (TM) isn't always the easy or popular thing. If finding and killing terrorists before they can strike is wrong, I don't want to be right.
Not to mention the fact that he wants to hold Americans without trial or due process indefinitely
If they're terrorists, they have almost no rights. To be considered lawful combatants and thus entitled to the protection of the Geneva Convention, you must meet four conditions: have a responsible chain of command (autonomous terrorist "cells" don't qualify), carry weapons openly, have a distinctive uniform or insignia, and follow the laws of war... Al-Queda meets NONE of these (the commentary I cited above is interesting... I recommend reading it).
The point I was making about Kerry had to do with his tendency to take special interest money. There have been a few articles about it in a few of the major papers, but I don't think it's gotten wide airplay.
Some of his other policies have yet to be tested, but he certainly has NO problem taking money from lobbying groups.
Just offhand, I'd guess there's much larger fish on GWBush's grill than the microsoft case.
Let's look at this from a larger perspective: the economy is just beginning to recover from the tech bust (not really bush's doing; presidents don't control the economy), there's a war and reconstruction effort going on, there's the ongoing hunt for terrorists, it's an election year... and you want Bush to focus on Microsoft?
Microsoft has the money, and we all know that politicians can be bought... John Kerry has certainly taken his share of special interest money over the years. So who would you have us vote for? Nader? (let's be realistic... he has no chance of winning).
Listen, if you want to take shots at Bush... have at it... that's practically required here at Slashdot. However, let's also be realistic about the bigger picture, and the lack of palatable alternatives. Kerry's no prize.
with almost everything you said, with the exception of the "free" samples... those samples are the only way some of my patients can get medications. Even if it's a sample of something we don't use much, we typically donate it to a missionary group that goes to central america a couple of times a year.
I could care less what type of magnets, pens, post-it notes, or neckties (yes, they have drug neckties) a drug rep gives me... I won't prescribe their drug unless there is a good clinical reason.
Much of the advertising is to let physicians know what new drugs are out there... not necessarily to get you to prescribe it (though that's often part of the pitch... "it's new and better for reason X"). If it's a field as crowded as PPIs for instance (proton pump inhibitors, like prilosec), they'd better have some damned compelling data to get me to prescribe it over a cheaper alternative like an H2 blocker (and no, I don't take company-sponsored studies at face value).
I know it seems like a waste, and some of it is... but you really have little to fear from those drug company billions spent on advertising... doctors largely ignore it.
You sound so much like a marketing guy it's hilarious... so confident in your ability to brainwash physicians into being your corporate puppets? Drug companies are the ones fooling themselves... I chuckle every time I think about how little their billions actually buy. Ask yourself why they pushed so long for direct-to-consumer advertising, and why it's increasing so dramatically.
Drug companies produce all kinds of little items that I use daily in my practice... but those have no bearing on what or how I prescribe. How can I be so sure? Easy... because I can tell you exactly what does influence my drug choices. I don't pick random drugs out of a hat where some subliminal advertising might tip the scales. I know why I prescribe every single drug I write. I have to know, because I have to be able to explain it whenever somebody asks (patient, private doctor, family member, administrator, attorney, etc), and believe me, they ask... frequently. Look, I don't mean to sound patronizing, but I don't think you really understand how doctors choose drugs:
Note that this list isn't exhaustive, and these are not necessarily in order:
1. Patient choice -"that drug doesn't work for me." Fair enough... everyone is genetically different... maybe they have a mutant receptor.
2. Patient allergies. I refuse to set myself up for a lawsuit, thanks.
3. Cost. My goal is compliance... otherwise, I'll end up seeing them back even sicker than before. If they can't afford it, they won't fill it, and I always start with generics.
4. Availability. No point in prescribing something that's not on formulary, or that local pharmacies don't carry. Incidently, I sit on my hospital's pharmacy committee, so I know how drugs get chosen... we always go with good&cheap whenever possible.
5. Efficacy. If, in my clinical experience, something just doesn't work (or doesn't work in my area due to local resistance patterns), I won't use it.
6. Safety. If they're at high risk for side effects, cross-reaction, or interaction with existing drugs, cautious prescribing is in order.
7. Convenience. If I can dose a medication 1x/day rather than four or five times, it greatly increases compliance... if it ensures compliance, a new/convenient/expensive medication is actually superior to a cheap/pain-in-the-ass one.
8. Peer-reviewed medical literature. Publications from the american college of my specialty, the Medical Letter, etc regarding DOC (drug of choice) for certain conditions.
9. Other patient factors (things like race, sex, pregnancy status).
There are too many clinically-important considerations that affect my prescribing... the fact that someone gave me a pen is utterly meaningless (I actually only use a specific type of pen... so I end up giving drug pens away... kids love 'em). Now free samples of drugs? I'll take those every day. Those are a great service, because I have plenty of patients who are too poor to afford even generic medications, and wouldn't get medication at all if it wasn't for samples.
The truth is that the drug companies largely waste their physician advertising dollars (which includes money to provide samples, BTW). But, they're free to spend what they want... it's their money.
The next time you try to indict an entire profession as corporate whores, make sure you really know how the system works. You're free to assume all doctors are relentlessly corrupt if you want... that's fine. For my own part, I prescribe what's in the best interests of the patient, nothing more, nothing less.
the Air Force is totally nuts about the gift rule. Here's a good example.
As military physicians, we were forbidden to accept anything from a pharmaceutical company rep. That "anything" also included things like pens, food, even a simple plastic goniometer (look it up). They were so worried about the "appearance" of impropriety, that they went beyond the 20$ rule to include things like pens. I'm not talking about a golfing vacation to Thailand... I'm talking about a 5 cent Bic pen.
What an insult... what a great way to piss off a group of people the military desperately needs to retain. My question was this: If they think I'm enough of a whore that I'd sell out my patients for the price of a pen, why even trust me to take care of people? If that's all the more they trust their physicians, I wish they'd just come down to my duty section, slap me, spit on my boots, and tell me to my face. Honestly... the military does some of the dumbest things, and it's all so someone in the chain of command can get an OPR bullet.
But yes... the gift rule has snagged many a military member... what the hell was microsoft thinking?
That doesn't square at all with my experience... former Air Force talking here.
Most pilots are bright folks, they just stumble when confronted with an area where they have no background or training (like anyone). If you're starting from scratch, Linux is just as intuitive as anything manufactured by microsoft.
Incidently, the Air Force has plenty of tech-saavy people, often in the form of reservists. I've had systems guys in deployed locations who were company-grade officers... but senior software engineers at major corporations, often using linux on-the-job. Many of them hated our reliance on MS products, and looked for ways to use more-functional things every chance they got. Good grief... our NT servers in Saudi Arabia had to be rebooted monthly or they'd simply cease to function (don't even get me started on service packs).
MS is notthe way... it is a way, and that's all you can say. Pilots are more than swift enough to use linux if you gave them a little training.
same situation with a neighbor... I cleaned Mydoom, Netsky, and Beagle (the J variant) out of his computer... his computer was slower and more unstable than usual, so he asked me to look at it for him (it's a win98 box... 'nuff said).
I've already set them up with a good firewall... controlling what they do with their Email attachments is a bit more problematic.
I support cutting off accounts for abuse, whether intentional or simply clueless/negligent. Hell, I'd be delighted if somebody warned me that something was up with my connection, for a couple of reasons. One: I have more than a passing interest in net security, so if my box just got pwned, I want to know about it, including how they did it. Two: I try to be a good netizen, and just like I'd expect one of my neighbors to call me if he noticed my house was on fire, I'd hope somebody would tell me if I was polluting the 'net.
This is comcast doing the user and their fellows a favor.
I get scanned from hosts within Cox's IP block all the time, and it's often the same IP doing it.
I sent cox an Email about it (I have their business service) and never received a reply.
So no, it's not just you... incidently, their phone support folks have been pretty reasonable when I've talked with them. They even knew what linux was... and they ceased to ask me the entry-level support tree questions when I began reading them the logs from Snort and TCPdump.
They're not all clueless... dunno, maybe I got the only good one.
but a bit simplistic, as a short post must necessarily be.
You won't be able to keep him away from bullies... they abound, and show a certain cunning in oppressing others. Far better a strategy may be found in your second point... teach them how to deal with these types until such time as the legal system offers remedies against the bully's physically assaultive behavior (I doubt too many geeks fear verbal sparring matches with these goons; as the quicker mind tends to prevail). It might also give them some experience with enduring pain and hassle... a valuable trait.
As for getting them laid early in life... I may be in the minority on this one, but caution is definitely in order. If you make their first sexual experience involve some Thai prostitute, you'll forever warp their expectations and impressions about intimacy. No bullsh*t... those experiences are emotionally powerful, and you tend to remember them. Depending on how you interpret those memories, they can become emotional baggage that affects your relationships with future partners.
Sex is a powerful thing... best let him save himself until such time as he can make his own conscious decisions about it, and has the maturity to handle it.
I'd never use paypal to directly pay for any big-ticket items; that's why God made escrow services.
Seriously, if it's over a hundred bucks or so (definitely if it's into the thousands), I'd seriously consider using an escrow service and paying the percentage... though dedicated fraudsters have gone so far as to set up fakes.
I tend to treat paypal as a convenient money order service for small-ticket items... if I lose, no big deal.
that BIOS code is critical and readily flashable...
Ever had a virus that hosed your bios? You've now got a dead motherboard unless you've got a burner and some extra ROMS laying around (doesn't everyone?). Some companies have instituted an auto-switching dual bios that helps mitigate this risk, while others are jumper switchable
Still... it bothers me to have an irreversible "kill" feature on my computer... particularly since I'm error-prone like most people. Ever had a BIOS flash interrupted? I have... not pretty.
I'd have to say stopping at accidents is a dicey business at best. If you don't have the tools/training, you might be hurting more than helping.
Disclaimer: I'm an ER doc, and I've got about every certification you can shake a stick at... BLS, ACLS, ATLS, Pediatric ALS, etc, etc... in addition to experience rendering care under fire as a tactical medic. I'm comfortable rendering care in the field, partially from my training, but also because EMS direction is part and parcel of EM practice. I also carry my jump bag in my vehicle, so I've got advanced airway management, hemorrhage control, monitoring capability... all in a backpack.
I stop at traffic accidents if they happen right in front of me, or if there is no EMS on scene. However, I would not expect a radiologist to stop (in fact, I'd almost hope he wouldn't... he'd probably just be in the way). If somebody is really FUBAR'd and needs me to stay with them, I stay until they're in qualified hands (that may mean a ride to the hospital)... otherwise, I immediately hand off to the medics and leave.
Having a medical license doesn't mean you're qualified to offer care in the field. For my own part, if I was laying bleeding in the road somewhere, I'd rather have a paramedic (or maybe a surgeon) than some of my colleagues. I don't mean that as an insult to other doctors... but care in austere environments is very different from the office... it's simply not within the scope of most physicians' practice or experience.
Our customers also want flexibility and customer-friendly store policies, and Electronics Boutique employs several. For example, we maintain a popular pre-owned program that allows customers to trade in their previously played games for store credit toward the purchase of the hottest new titles, thereby satisfying the rapid play tendencies of avid gamers. And, since we sell an extensive selection of pre-owned titles, we provide a lower priced purchase option for more casual gamers.
Yeah... great. Apparently they've been drinking their own corporate koolaid. I'd say they need to add a few more customer-friendly policies, instead of felon-friendly ones.... something that complies with state law would be dandy.
except it doesn't take into account the other risks of surgery (anesthesia reactions are ugly). Also, we already operate to fix previous operations, whether for functional or cosmetic reasons. Plastic surgeons often do scar revisions to cosmetically improve on prior surgeries, for example.
Also, there are some types of wounds/injuries that are almost scarless, at least in the long term. Mucosa doesn't scar much... neither does bone (although bone may take years to remodel). For instance, look for scars on the inside of your lip and think about how many times you've bitten it over the course of your life.
Gene therapy is really in its infancy, but it holds tremendous promise, since many many of the big killers (excepting smoking, drinking, trauma, et al) are genetic in origin. If all you have to do is fix a single protein, you could cure familial hypercholesterolemia (bad ones die of heart attacks by their teens or twenties), all the hemoglobinopathies, cystic fibrosis... the list is endless. The challenge would come in targeting multi-gene problems like syndrome X.
I don't know if "good enough" would truly cut it with gene therapy. All it takes is one big lawsuit to wipe out an entire company, and it seems to be uniquely american to sue for simple bad luck. While people seem able to accept that "sh*t happens," when it happens to somebody else, they immediately attempt to assign blame when it happens to them... because somebody has to be at fault...
yes... what is it with nurses who smoke? I also know vascular surgeons and respiratory therapists(!) who smoke... boggles the mind.
But you're right... I'm a computer-geek physician, and I've rescued more colleagues laptops and desktops from viruses, spyware, and other assorted nasties. It's scary, because if there's one person whose identity you might like to steal, it would probably be a doctor... they tend to have great credit ratings. If the physician had the necessary docs in their computer, you could perhaps steal their professional identity too, which would be far, far worse.
Mirrors my experience with my neighbors (most of whom are highly-educated... some terminally-degreed).
I've rooted out more copies of Gator, Cydoor, etc from neighbors, friends, and family members... I can't even count the infections.
I typically recommend/setup the following bare minimum set of tools to avoid spyware, hax0rs, etc.
Firewall (I like smoothwall on an old PC) Current anti-virus, set to auto-scan. Spybot Search and Destroy run periodically.
I don't think I've ever had to look twice at a home computer setup that took those measures... and the users invariably learn what to look out for (particularly after Norton keeps flagging all those MyDoom, Klez, etc emails).
Slashdot Mirror
but exactly where did I reference the Hopkins study? That one reportedly dealt with a putative parkinsons/MDMA link. No matter, there's plenty of research for you to peruse on MDMA, much of which deals with the Neuropharmacology of the drug. The Hopkins study is hardly representative of the entire body of literature on the subject.
As a heads up, Prozac use often tags people with seratonin imbalances. Seratonin is in the MDMA equation and intensifies positive and negative effects of the drug on these people
Excuse me... what? I'm not even sure what you're trying to say here... In the animal studies currently available, Prozac has not been shown to intensify the effects of MDMA... in fact, the opposite is true. The mechanism has even been elucidated. Prozac can reportedly intensify some neurotransmitter effects of other amphetamines, but I've never seen research to suggest that effect exists with ecstasy.
Lastly, ecstacy tablets bought on the street are almost never ever pure and are often cut with speed,cocaine,heroin,DXM (this causes major overheating),drano or other nasties which are responsible for ER visits, imho.
Street drugs are often misrepresented... a point I made in my initial post. Even so, it an incredible stretch to blame the deleterious effects of ecstasy on adulterants. The adulterants you mentioned are harmful, but that hardly evidence that ecstasy is harmless.
Were you making a legalization argument there?
Alcohol in moderation seems to cause no ill effects, and can even have some benefits... the same cannot be said for MDMA and the other scheduled amphetamine
I think if you want to smoke, drink to excess, shoot-up, whatever... you are pretty much free to do so... all the above are widely available (some with legal penalties, some not). What I also believe, however, is that in making that conscious, informed, adult decision to indulge in such behavior, you should then absorb the costs for your habit, including purchase, medical costs, or even eventual detox.
It's fine with me if you want to shoot up... you're only hurting yourself... but I think it is morally wrong to attempt to force an uninvolved party to pay the price for another's stupidity.
Don't pitch Ecstasy like it's a harmless medication... it is not. (Disclaimer: I'm an ER physician, and I've treated ecstasy users)
Ecstasy (MDMA) is chemically related to the amphetamine family, and has many of the same effects. One of the side-effects of Ecstasy is hyperthermia... an elevation of body temperature that can lead to rhabdomyolysis (mass breakdown of muscle tissue, often leading to kidney failure), brain damage, and death.
Ecstasy acts primarily on the serotonergic and dopaminergic neurons in the CNS, and appears to irreversably harm the former (documented pathologically in animal studies, and observationally in humans). Interestingly, Prozac and some of the SSRI drugs seem to partially antagonize the effects of Ecstasy (but if you're planning on stopping your anti-depressant so you can get a better buzz on the weekend, you need serious help).
There's another problem: you never know what you're getting when you buy street drugs. Unless you have a degree in organic chemistry and are making your own (which can be done), it pays to be cautious.
Maybe you've taken ecstasy hundreds of times and had no problem... good for you. But ecstasy is not harmless... I've seen it go wrong, and it's not pretty.
Hyponatremia can be a problem, though rarely in a normal person (IIAD, BTW).
The most common scenario where I've seen symptomatic hyponatremia in a non-athlete is in a syndrome called SIADH (AKA: Syndrome of Inappropriate Anti-Diuretic Hormone). I've rarely seen it in psychiatric patients who compulsively drink massive quantities of fluids as part of their psychosis... Believe it or not, it's actually possible to drink enough water that you dilute out your electrolytes.
Anti-Diuretic Hormone is what determines the final concentration of your urine (ie. how much free water your kidneys scavenge from the filtrate in your kidneys)... it works in the kidney's distal tubules. Interestingly, ADH is inhibited by ethanol. Ever wonder how beer seems to go through you so quickly? Well, the answer is that it really doesn't... part of that massive urination is from the alcohol inhibiting ADH secretion, your kidneys start dumping free water, and you start peeing like a racehorse. The result? You get dehydrated; one of the major contributors to the discomfort of hangovers. Heh... a bag or two of IV fluids does wonders for a hangover.
Dilutional Hyponatremia is relatively easy to fix (obviously depending on severity)... just restrict fluid intake. In the case of SIADH, you also have to hunt for the cause... some lung cancers are notorious for secreting excess Anti-Diuretic Hormone.
Note that severe hyponatremia is life-threatening... you can have refractory seizures, coma, and profound mental status changes. Fixing it too quickly is also dangerous, and can cause a nasty (and permanent) condition called Central Pontine Myelinolysis... definitely not on the top-ten-diseases-to-have list.
Mr. Wright is it? I don't necessarily disagree with everything you wrote... your tone could use a bit of work.
I'd love to see you define 'state sponsors of terrorism', 'genocidal regimes' and (especially nice) 'rogue nations pursuing WMD'
Challenge accepted.
State Sponsor of Terrorism: Iran (also Syria)
Genocidal Regime: Iraq, N. Korea (primarily against its own starving people)
Rogue nation pursuing WMD: Iran, N. Korea, (also Syria)
You brought up a good point. Like you, I don't think the list should be only 3 countries long... there are plenty more I would add... but all in good time; we'll deal with the worst first.
just like going round the League of Nations was right?
The UN wasn't doing its job... somebody had to do it.
Good thing - because you're not.
Really? Perhaps you're a pacifist... I am not. I have no problem hunting and killing terrorists and their allies. In fact, I've personally taken part in/supported operations of exactly that type during my military service. To answer your unspoken question, yes... I sleep very well at night.
some poor British guy (web designer) who you held hostage for 2 years, tortured, starved, and beat, ritually.
So he says... I don't know the circumstances under which he was captured, and neither do you. As for his claims... I'm sure he has no axe to grind against his captors... If he innocent, I'm glad he was released. Yes, 2 years is a chunk out of his life he'll never get back, but at least he's free now... the system was slow, and certainly less than ideal, but it worked.
Hating America, and Americans, is increasingly easy these days. Because of fuckers like you. We know we shouldn't, but jesus, you're loud obnoxious pricks.
On the contrary, Mr. Wright... I've simply offered some reasoned counterpoint to some fairly over-the-top posts. I'm frankly surprised that you're so upset... that kind of vehemence in the face of this simple debate says something about you, sir.
don't fuck with the rest of the world
This may come as a surprise to you, but nothing would please most americans more than to simply be left alone. We didn't ask for this fight... but the Al-Queda have been targeting americans for over ten years, and it's time to deal with them, and the environment that's spawned them (radical islam and state terrorist sponsors).
Bush is the least qualified President we have ever had
After checking the Wikipedia...
Kennedy - Bachelor's degree
Carter - Bachelor's degree
Reagan - Bachelor's degree
Bush I - Bachelor's degree
Clinton - Bachelors and JD
Bush II - Bachelors and MBA
Least qualified? Not by comparison to some other recent presidents.
His ties to Enron alone are enough to want him out.
Much of the Enron shenanigans were ongoing before he even took office. Clinton had some ties also. Would that have made you impeach Clinton too, or only Bush?
Bush squandered the greatest chance for peace in our time by calling all of the world "Evil"
It was 3 countries, and those countries are either state sponsors of terrorism, genocidal regimes, or rogue nations pursuing WMD. If that's not evil, I'd love to see how you define "good."
say a big fuck you to the world
Kerry supported it... No, Bush got tired of UN corruption and inaction, and going around the UN was arguably the right thing to do. Check out the latest dirt on the UN's "Oil for Pala^H^H^H^H Food" program.
think of America as a "play by its own rules" bully
If those "rules" include reining in WMD proliferators and demolishing terrorist states, screw the opposition; The Right Thing (TM) isn't always the easy or popular thing. If finding and killing terrorists before they can strike is wrong, I don't want to be right.
Not to mention the fact that he wants to hold Americans without trial or due process indefinitely
If they're terrorists, they have almost no rights. To be considered lawful combatants and thus entitled to the protection of the Geneva Convention, you must meet four conditions: have a responsible chain of command (autonomous terrorist "cells" don't qualify), carry weapons openly, have a distinctive uniform or insignia, and follow the laws of war... Al-Queda meets NONE of these (the commentary I cited above is interesting... I recommend reading it).
It's OK that you hate Bush... really.
Hey there Ryan.
The point I was making about Kerry had to do with his tendency to take special interest money. There have been a few articles about it in a few of the major papers, but I don't think it's gotten wide airplay.
Some of his other policies have yet to be tested, but he certainly has NO problem taking money from lobbying groups.
Just offhand, I'd guess there's much larger fish on GWBush's grill than the microsoft case.
Let's look at this from a larger perspective: the economy is just beginning to recover from the tech bust (not really bush's doing; presidents don't control the economy), there's a war and reconstruction effort going on, there's the ongoing hunt for terrorists, it's an election year... and you want Bush to focus on Microsoft?
Microsoft has the money, and we all know that politicians can be bought... John Kerry has certainly taken his share of special interest money over the years. So who would you have us vote for? Nader? (let's be realistic... he has no chance of winning).
Listen, if you want to take shots at Bush... have at it... that's practically required here at Slashdot. However, let's also be realistic about the bigger picture, and the lack of palatable alternatives. Kerry's no prize.
with almost everything you said, with the exception of the "free" samples... those samples are the only way some of my patients can get medications. Even if it's a sample of something we don't use much, we typically donate it to a missionary group that goes to central america a couple of times a year.
... doctors largely ignore it.
I could care less what type of magnets, pens, post-it notes, or neckties (yes, they have drug neckties) a drug rep gives me... I won't prescribe their drug unless there is a good clinical reason.
Much of the advertising is to let physicians know what new drugs are out there... not necessarily to get you to prescribe it (though that's often part of the pitch... "it's new and better for reason X"). If it's a field as crowded as PPIs for instance (proton pump inhibitors, like prilosec), they'd better have some damned compelling data to get me to prescribe it over a cheaper alternative like an H2 blocker (and no, I don't take company-sponsored studies at face value).
I know it seems like a waste, and some of it is... but you really have little to fear from those drug company billions spent on advertising
You sound so much like a marketing guy it's hilarious... so confident in your ability to brainwash physicians into being your corporate puppets? Drug companies are the ones fooling themselves... I chuckle every time I think about how little their billions actually buy. Ask yourself why they pushed so long for direct-to-consumer advertising, and why it's increasing so dramatically.
Drug companies produce all kinds of little items that I use daily in my practice... but those have no bearing on what or how I prescribe. How can I be so sure? Easy... because I can tell you exactly what does influence my drug choices. I don't pick random drugs out of a hat where some subliminal advertising might tip the scales. I know why I prescribe every single drug I write. I have to know, because I have to be able to explain it whenever somebody asks (patient, private doctor, family member, administrator, attorney, etc), and believe me, they ask... frequently. Look, I don't mean to sound patronizing, but I don't think you really understand how doctors choose drugs:
Note that this list isn't exhaustive, and these are not necessarily in order:
1. Patient choice -"that drug doesn't work for me." Fair enough... everyone is genetically different... maybe they have a mutant receptor.
2. Patient allergies. I refuse to set myself up for a lawsuit, thanks.
3. Cost. My goal is compliance... otherwise, I'll end up seeing them back even sicker than before. If they can't afford it, they won't fill it, and I always start with generics.
4. Availability. No point in prescribing something that's not on formulary, or that local pharmacies don't carry. Incidently, I sit on my hospital's pharmacy committee, so I know how drugs get chosen... we always go with good&cheap whenever possible.
5. Efficacy. If, in my clinical experience, something just doesn't work (or doesn't work in my area due to local resistance patterns), I won't use it.
6. Safety. If they're at high risk for side effects, cross-reaction, or interaction with existing drugs, cautious prescribing is in order.
7. Convenience. If I can dose a medication 1x/day rather than four or five times, it greatly increases compliance... if it ensures compliance, a new/convenient/expensive medication is actually superior to a cheap/pain-in-the-ass one.
8. Peer-reviewed medical literature. Publications from the american college of my specialty, the Medical Letter, etc regarding DOC (drug of choice) for certain conditions.
9. Other patient factors (things like race, sex, pregnancy status).
There are too many clinically-important considerations that affect my prescribing... the fact that someone gave me a pen is utterly meaningless (I actually only use a specific type of pen... so I end up giving drug pens away... kids love 'em). Now free samples of drugs? I'll take those every day. Those are a great service, because I have plenty of patients who are too poor to afford even generic medications, and wouldn't get medication at all if it wasn't for samples.
The truth is that the drug companies largely waste their physician advertising dollars (which includes money to provide samples, BTW). But, they're free to spend what they want... it's their money.
The next time you try to indict an entire profession as corporate whores, make sure you really know how the system works. You're free to assume all doctors are relentlessly corrupt if you want... that's fine. For my own part, I prescribe what's in the best interests of the patient, nothing more, nothing less.
the Air Force is totally nuts about the gift rule. Here's a good example.
As military physicians, we were forbidden to accept anything from a pharmaceutical company rep. That "anything" also included things like pens, food, even a simple plastic goniometer (look it up). They were so worried about the "appearance" of impropriety, that they went beyond the 20$ rule to include things like pens. I'm not talking about a golfing vacation to Thailand... I'm talking about a 5 cent Bic pen.
What an insult... what a great way to piss off a group of people the military desperately needs to retain. My question was this: If they think I'm enough of a whore that I'd sell out my patients for the price of a pen, why even trust me to take care of people? If that's all the more they trust their physicians, I wish they'd just come down to my duty section, slap me, spit on my boots, and tell me to my face. Honestly... the military does some of the dumbest things, and it's all so someone in the chain of command can get an OPR bullet.
But yes... the gift rule has snagged many a military member... what the hell was microsoft thinking?
That doesn't square at all with my experience... former Air Force talking here.
Most pilots are bright folks, they just stumble when confronted with an area where they have no background or training (like anyone). If you're starting from scratch, Linux is just as intuitive as anything manufactured by microsoft.
Incidently, the Air Force has plenty of tech-saavy people, often in the form of reservists. I've had systems guys in deployed locations who were company-grade officers... but senior software engineers at major corporations, often using linux on-the-job. Many of them hated our reliance on MS products, and looked for ways to use more-functional things every chance they got. Good grief... our NT servers in Saudi Arabia had to be rebooted monthly or they'd simply cease to function (don't even get me started on service packs).
MS is not the way... it is a way, and that's all you can say. Pilots are more than swift enough to use linux if you gave them a little training.
same situation with a neighbor... I cleaned Mydoom, Netsky, and Beagle (the J variant) out of his computer... his computer was slower and more unstable than usual, so he asked me to look at it for him (it's a win98 box... 'nuff said).
I've already set them up with a good firewall... controlling what they do with their Email attachments is a bit more problematic.
I support cutting off accounts for abuse, whether intentional or simply clueless/negligent. Hell, I'd be delighted if somebody warned me that something was up with my connection, for a couple of reasons. One: I have more than a passing interest in net security, so if my box just got pwned, I want to know about it, including how they did it. Two: I try to be a good netizen, and just like I'd expect one of my neighbors to call me if he noticed my house was on fire, I'd hope somebody would tell me if I was polluting the 'net.
This is comcast doing the user and their fellows a favor.
I get scanned from hosts within Cox's IP block all the time, and it's often the same IP doing it.
I sent cox an Email about it (I have their business service) and never received a reply.
So no, it's not just you... incidently, their phone support folks have been pretty reasonable when I've talked with them. They even knew what linux was... and they ceased to ask me the entry-level support tree questions when I began reading them the logs from Snort and TCPdump.
They're not all clueless... dunno, maybe I got the only good one.
but a bit simplistic, as a short post must necessarily be.
You won't be able to keep him away from bullies... they abound, and show a certain cunning in oppressing others. Far better a strategy may be found in your second point... teach them how to deal with these types until such time as the legal system offers remedies against the bully's physically assaultive behavior (I doubt too many geeks fear verbal sparring matches with these goons; as the quicker mind tends to prevail). It might also give them some experience with enduring pain and hassle... a valuable trait.
As for getting them laid early in life... I may be in the minority on this one, but caution is definitely in order. If you make their first sexual experience involve some Thai prostitute, you'll forever warp their expectations and impressions about intimacy. No bullsh*t... those experiences are emotionally powerful, and you tend to remember them. Depending on how you interpret those memories, they can become emotional baggage that affects your relationships with future partners.
Sex is a powerful thing... best let him save himself until such time as he can make his own conscious decisions about it, and has the maturity to handle it.
Some of our Slashpervs may, of course, disagree.
I'd never use paypal to directly pay for any big-ticket items; that's why God made escrow services.
Seriously, if it's over a hundred bucks or so (definitely if it's into the thousands), I'd seriously consider using an escrow service and paying the percentage... though dedicated fraudsters have gone so far as to set up fakes.
I tend to treat paypal as a convenient money order service for small-ticket items... if I lose, no big deal.
that BIOS code is critical and readily flashable...
Ever had a virus that hosed your bios? You've now got a dead motherboard unless you've got a burner and some extra ROMS laying around (doesn't everyone?). Some companies have instituted an auto-switching dual bios that helps mitigate this risk, while others are jumper switchable
Still... it bothers me to have an irreversible "kill" feature on my computer... particularly since I'm error-prone like most people. Ever had a BIOS flash interrupted? I have... not pretty.
like Darl?
Sorry... too much SCO for one day... my bad.
I'd have to say stopping at accidents is a dicey business at best. If you don't have the tools/training, you might be hurting more than helping.
Disclaimer: I'm an ER doc, and I've got about every certification you can shake a stick at... BLS, ACLS, ATLS, Pediatric ALS, etc, etc... in addition to experience rendering care under fire as a tactical medic. I'm comfortable rendering care in the field, partially from my training, but also because EMS direction is part and parcel of EM practice. I also carry my jump bag in my vehicle, so I've got advanced airway management, hemorrhage control, monitoring capability... all in a backpack.
I stop at traffic accidents if they happen right in front of me, or if there is no EMS on scene. However, I would not expect a radiologist to stop (in fact, I'd almost hope he wouldn't... he'd probably just be in the way). If somebody is really FUBAR'd and needs me to stay with them, I stay until they're in qualified hands (that may mean a ride to the hospital)... otherwise, I immediately hand off to the medics and leave.
Having a medical license doesn't mean you're qualified to offer care in the field. For my own part, if I was laying bleeding in the road somewhere, I'd rather have a paramedic (or maybe a surgeon) than some of my colleagues. I don't mean that as an insult to other doctors... but care in austere environments is very different from the office... it's simply not within the scope of most physicians' practice or experience.
read their own corporate website.
Our customers also want flexibility and customer-friendly store policies, and Electronics Boutique employs several. For example, we maintain a popular pre-owned program that allows customers to trade in their previously played games for store credit toward the purchase of the hottest new titles, thereby satisfying the rapid play tendencies of avid gamers. And, since we sell an extensive selection of pre-owned titles, we provide a lower priced purchase option for more casual gamers.
Yeah... great. Apparently they've been drinking their own corporate koolaid. I'd say they need to add a few more customer-friendly policies, instead of felon-friendly ones.... something that complies with state law would be dandy.
except it doesn't take into account the other risks of surgery (anesthesia reactions are ugly). Also, we already operate to fix previous operations, whether for functional or cosmetic reasons. Plastic surgeons often do scar revisions to cosmetically improve on prior surgeries, for example.
Also, there are some types of wounds/injuries that are almost scarless, at least in the long term. Mucosa doesn't scar much... neither does bone (although bone may take years to remodel). For instance, look for scars on the inside of your lip and think about how many times you've bitten it over the course of your life.
Gene therapy is really in its infancy, but it holds tremendous promise, since many many of the big killers (excepting smoking, drinking, trauma, et al) are genetic in origin. If all you have to do is fix a single protein, you could cure familial hypercholesterolemia (bad ones die of heart attacks by their teens or twenties), all the hemoglobinopathies, cystic fibrosis... the list is endless. The challenge would come in targeting multi-gene problems like syndrome X.
I don't know if "good enough" would truly cut it with gene therapy. All it takes is one big lawsuit to wipe out an entire company, and it seems to be uniquely american to sue for simple bad luck. While people seem able to accept that "sh*t happens," when it happens to somebody else, they immediately attempt to assign blame when it happens to them... because somebody has to be at fault...
It's pretty tough to fight human nature.
for mentioning that. I find that OE is a tool of the devil. So many people use that preview pane....
yes... what is it with nurses who smoke? I also know vascular surgeons and respiratory therapists(!) who smoke... boggles the mind.
But you're right... I'm a computer-geek physician, and I've rescued more colleagues laptops and desktops from viruses, spyware, and other assorted nasties. It's scary, because if there's one person whose identity you might like to steal, it would probably be a doctor... they tend to have great credit ratings. If the physician had the necessary docs in their computer, you could perhaps steal their professional identity too, which would be far, far worse.
Mirrors my experience with my neighbors (most of whom are highly-educated... some terminally-degreed).
I've rooted out more copies of Gator, Cydoor, etc from neighbors, friends, and family members... I can't even count the infections.
I typically recommend/setup the following bare minimum set of tools to avoid spyware, hax0rs, etc.
Firewall (I like smoothwall on an old PC)
Current anti-virus, set to auto-scan.
Spybot Search and Destroy run periodically.
I don't think I've ever had to look twice at a home computer setup that took those measures... and the users invariably learn what to look out for (particularly after Norton keeps flagging all those MyDoom, Klez, etc emails).
is the absolute bomb...
Note the paypal link... throw the author a few bones; it's a great program.