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Anti-Ebola Drug ZMapp Makes Clean Sweep: 18 of 18 Monkeys Survive Infection

BigDukeSix Re:Human Subjects (91 comments)

When the human testing starts, should it be old people first? afftected-continent people first? family-receives-high-payment people first?

Real clinical trials do not work like this. If you want to do a real trial, you first have to establish a team and treatment center that can administer your therapy and collect the data you need. You then establish EXCLUSION criteria, i.e., people who will not be included in the trial (usually old people, who have an annoying tendency to die, and children, because sick kids scare the shit out of most doctors). *Everybody* else who comes to the center, who has the disease, gets offered enrollment in the trial. It's up to them if they want to participate.

Anything else will get you laughed at, at the very least.

about two weeks ago

Chinese Researchers' 'Terror Cam' Could Scan Crowds, Looking for Stress

BigDukeSix Re:Well, you get what you vote for or submit to... (146 comments)

It is with 100% certainty already here. DARPA had a program ten years ago looking into this very concept. Google "darpa multispectral imaging face" and you will see a bunch of PDF reports.

about a month ago

"Secret Serum" Used To Treat Americans With Ebola

BigDukeSix Re:hmmmmm (390 comments)

Okay, I'll feed the AC troll.

I'm not talking about "most rashes"; real physicians have words to describe different kinds of rashes. The word that describes the rash of Ebola is "purpura." The distinguishing feature of this kind of rash is that when you push on it, it doesn't stop looking like a bruise. That is because the blood isn't contained within blood vessels that can be pressurized and allow the blood to be pushed out of the way. Because IT'S A FUCKING BRUISE.

Once blood leaves the vasculature, it is broken down into a couple of proteins. Hemosiderin is taken up by white blood cells. Biliverdin turns your turds brown (eventually). They make your bruises turn "black and blue" and eventually yellow. This takes days and is the reason why purpuric rashes don't fade immediately in response to anything.

You are conflating "hives" and "purpura." Kindly pay tuition if you want to continue.

about a month and a half ago

"Secret Serum" Used To Treat Americans With Ebola

BigDukeSix hmmmmm (390 comments)

It seems possible that a monoclonal antibody might have a dramatic effect on virus replication. Since Ebola makes one ill by direct cell destruction it might even make one feel better quickly. But the rash comes from bleeding under the skin (it's the same as any big bruise you might have had). It makes no sense that it should fade immediately from the administration of a monoclonal against the virus. I hope this drug is successful in a trial, but at least that part of the article is suspicious.

about a month and a half ago

Interview: Ask Alan Adler About Flying Toys and the Perfect Cup of Coffee

BigDukeSix disc golf (76 comments)

Do you play disc golf, and if so, what is your long-distance driver?

about 8 months ago

Imagining the Post-Antibiotic Future

BigDukeSix Re:Easy solution (453 comments)

I don't disagree with the general premise that reducing antibiotic use in livestock would be helpful in reducing the emergence of resistant strains of bacteria. I have to take issue, though, with the assertion that even eliminating entirely their use in the food industry would provide any sort of enduring solution. It would not.

The dirty little secret about antibiotic resistance that no one wants to talk about is this: resistance emerges from repeated use of different antibiotics in the same human, many of whom are not supposed to (according to nature) survive anyway. This group includes critically ill or injured people, cancer patients, patients with chronic organ failure, and most importantly old people. All of these groups have the common characteristic of impairment of immune function.

Antibiotics don't really "cure" infection. They kill enough of the circulating organisms so that the host immune system can take care of the rest. Some very good antibiotics don't kill any bacteria, they just stop replication. So if you actually wanted to create a petri dish for resistant organisms, you would take a host with poor immune system function, infect it, and give antibiotics that kill most of the bacteria and let the rest play on.

In this regard, the best possible "petri dish" is the transplant recipient. In something of a bittersweet triumph for modern medicine, the exact mechanism by which VRSA (vancomycin-resistant Staph aureus) would later emerge was predicted, carried out in the lab in an elegant esperiment which demonstrated the mechanism (plasmid exchange of the VanA resistance gene from VRE into Staph), and later confirmed when the first case emerged, in the Transplant ICU of the University of Pittsburgh Medical Center (ironically where transplants were originally perfected).

Biological systems have tons of complexity so there will be new drug targets in the future, but the obvious ones have been hit by now, so new drugs will be more expensive. The balanced approach would be to reduce antibiotic use on the human end, which inevitably brings up discussion of limits of care and "death panels." It is no accident that these pathogens tend to emerge in the U.S., where such discussion is difficult with our demographics, and where the entire population (doctors included) holds an almost mythical belief in the power of antibiotics. All they do (seriously) is rearrange the population of bacteria that inhabit your body. Sometimes that helps, a lot. We need to be honest about when those times really occur.

tl;dr Stop all the use of these drugs in livestock and you will only change the rate of emergence of resistance, not the fact. This problem is not going to go away.

about 10 months ago

More Bad News From Fukushima

BigDukeSix Re:Oblig. (268 comments)

These are really big doses we are talking about, in the range of what external-beam radiotherapy uses to destroy tumors. When stating that four hours' dosage at this level is likely to be lethal, this means "likely to be lethal by acute radiation sickness with death occurring in days." In reality, much shorter exposures are likely to be lethal from induced cancers (leukemia and thyroid cancers being common). It will just take longer for those people to die. I suspect that most of the workers who have been on site to this point have likely had their fates sealed.

1 year,14 days

Medical Costs Bankrupt Patients; It's the Computer's Fault

BigDukeSix Re:A cynic's view (637 comments)

I'd be "amazed how difficult it is to track accumulated values"? Are you fucking serious? Are you suggesting that the insurance companies that host this software don't know what patients are paying out-of-pocket down to the last decimal point? The rest of your post is just meaningless legacy code bullshit- there is simply no way that insurance companies haven't put customer out-of-pocket payments into their business models, which makes your whole point inane.

about a year ago

Obama's Privacy Reform Panel Will Report To ... the NSA

BigDukeSix Re:Happy President (569 comments)

posting to undo errant mod

about a year ago

NRA Launches Pro-Lead Website

BigDukeSix Re:Bullets but not wheel weights?: (780 comments)

This right here is the most important point I have seen raised. It is the shooters that need to be concerned, especially when firing at an indoor range. Some small amount of lead is vaporized with every shot; you can easily smell the difference between jacketed and bare lead rounds. My city recently banned the use of unjacketed and semi-jacketed rounds at indoor ranges for this reason; nobody seems to be complaining.

about a year ago

I am fairly prepared for a storm outage of ...

BigDukeSix Re:Missing option: no outages here. (398 comments)

I envy you for that, and agree with you that power around here should be considered unreliable (else I wouldn't have a whole-house generator!). For this service I pay 14.3 cents/kwh. If I lived 50 miles further inland I could have buried power lines too, but the job is here by the coast. At least I don't really have to worry about tornadoes.

about a year ago

I am fairly prepared for a storm outage of ...

BigDukeSix Re:Missing option: no outages here. (398 comments)

I suspect your experience has less to do with "proper power supply," whatever that means, and more to do with peculiarities of the coastal geography where you live. Around here we have this thing called storm surge. Because the continental shelf is very broad and very shallow, at Cat 5 will pile up 30-40 feet of water that will absolutely inundate all underground infrastructure (imagine a tsunami that lasts twelve hours) . We do put stuff underground, but not anything important.

about a year ago

Ask Slashdot: What Is the Best Position To Work For Long Hours?

BigDukeSix Re:none (262 comments)

It is important to change positions in the correct way. If it's your lower back that starts hurting, you should switch chairs, stand up, or otherwise change your seating position. Everyone has favorite ways of dealing with this, or you simply don't become a computer geek.

The upper back and neck are a different story. Pain in these muscle groups is related to bad arm mechanics and is only partially related to your chair selection. You also need to change the height of your keyboard and mouse relative to your shoulders, so that at least some of the time your elbows are not hanging below your wrists.

This is especially important if you use your mouse a lot. Many people, over time, start to relax their shoulder muscles such that your wrist, sitting on your desk, becomes a primary support for the weight of your arm while only the hand moves freely. The elbow and arm then pull down on the shoulder joint, stretching the shoulder ligaments and eventually stretching the 11th cranial nerve. You feel this as the awful aching pain at the junction of the shoulder and neck, as well as between the shoulder blade and spine (the trapezius muscle is the downstream target of this nerve). I have heard this called "mouse shoulder."

To combat this you should try to have your elbow and wrist supported at the same height, like on a side table. Varying your chair height then varies your arm mechanics quite a bit.

more than 2 years ago

After Recent US Storms, Why Are Millions Still Without Power?

BigDukeSix Re:Wires (813 comments)

undoing wrong mod

more than 2 years ago

You're Driving All Wrong, Says NHTSA

BigDukeSix Re:Don't honk the horn (756 comments)

This instruction can be generalized: don't lock any of your joints in extension against the car. A huge amount of suffering occurs from locking the leg in extension against the brake pedal. The dashboard will destroy the knee. Actually, locking your joints against any load is never a good idea.

more than 2 years ago

When Are You Dead?

BigDukeSix Re:I have an organ donor card... (516 comments)

You've been modded to +5, so at least a few other people share your belief that there are other tests that are in some way better. This reflects a typical belief on Slashdot, that the people who spent time creating a solution somehow didn't think of what took you all of five minutes. Brain death is not a subjective determination about one's quality of life after brain injury. It's meant to determine whether or not it's just the machine's that are keeping you alive, without actually killing you.

Recall that the brain may divided into the cerebrum, or "monkey brain," where all of the higher functions that make us human live; and the medulla, or "lizard brain," where all of the lower functions that keep us alive live. By the time we're talking about brain death determination, the monkey brain is gone. This is an unresponsive patient, off all sedating meds for several days, whose EEG shows at best sporadic activity (EEG will only truly flatline once the heart stops providing blood flow). You should have had an EEG before you ever get to this point.

The "wet willy" test is meant to excite the oculogyric reflex, where cold water gets the fluid in your semicircular canals convecting just a bit. The reflex makes your eyes move as part of the (lizard-brain mediated) attempt to remain standing in what is perceived as a loss of balance. The "shut off your air" part is to see if you retain the deepest held mammalian reflex, the drive to breathe, which is biochemically mediated by retained carbon dioxide.. Neither of these has anything to do with the cerebrum. If you can't do these things, you really are dead.

The fact that someone somewhere fucked up and nearly killed someone isn't really news. Nor does it really bear on the subject of whether or not "brain dead is really dead." The alternative is to waste away, unresponsive, on a ventilator, until you die of overwhelming infection. You have to set the standard somewhere.

more than 2 years ago

Stem Cell Tourist Dies From Treatment In Thailand

BigDukeSix Re:Aim for the real problem. (451 comments)

But for some reason all the noise is made about embryonic research. I really do not understand why

I'll take a shot at this.

The existing treatments utilizing adult stem cells are all for treatment of blood borne cancers (ie, leukemia). The treatment consists of harvesting (patient or someone else's) bone marrow, processing it in some way, and freezing it for later infusion. You then give the patient a most excellent collection of poisons which destroy the existing bone marrow. You then reinfuse the frozen bone marrow (stem) cells to (hopefully) repopulate the patient's bone marrow. The difference between "bone marrow transplant" and "stem cell transplant" lies only in the processing. When this works it is resurrection. When it doesn't it is a fate worse than death.

The promise of NEW stem cell therapy is that you could harvest that same bone marrow (or fat cell, or whatever), process it, and use it to treat some completely unrelated-to-blood disease (like heart disease or spinal cord injury). This idea is that because embryonic stem cells are earlier in the stem cell lineage, they can differentiate into more cell types and are hence in come way "better". Multiple reports have shown (and been reported here) that you can take most any stem cell and turn it into any other cell type, so there is no real benefit to using stem cells of embryonic lineage.

more than 4 years ago

Stem Cell Tourist Dies From Treatment In Thailand

BigDukeSix Re:Aim for the real problem. (451 comments)

For what it's worth, at least some "religious freaks" are perfectly capable of differentiating between stem cells of embryonic origin versus autologous stem cells. I have a number of colleagues who have (successfully) lobbied for funding from some of these same people to support their own stem cell work (adult autologous only). The message "don't just stand against things, be in favor of a solution" has been very, very powerful for people who do not consider themselves to be either hypocrites or freaks.

more than 4 years ago

The World's First Full Face Transplant

BigDukeSix Re:The donor? (193 comments)

Modern medicine has no sense of humor. There is a form of colitis caused by Clostridium difficile which results from destruction of the normal colonic flora by antibiotic use. It frequently recurs and can be lethal. There is currently on ongoing clinical trial evaluating the use of stool transplantation to prevent recurrence of this infection.

more than 4 years ago

New Wave of Antibiotic-Resistant Bacteria

BigDukeSix Re:The slashdot post is kinda funny... (404 comments)

While TFS is indeed inflammatory, your post is factually incorrect. Specifically, gram negative bacteria are very much more virulent than gram positive bacteria (or, for that matter, organisms that don't gram stain at all). The gram negatives are the only class of bacteria that express lipopolysaccharide endotoxin. The human immune system has specific receptors (like CD14) for this toxin, resulting in an extreme inflammatory response which is the pre-death phenomenon called 'sepsis'.

We saw these pathogens emerge in our ICU three years ago and have been using colistin. The side effects are real but not nearly as common with modern supportive care as they were 40 years ago. Which is good, because when the colistin quits working, well, your patient is dead. Currently these pathogens only emerge after many weeks of critical illness and multiple runs of strong intravenous antibiotics.

We go through fairly draconian measures to limit any spread of these organisms, which so far seem to work. Negative pressure rooms, isolation gowns and masks for simply entering the room, disposable stethoscopes, etc. all help. Rooms and gear are disinfected by two different individuals so that personal tendencies don't allow transmission. And we wash our hands. A lot.

more than 4 years ago


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