Readit NewsCass commented on Earl Grey tea intoxication (2022) thelancet.com/journals/la... · Posted by u/disadvantage
That's quite circumstantial evidence though. Nothing in that story tells me you've accurately concluded that it was the green tea.
Patient had unknown liver failure and drank a ton of green tea. Liver failure went away while still drinking tons of lower quality stuff. He proceeded to limit high quality green tea without it coming back, but if it was unrelated it wouldn't have come back regardless if he limited green tea or not.
Oh, and I phrased that badly, but he didn't drink a ton of tea at the hospital. The hot water for tea comes in limited amounts from those samovar type things, and he didn't want to use too much of it, so he only drank 2-3 cups per day.
We were all burningly curious whether the liver failure would come back if he resumed his normal green tea consumption, especially him (very "try everything, you only live once" type of personality; see also, consumption of mysterious Peruvian rain forest drugs), thus proving whether the tea was the culprit or not, but for ethical reasons I had to caution him against experimenting on the only liver he had, and he reluctantly agreed he wasn't THAT curious. Therefore, the cause of his liver failure will never be fully and conclusively proven to be green tea.
Cass commented on Earl Grey tea intoxication (2022) thelancet.com/journals/la... · Posted by u/disadvantage
That's quite circumstantial evidence though. Nothing in that story tells me you've accurately concluded that it was the green tea.
Patient had unknown liver failure and drank a ton of green tea. Liver failure went away while still drinking tons of lower quality stuff. He proceeded to limit high quality green tea without it coming back, but if it was unrelated it wouldn't have come back regardless if he limited green tea or not.
Oh, certainly, there's nothing to prove it was the green tea. We did rule out any other cause of liver failure we possibly could, but there's nothing to say we didn't miss something. But green tea in high doses IS a known cause of liver failure (admittedly, not known to us at the time, but there's case studies on pubmed I found once I started searching), so it remained the most likely cause after eliminating anything else plausible apart from the good old doctor standby of "sometimes shit just happens, shrug emoji" also known as "idiopathic."
Cass commented on Earl Grey tea intoxication (2022) thelancet.com/journals/la... · Posted by u/disadvantage
No shame in missing something local among all the exotic red flags, but how does a person consume 4-5 liters of green tea per day to 'detox' while literally in a hospital? Isn't a fluids/diet survey part of admittance?
It's been a bit since my dad was in a hospital, but they wanted to know about literally everything that entered his mouth.
He didn't drink 4-5 Liters at the hospital, just a few (two or three) small cups per day. We'd asked about alcohol and drug consumption, but didn't think to ask about his normal food and drink consumption beyond asking for possible sources of infection (asking about any potential spoiled food or exotic meats he might have consumed.) In retrospect, certainly a big oversight in this case!
Cass commented on Earl Grey tea intoxication (2022) thelancet.com/journals/la... · Posted by u/disadvantage
The most House (the TV show)-like case that ever happened in my medical career was the case of the patient with liver failure due to green tea intoxication.
A young man presented in our hospital with acute liver failure. He'd just spent a month traveling through the rain forests of Brazil, Colombia and Peru. During his trip, he'd consumed unknown drugs in a Peruvian shaman ceremony and had unprotected sex with a Peruvian sex worker.
We tested him for everything obvious. He didn't test positive for any known drugs or any obvious drug-related toxins. He didn't have HIV. He didn't have hepatitis A, B, or C. He didn't have EBV, he didn't have CMV, he didn't have Dengue Fever, he didn't have Yellow Fever, he didn't have Malaria. He didn't have any sign of autoimmune conditions.
We called the institute for tropical diseases. We tested him for tropical diseases we'd never even heard of. He didn't have those. He didn't have Syphilis. He didn't have Gonorrhea. He didn't have liver cancer, or any other discernible cancers.
We called the institute for tropical diseases again. They started researching. We tested him for diseases the experts for tropical diseases hadn't even heard of. He had none of those, either.
His liver, which had started failing for no discernible reason, now stopped failing, for equally indiscernible reason. We started planning his discharge.
We had a nice final discussion. He really appreciated how hard we'd tried, he said, and he really appreciated how kind everyone had been, and sorry again about the unprotected sex with sex workers thing, that was effing stupid in retrospect. He said he was looking forward to getting home and detoxing from all this. He said he didn't think the green tea we had on the ward (cheap, shit, comes in bags, unlikely to have ever encountered a tea plant in real life) did anything much, detox-wise, and anyway he'd feel bad emptying our hot water carafe all the time.
Um. How much green tea do you drink, I asked him.
4 to 5 liters per day, he said.
I googled "green tea liver failure," with some vague memory that sometimes tea gets contaminated during the drying process and maybe he'd caught a bad batch? Turns out, green tea just... causes liver failures, occasionally, in higher doses. Probably due to the anti-oxidants.
You live and you learn.
The patient went home and limited his green tea consumption to no more than a cup per day. He checked in with me a year later, because I'd asked him for an update, and his liver was doing perfectly fine and had never failed him again.
I think the bigger point from the article is that by the time people are fighting hand-to-hand in the tower stairwells, the defenders have already well and truly lost: comeback from such a state was probably impossible (and if the walls were breached the defenders would almost certainly have surrendered rather than fought to the last man). So it wouldn't have really made sense to design things for this possibility.
That's a bizarre line of thought to me. If you build an expensive structure for fortification, you don't usually get to the interior design and then go "Oh fuck it, this extra safety measure wouldn't cost anything, but if they've got this far we might as well surrender, so let's not bother."
Going by that logic, the president's bunker under the pentagon would've been built without a lock. After all, people don't usually have to physically drag a country's leader out of their locked bunker, right? By the time anyone's knocking on that door, usually the war is lost and the country has surrendered.
And yet, if you're designing for defense, why NOT take such a cheap and easy countermeasure as putting a lock on the door or choosing the more defensible way to spiral your staircase? You might want to buy a few more minutes to negotiate in a desperate situation; you might want at least the option of taking that futile last stand; you might be facing not an invading army but a single lunatic with a sword who snuck past the outer guards.
Cass commented on Endemic pathogens are causing psychiatric illnesses and shortening lives return.life/2022/05/endem... · Posted by u/sebg
What do you think is causing the massive increase in autism seen in the US over the last few decades? I did buy the "better diagnosis" line, until I saw how much it had risen by. It's one in 50 in the US. It's lower in Europe (as are the number of vaccines administered to children). Not saying vaccines are the cause, but better diagnosis doesn't cut it for me.
The phrasing of this question seems meant to imply that because one explanation doesn't satisfy you (better diagnosis), it must be the other (vaccines). This sets up a false dichotomy, though--there's no reason it would have to be one or the other.
We know vaccines aren't the cause, because large-scale studies have been done that show that autism rates aren't higher in vaccinated children. This leaves us with basically every other possible cause, including not just better diagnostics (I personally find that explanation highly plausible), but also changes in nutrition, effects of some sort of virus, pollution, microplastics and everything else under the sun that's changed in the last decades.
Cass commented on The United States of America vs. Samuel Bankman-Fried Indictment [pdf] justice.gov/usao-sdny/pre... · Posted by u/dereg
Cass commented on Exoskeletons qualify for direct disability compensation in Germany therobotreport.com/exoske... · Posted by u/bookofjoe
Here’s a thought - at what price point is it cheaper to buy everyone that needs one an exoskeleton than to rebuild every building to be ADA accessible?
Most wheelchair users are either elderly or suffering from some other deteriorating condition associated with pain, overall weakness, or instability, and will therefore likely not be able to use these. (Note that even in the promotional images, people are using crutches to balance in addition to the exo-skeletons.)
The classic "strong above the waist, paralyzed from the waist down" image of a wheelchair user that people might have from eg the paralympics is the minority.
Stem cell transplantation is a standard treatment for several blood cancers, but will almost certainly never be a standard HIV treatment for anyone except patients who need a transplantation anyway, for one single reason: with modern medicine, living with transplanted stem cells is significantly worse than living with HIV.
With modern meds, HIV patients can have a normal life expectancy and live basically normal lives.
You know how in traditional organ transplantation, your own immune cells will attack and often destroy the transplanted organ? In stem cell transplantation, your transplanted immune cells will attack every single organ in your body. Look up "graft versus host disease."
After stem cell donation, most patients will have to take immuno-suppressants that a have significantly worse side effects than modern HIV meds do, often for the rest of their lives - and that's the lucky ones, where the meds will successfully treat the graft versus host disease. One of the more gruesome sights I've seen in my medical career was a lady with a severe graft versus host skin reaction that her doctors couldn't get under control despite massive doses of immuno-suppressants. Eventually large parts of her skin peeled off in strips, like something out of a horror movie. Then she died of pneumonia from the immuno-suppressants.
This is an extreme example, of course, and many people live perfectly ordinary lives after stem cell transplantation, but the failure more is both more likely and more gruesome than the one for antiviral HIV treatment.