If there’s a brain microbiome then why does nothing grow when I send CSF from an EVD?
Readit Newsjac241 commented on The brain has its own microbiome newscientist.com/article/... · Posted by u/janandonly
jac241 commented on We're not going to run out of new anatomy anytime soon svpow.com/2024/09/07/were... · Posted by u/jfil
That was a super interesting read. Another factor that's probably missing is a weird form of prudeness/sexism. I remember reading articles years ago about new discoveries about the clitoris, and thinkig "how the fuck was this missed", or the debate around the existance of the G-spot, or the existence (or not) of female ejaculate. I suspect there's more female anatomy left to be discovered/described than male.
Maybe, but I think more likely is the time factor for med students. There’s really only time to find the major structures implicated in disease. Surgeons also not likely dissecting around the clitoris much. Wouldn’t want to risk injury obviously.
jac241 commented on Surgeons Cut a Giant Tumor Out of My Head. Is There a Better Way? bloomberg.com/news/featur... · Posted by u/melling
A friend is a neurosurgeon and they use some special saw that stops as soon as there's no hard tissue providing resistance. So you press it hard into the skull, and when it's done chewing through the bone, it immediately stops.
Apparently the scariest bit for the junior doctors to learn to use, somehow.
That is known as the perforator drill bit - https://www.reddit.com/r/toolgifs/comments/z2zikm/cranial_pe...
Used to make burr holes so that the dura can be stripped away from the skull using the Penfield 3 instrument.
Then what's used is what's known as the B1 with footplate to create the bone flap - https://www.researchgate.net/publication/323134344_Exposure_...
Here is an example of the drill system - Midas Rex MR8 - https://www.ebay.com/itm/125960633809
Here's a video of a surgeon performing the pterional craniotomy, probably the most common craniotomy for things like aneurysms, - https://www.neurosurgicalatlas.com/volumes/cranial-approache...
jac241 commented on I mapped almost every USA traffic death in the 21st century roadway.report... · Posted by u/Bencarneiro
Strong work. Looking forward to / dreading the update with the 2023 and 2024 data that I've been more involved with. RIP to all of the young people in their late teens and 20s who made the mistake of using a road for anything other than driving. RIP to the older folks who got smoked just crossing the street. RIP to everyone else who didn't deserve to go. Hopefully there is traffic calming and reliable, frequent public transit in heaven.
Unfortunately this dataset doesn't include the, probably more frequent, severe TBIs. Surely wouldn't take many patients for the cost of a hemicraniectomy, 2 week neuro-ICU stay, trach/peg, and long term acute care stay to equal the cost of a few measures to slow drivers down. Not to mention lost earning/tax potential. Too bad it's not from the same budget.
Wear your seatbelt and a helmet and hopefully you can avoid the pain of your family having to have a surprise end-of-life discussion with me.
I never quite fully grasped the purpose of having patients stay engaged during brain operations. Is it possible to undo a brain incision? If not, what good is it to know a patient's abilities are degraded after having made a cut? Is it just to mitigate compounding unexpected damage?
You electrically stimulate around the spot with a probe where you’re planning to resect. If the patient can’t perform whatever task you’re evaluating then you know you can’t resect in that area. Generally looking for a 1cm margin between tissue you’re going to resect and a positive stim site.
Can’t undo brain cuts. CNS neurons don’t repair themselves like peripheral neurons or your skin. Generally not cutting glioma brain tumors out per se more likely to use ultrasonic aspiration to suck the tumor out piecemeal. Depends on the tumor though.
Anytime someone mentions the AMA I just have to ignore them completely. It’s not that the AMA hasn’t done some shady shit throughout the years (especially the 60s), it’s just that in 2022 they are so close to irrelevant that painting them as a boogieman merely shows that your name information is about 50 years out of date.
The “medical cartel” as you call it is more and more getting shaped by a number or powerful interest groups none of which are the AMA that is pushing somewhat successfully for fewer doctors in most specialities.
Amen. The American Hospital Association wields way more power now. Mergers between hospital systems have led to the large hospital systems being among the largest employers in many states, which means that senators and representatives are going to listen to what they want. Certainly more than they do to the AMA, which might only represent like 25% of doctors anymore.
jac241 commented on Ask HN: Beating depression with or without anti-depressants? · Posted by u/jpgvm
This is really weird advice.
Yea it's mainstream and to be expected under legaleeze circumstances.
But it's not the kind of advice I would give to a friend whom I'm genuinely concerned about.
Have you known anyone who was depressed and managed to get better by following the advice of a generic "profressional"?
I haven't.
Quite the opposite. I've seen people get worse in one dimension or another by taking medication or following other professional advice.
Probably many people you know have seen a doctor for depression and gotten better, they’re just not telling that to the guy who says things like you did in your post… Very stupid take here man…
jac241 commented on First images of cerebrospinal fluid in the brain during sleep (2019) bu.edu/articles/2019/cere... · Posted by u/robg
I thought that was an interesting question as a layman. I found this, which I thought was an interesting read. [0]
[0]: https://www.sciencedirect.com/topics/medicine-and-dentistry/...
Yeah sterile technique has to be meticulous in shunt cases. There’s evidence that the number of people scrubbed into the case influences the shunt infection rate so students like me occasionally would not be permitted to scrub.
jac241 commented on First images of cerebrospinal fluid in the brain during sleep (2019) bu.edu/articles/2019/cere... · Posted by u/robg
“ MAH and JM are co-applicants on the RELEASE and RELEASE + trials in Australia, funded by the Medical Research Future Fund (MRFF) and the National Health and Medical Research Council (NHMRC), evaluating hyperbolic tapering of antidepressants against care as usual. MAH reports being a co-founder of and consultant to Outro Health, a digital clinic which provides support for patients in the US to help stop no longer needed antidepressant treatment using gradual, hyperbolic tapering; and receives royalties for the Maudsley Deprescribing Guidelines. JM receives royalties for books about psychiatric drugs, and was a co-applicant on the REDUCE trial, funded by the National Institute of Health Research, evaluating digital support for patients stopping long-term antidepressant treatment. MP and RL have no conflicts of interest to declare.”
I would caution those in this thread who have never seen or treated patients in any psychiatric clinic or hospital let alone a pediatric one to be careful assuming that they have adequate experience to make sweeping judgements on the utility of antidepressants in children.