This health segment is completely wild. Seeing Sam fully co-sign the replacement of medical advice with ChatGPT in such a direct manner would have been unheard of two years ago. Waiting for GPT-6 to include a segment on replacing management consultants.
Readit Newsquantumwoke commented on Once a death sentence, cardiac amyloidosis is finally treatable nytimes.com/2025/08/04/we... · Posted by u/elektor
> The more common form according to my wife
Not sure what relevance the source has here, but it’s not correct. Primary (AL) is the most common in the developed world and secondary (AA) elsewhere. There are some foci of ATTR but it is by far not the most common.
I should have mentioned my wife is a physician, apologies.
The true prevalence of ATTR is not known since it's only been investigated for recently as described in the article. If you look up recent data you'll see a big difference.
quantumwoke commented on Once a death sentence, cardiac amyloidosis is finally treatable nytimes.com/2025/08/04/we... · Posted by u/elektor
a) average age is 77
b) drugs cost a shitload (hundereds of thousands/yr) to extend lifespan by...months
c) only for ATTR (not AL) amyloidosis
d) the drive to diagnose and treat only really started after tafamidis (1st drug with any effectiveness) was marketed...hmmm
e) the dude in the article used as an example was probably helped more by treating his afib than by the fancy drugs
for sure there are some genetically transmitted younger patient for whom this is important. But there are a lot of frail older people who are getting diagnosed with wild-type ATTR amyloid for...questionable benefit at massive cost. IMO, the jury is still out
What's with the kneejerk takedown?
a) Yes, it's more common in older people. A lot of old people end up in hospital
b) 30% fewer deaths and hospital admissions is a good thing in my book
c) The more common form according to my wife
This test is also being heavily misused and misinterpreted in some online communities. There are a lot of people posting CAC scan results after something like a year of keto dieting in their 20s or 30s and using that to conclude that the saturated fat connection to atherosclerosis is a myth or that high cholesterol is fine.
These tests don’t have perfect accuracy and resolution, so low or zero results don’t mean that a lifetime of high cholesterol won’t catch up with someone in their 60s and 70s, yet a lot of podcasters and social media influencers are making those claims.
This is correct advice, thank you. I am reminded once again that correlation != causation and that doing tests 'just to be sure' is not a healthy or safe way to live. There is a lot of literature out this on what makes a good screening test.
CAC is pretty common, but I prefer Coronary CT Angiography, which is much more detailed CT of the heart and coronary arteries using IV contrast. It's a bit more radiation, but it shows soft plaque and arterial narrowing, which CAC does not.
It's better, but the contrast and much higher radiation dose compared to CAC carry their own risks. Individuals can evaluate their own risk but I wouldn't get this test under the age of 40 or 45 or so unless I had diabetes.
What I always wondered is if I get this test done, what would I even do with the results? If my arteries are already clogged, etc.
Can this plaque be reversed?
AIUI per my doctor wife, plaque cannot currently be reversed with a medication. It's about minimising future risk rather than reversing damage. Remodelling the plaque with medications does happen to a limited extent as commented elsewhere in this thread.
My cardiologist pointed out that hard calcified plaques are unlikely to come loose, so unless there’s significant narrowing, they’re not a big problem. However, that situation correlates with a high calcium score. So the calcium score is not always correlated to risk.
A CT angiogram distinguishes soft vs. hard plaques (and shows narrowing), so that’s the ultimate way to clarify the situation. (Bearing in mind radiation exposure risk and cost, of course.)
Better characterisation on CAC is key. This is a software problem - AI will help.
EKGs should be extremely easy for AI to identify every disease with a range of probabilities and even some humans can’t identify from EKGs. Do we have the labelled dataset for this?
EKG changes are a late sign. You need structural imaging like CAC or CCTA or echo.
quantumwoke commented on Mary had schizophrenia, then suddenly didn't newyorker.com/magazine/20... · Posted by u/fortran77
I think the article is far more interesting than you make it out to be.
There is pretty clear evidence that some subset of schizophrenic diagnosis are due to autoimmune issues. If we can use antibodies in the spinal fluid to detect when autoimmune treatments can be effective in treating schizophrenia, that alone will be huge.
However, the even bigger insight to be drawn from all of this is the potential for other psychological problems that psychiatry has struggled to treat, to also have autoimmune causes. When you try to treat something that has multiple, quite different causes, with a single treatment, it makes sense that it would be hard to find that treatment that works reliably (as is the case for many psychiatric medicines.)
I predict we may eventually see immune antibody tests (or some functional successor) become a standard part of all mental health care.
Immune antibody tests are already a standard part of a lot of mental health care, particularly psychosis. My wife tells me depending on the centre it may be mandated for all new diagnoses of psychosis. It is called an "organic screen".
This was put into OpenBSD back in 2017. It's not "trap instructions". It's "trapsleds". The idea is to trap the sleds (a.k.a. slides) of NOP instructions that linkers used to put in between compiled code for alignment, and which could be exploited with "return-oriented programming" where an attacker could cause execution to jump to any address in the padding range (possibly needing the inexactitude because of constraints upon byte substitutions) and slide along all of the NOPs to the target function.
* https://undeadly.org/cgi?action=article;sid=20170622065629
* https://isopenbsdsecu.re/mitigations/trapsled/