The BG Health Care Thread: Decreasing the Surplus Population

[archibaldcrane]

Is...there any evidence at all that people using Ketamine are ending up with opioid abuse disorder?

[Byrthnoth]

The study that the linked article cites is weak but fine for the state of the field. The claims the article makes are terrible.

Here is the study:

If Ketamine works through the opioid system to alleviate depression, we should be able to block alleviation of depression by giving an opioid blocker before ketamine treatment.

The ketamine treatment without opioid blocker "worked" on the day of the injection in 7 of 12 patients tested. Those patients, who were also subjected to the blocker+ketamine condition, rated "more depressed" on a behavioral test of depression after receiving it with the blocker than without on days 1 and 3.

Two problems with the study:
* Within sample control with an N of 7 and stopping the study before the midpoint to publish is pretty lame even for a human study and probably isn't responsible study design for something like depression even with suitable N.
* The authors defined "working" as showing a 50% reduction in depression-score in the placebo+ketamine case on day 1 and only further analyzed the 7 who made the cut. By filtering for the 7 who showed the largest effect in the no-blocker condition, they are naturally going to be inflating the size of the no-blocker group's effect. Thus, the blocker-group (same people) will be lower just due to random chance. If you had picked the 7 with the largest reduction in the blocker group, perhaps you would have found that adding an opioid blocker increases the efficacy of ketamine.


Problems with the MPR article: Everything. The authors of the paper aren't saying shit about how Ketamine is addictive because opioids blah blah blah and the science desk at MPR really screwed the pooch on this one. They turned a shit-tier science paper into clickbait.

[Heavencloud]

the study doesn't really say that ketamine works on opioid receptors... naltrexone does work on opioid receptors but clearly has other effects (probably dopaminergic) as it helps with reducing drinking in alcoholics. also the reason we use so much ketamine is that it doesn't cause respiratory depression which it would cause if it were working on opioid receptors. this is why it's used for conscious sedation. that said, i doubt there's any studies looking at people who got ketamine for pain (0.1-0.3mg/kg over 15-30min) correlating to opioid use disorder as it's not a practice in most of the us yet.

[6souls]

Problems with the MPR article: Everything. The authors of the paper aren't saying shit about how Ketamine is addictive because opioids blah blah blah and the science desk at MPR really screwed the pooch on this one. They turned a shit-tier science paper into clickbait.

*NPR, MPR just reposted the article.

https://www.npr.org/sections/health-...like-an-opioid
https://www.npr.org/people/2100615/jon-hamilton

Jon Hamilton is a correspondent for NPR's Science Desk. Currently he focuses on neuroscience, health risks, and extreme weather.

Hamilton contributed several pieces to the Science Desk series "The Human Edge," which looked at what makes people the most versatile and powerful species on Earth. His reporting explained how humans use stories, how the highly evolved human brain is made from primitive parts, and what autism reveals about humans social brains.

[Heavencloud]

yikes, NPR's title is even more (bs) sensationalist and misleading

[Athas]

But the study doesnt answer the real question if it can be used to cure chronic pain from muscle death after an infarction.

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[Zealot]

Igotthatreference.gif

[6souls]

https://www.npr.org/sections/health-...rries-naloxone

Health Care employees are being denied Life Insurance if they carry Naloxone or use it at their job.

[Fiye]

Damn now they turning against poor white people now.

[kuronosan]

https://www.npr.org/sections/health-...rries-naloxone

Health Care employees are being denied Life Insurance if they carry Naloxone or use it at their job.

Are you fucking serious?

[Yuri-G]

ACA has been struck down by a federal judge in Texas who ruled that the individual mandate is unconstitutional (due to Republicans reducing the penalty to $0) and that the remaining provisions of the law are inseverable from the mandate, rendering the entire law unconstitutional.


https://www.cnn.com/2018/12/14/polit...uit/index.html


someone light the AG signal, I need context and predictions

[Yuri-G]

fine I'll do it myself god

we'll see, it's a clever work around to nullify the associated tax but the logic that invalidates the entirety of the law is extremely suspect. the Republicans effectively gutted a revenue stream and eliminated the mechanism by which the feds could compel participation but how that invalidates components like preexisting conditions mandates is entirely beyond me. and Roberts already broke with the conservative bloc to declare the individual mandate constitutional, it would be rather floppy and out of character for him to say yes this tax adjustment renders the entire bill unconstitutional.

but we shall all find out together, this bitch is getting appealed asap.

[Gredival]

Lol how did I know that a judge that thinks Sebelius isn't settled law would also be an "anti-activist" federalist society member?

[archibaldcrane]

His argument "that determining the will of Congress in 2017 is unknowable" is laughable on it's face.
https://twitter.com/nicholas_bagley/...43858876514304

[6souls]

https://www.propublica.org/article/t...ard-journalist

ProPublica journalist is given a "top doctor" accolade despite not having a medical degree nor being a physician.

I spoke to a cheerful saleswoman named Anne at a company on New York's Long Island that hands out the Top Doctor Awards. For some reason, she believed I was a physician and, even better, worthy of one of their awards. Puzzled and amused, I took notes.

I asked how I had been selected. My peers had nominated me, she said buoyantly, and my patients had reviewed me. I must be a "leading physician," she said.

I knew such awards are the perfect dovetail of doctors' egos and patients' desperate need to find a good physician. Many patients assume that the awards are backed by rigorous vetting and standards to ensure only the "best" doctors are recognized. Hospitals and physicians lend credibility to the facade by hanging the awards in their offices and promoting them on their websites.

I've spent the last 13 years reporting on health care, a good chunk of it examining how our health care system measures the quality of doctors. Medicine is complex, and there's no simple way of saying some doctors are better than others. Truly assessing the performance of doctors, from their diagnostic or surgical outcomes to the satisfaction of their patients, is challenging work. And yet, for-profit companies churn out lists of "Super" or "Top" or "Best" physicians all the time, displaying them in magazine ads, online listings or via shiny plaques or promotional videos the companies produce for an added fee.

On my call with Anne from Top Doctors, the conversation took a surreal turn.

"It says you work for a company called ProPublica," she said, blithely. At least she had that right.

I responded that I did and that I was actually a journalist, not a doctor. Is that going to be a problem? I asked. Or can you still give me the "Top Doctor" award?

There was a pause. Clearly, I had thrown a baffling curve into her script. She quickly regrouped. "Yes," she decided, I could have the award.

[Cail]

Not exactly healthcare

H.I.V. Is Reported Cured in a Second Patient, a Milestone in the Global AIDS Epidemic

https://nyti.ms/2EMBHRC

[kuronosan]

Bone Marrow transplant.

[Byrthnoth]

Yeah... unless their upcoming paper actually has something novel in it, they might as well be publishing "WE GOT LUCKY AGAIN!"

[archibaldcrane]

They intentionally sought bone marrow from a naturally immune to HIV donor, so it wasn't just luck, but the process of obliterating your immune system on purpose before the transplant makes it a dangerous and probably not scalable cure for people who don't need the procedure for cancer purposes.

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[kuronosan]

They intentionally sought bone marrow from a naturally immune to HIV donor, so it wasn't just luck, but the process of obliterating your immune system on purpose before the transplant makes it a dangerous and probably not scalable cure for people who don't need the procedure for cancer purposes.

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This. This is exactly how I explained it to someone who asked me about it, actually.