haldujai

41 ms·

451.
by haldujai 3y ago
I think people misunderstand what evidence based medicine is[0]. There are many types of evidence ranging from lab studies and expert opinion at the bottom to systematic reviews/meta-analyses at the top. The point being that we should
452.
by haldujai 3y ago
You seem to be misunderstanding how evidence works, it is not about “what you consider” and is entirely based on fact. We also don’t talk ARR in isolation when we decide on interventions, it’s NNT vs NNH and considering the specific risk be
453.
by haldujai 3y ago
This article predates the Cochrane review and pandemic so I doubt that was their goal.
454.
by haldujai 3y ago
Yes but why on earth would testosterone be part of HRT for menopause? The point is to replace what’s missing and causing symptoms. Menopause =/= estrogen insensitivity.
455.
by haldujai 3y ago
It’s used as life saving drug for critically ill patients in ICU…
456.
by haldujai 3y ago
I have never heard of or seen statin-induced cirrhosis practicing in a liver transplant center so if this is real it’s a case report.
457.
by haldujai 3y ago
As stated thennt is from 2013, many statin trials have come out since. 2% diabetes is overstated as in link 1 except you discount it because of declared disclosures despite the fact that it’s one of the most highly cited papers on the subje
458.
by haldujai 3y ago
What..? I don’t understand where this is coming from. Why on earth would we give testosterone to menopausal patients?
459.
by haldujai 3y ago
So every link I provided give you a risk of MACE. Reversal of atherosclerosis is not the outcome measure we care about lol. Certainly not lowering coronary calcium which is not possible. You’re literally making this up… Statins work amazing
460.
by haldujai 3y ago
Do you have a single citation to back this claim up? Unless you’re talking about prophylactic statins in patients with no known risk factors (I.e. primary prevention which is not standard of care) this is complete misinformation.
461.
by haldujai 3y ago
> estrogen is risky for fat women I think what you meant to say is unopposed estrogen is risky for all women.
462.
by haldujai 3y ago
What patient population are you talking about? Statins have excellent evidence behind them. > - Absolute risk reduction in CVD-caused mortality is mild at best (<1-2% absolute risk reduction) It depends what your baseline risk is and
463.
by haldujai 3y ago
It's because medicine is as much an art as a science given the impossibility of problem space, also whenever we ignore evidence we end up harming/killing people.
464.
by haldujai 3y ago
I think of EBM as "where stronger evidence exists it trumps expert opinion" (almost all of the time). In other words, go down the hierarchy[0]. > I worked with physicians who would examine and talk with a patient and tell me th
465.
by haldujai 3y ago
OP is referring to "leaky gut disorder" that people (quacks) will try to treat today. It is not a recognized disorder that requires or has a treatment so it is correctly classified as pseudoscience (there is no scientific basis fo
466.
by haldujai 3y ago
Right, I don't think anyone doubts that altered intestinal permeability may be seen in several conditions. The etiological theory of "leaky gut" (i.e. leaky gut is the cause of disease) is not accepted in medicine. This artic
467.
by haldujai 3y ago
Today? Both.
468.
by haldujai 3y ago
I think you may be misunderstanding this article. Intestinal permeability is not a diagnosis in this paper, they are referring to the physical permeability of the gut which can be altered in many diseases and is not in dispute (i.e. "a
469.
by haldujai 3y ago
Interesting, at first I thought you were referring to "post-treatment Lyme disease syndrome" which has some medical legitimacy to it. It appears that there is a distinct "chronic Lyme disease"[0] rooted in quackery, le
470.
by haldujai 3y ago
Ah ANA, the wonderful test that everyone orders and then shamefully consults rheumatology because no one knows how to interpret it[0]. Almost a rite of passage in medical training now. I jest but I think these tests are still a bit of a mys
471.
by haldujai 3y ago
As a physician I also fully support the not hot-at-all take that we do a huge disservice to these patients and a very poor job with psychiatric and constitutional symptoms/illnesses in general with “good care” being the exception, as y
472.
by haldujai 3y ago
I think Dr. Mate raises some interesting theories. Chronic stress is poorly understood and not well addressed in modern medicine (because it’s really hard to study and treat) but: > is it about as good of a risk factor as smoking is to l
473.
by haldujai 3y ago
Your point being..? Every treatment for anything has benefits and harms, there is evidence that the benefits of ECT outweighs the harms in select patients (like those refractory to conventional treatments) so it has been accepted medical pr
474.
by haldujai 3y ago
Good question, I’m much more familiar with the oncology literature and there is definitely causative evidence linking EBV and to a lesser extent CMV with lymphoma/lymphoproliferative disorders (particularly in the post-transplant setti
475.
by haldujai 3y ago
Lyme disease can be “autoimmune” like in clinical manifestation but is more accurately described as a tick borne infectious disease treated primarily with antibiotics, as opposed to the viruses being discussed here which are more weakly lin
476.
by haldujai 3y ago
This isn’t true (that your hypothesis is mainstream), there is no evidence the virus itself was more severe or resulted in more severe illnesses than expected to support the impaired immune system theory[0]. There is endless literature on t
477.
by haldujai 3y ago
The question becomes why do only certain people get the illness? 50-90% of the US population are EBV or CMV positive yet it’s a much smaller percentage that develop autoimmune illnesses. I’m the farthest thing from a rheumatologist but it s
478.
by haldujai 3y ago
Electroconvulsive therapy is an evidence-based intervention for certain types of depression. It should be “accessible” in every state although access to psychiatric care is often questionable unfortunately.
479.
by haldujai 3y ago
This is a bit dramatic but many think the RSV crisis was a result of naive immunity due to COVID-19 public health measures. https://onlinelibrary.wiley.com/doi/abs/10.1002/ppul.25582
480.
by haldujai 3y ago
> I'm going to take a wild guess that 90+% of things we describe as 'autoimmune' are in fact initially caused by some bacteria/virus/pollution we haven't yet identified. As a wild guess probably a bit high b

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