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[ { "answer_id": 29408, "body": "<p>Finding data on effects with specific comorbidities is difficult, there are some data out there for obesity (which often, but definitely not always, goes with heart disease, blood pressure problems, breathing problems etc.). I have not found any with age and comorbidities separated out. I have found one with comorbdities alone, with specific risks for each potential side-effect of the vaccine.</p>\n<p>New England Journal of Medicine has the <a href=\"https://www.nejm.org/doi/10.1056/NEJMoa2110475\" rel=\"nofollow noreferrer\">paper</a>¹ that describes the risks associated with the vaccine in Israel for over 2 million people, which means that it covers the gamut of the population, including those with illnesses such as heart disease, cancer etc. These comorbidities were case-matched for the treatment (vaccine) and control (placebo) groups, aiming to match location, age, BMI, health condition etc.</p>\n<p>Table 2 shows the number of adverse events in the treatment and control groups for a list of potential side effects of the vaccine:</p>\n<p><a href=\"https://i.stack.imgur.com/aOfnp.png\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/aOfnp.png\" alt=\"Barda Table 2\" /></a></p>\n<p>Figure 4 shows a simplified version of these data in a graphical form:</p>\n<p><a href=\"https://i.stack.imgur.com/qpXC7.png\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/qpXC7.png\" alt=\"Barda Fig 4\" /></a></p>\n<p>However, the real data is in the <a href=\"https://www.nejm.org/doi/suppl/10.1056/NEJMoa2110475/suppl_file/nejmoa2110475_appendix.pdf\" rel=\"nofollow noreferrer\">supplementary appendix</a>. You want to look at tables S3-S6 to see that the data is all population matched and that the numbers/risk ratios (S6 for events in each group) show that the risk from the vaccine is very small for almost all conditions compared to the risks from COVID-19.</p>\n<p>Unfortunately for you, as you have found out, anecdote != data and &quot;personal&quot; experience often outweighs the real evidence in the minds of most. The numbers out there (e.g linked paper) are quite complicated and confusing for non-scientists. I wish you well in your endeavour to provide some real information to your friends and family.</p>\n<p>1: Barda et al. Safety of the BNT162b2 mRNA Covid-19 Vaccine in a Nationwide Setting. New England Journal of Medicine. 2021. 385:1078-1090</p>\n", "score": 2 } ]

[ "covid-19", "vaccination" ]

[ { "answer_id": 29405, "body": "<p>Your question is founded on a misconception. The material in the syringe is the same for all 3. It has not been adjusted for new strains. (See for example <a href=\"https://www.canada.ca/en/health-canada/services/drugs-health-products/covid19-industry/drugs-vaccines-treatments/vaccines/pfizer-biontech.html\" rel=\"nofollow noreferrer\">this government of Canada info page</a> on the Pfizer vaccines.) It doesn't need to be: it protects against the new strains as well as the old. In some cases the degree of protection is slightly less, eg 92% instead of 95% kind of thing. The vaccine is the vaccine and that's that.</p>\n<p>Like many other vaccinations, full immunity requires more than one dose. (See <a href=\"https://www.hepb.org/prevention-and-diagnosis/vaccination/guidelines-2/\" rel=\"nofollow noreferrer\">this example</a> for hepatitis.) You can't get &quot;just the third jab.&quot; Whatever you get now will be your first. You will have some protection, and several weeks later you can have a second and get more.</p>\n<p>The exact spacing between vaccinations varies with factors like &quot;how much vaccine do we have?&quot; - some countries delayed second shots to get more people first shots, then it turned out those people had more immunity so the recommendations changed to a longer spacing. But now we're facing things like &quot;against Omicron it's better to have a second that gives you x% (even though you'd get x+something% if you waited) than just a first that gives you a much smaller y% protection.&quot;</p>\n<p>Anyway, go get one shot. It will give you some protection. Then, after the spacing recommended where you live - probably 3 to 8 weeks - get a second. Then don't worry about the third for 6 months after that.</p>\n", "score": 2 } ]

[ "covid-19" ]

[ { "answer_id": 29433, "body": "<p>If you remember the structure of the glomerulus there are three barriers that regulate the filtration process: the first barrier is endothelial cells which has spaces between them that allow the passage of molecules of certain size, and among the molecules these spaces allow to pass are proteins (Ig, albumin,different transportation proteins, etc...) but such spaces are so small (70-80 nm at maximum) and do not allow red cells to pass (diameter between 6-8 micrometeres which is much bigger than 80 nanometers).\n(<a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2681366/\" rel=\"nofollow noreferrer\">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2681366/</a>)</p>\n<p>The second barrier is the basement membrane which also do not allow large structures like different cells in the blood to pass but allow small molecules to pass.\nRemember that glomerular filtration is not governed only by size of molecules, but the charge of the molecules play a role, for example the basement membrane is negatively charged which leads to repulsion of molecules with negative charges like albumin and do not allow them to pass. If i am not mistaken the podocytes also contribute to the regulation of charge in basement membrane and problems in podocytes could lead to alteration in charge in basement membrane which could contribute to albumin passage into tubules. (<a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2895306/\" rel=\"nofollow noreferrer\">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2895306/</a>)</p>\n<p>And the third barrier is the podocytes which produce the basement membrane among the other functions that they have. The podocytes also regulate filtration by contracting and restricting spaces between their foot processes which leads to decrease in filtration.\n(<a href=\"https://academic.oup.com/jes/article/4/4/bvaa029/5781251\" rel=\"nofollow noreferrer\">https://academic.oup.com/jes/article/4/4/bvaa029/5781251</a>)</p>\n<p>Podocytes allow micromolecules to pass like electrolytes and glucose, drugs, etc... through the spaces between their foot process (called slit pore) but do not allow macromolecules to pass like albumin (although a very small quantity can pass but majority do not).\n(<a href=\"https://www.hindawi.com/journals/ijn/2012/481520/\" rel=\"nofollow noreferrer\">https://www.hindawi.com/journals/ijn/2012/481520/</a>)</p>\n<p>As you can see even if there is an abnormality in podocytes at maximum it will allow macromolecules to pass like albumin, because larger structures like red cells will be blocked by endothelial cells and basement membrane before they even reach the podocytes level.</p>\n", "score": 2 } ]

[ "neurology", "pathophysiology", "kidney-disease" ]

[ { "answer_id": 29443, "body": "<p>The branch that studies the different structures at microscopic level is Histology and histopathology (in case you study tissue for abnormalities). In histopathology you apply different preparation and staining techniques and try to study the tissue under the microscope and figure out if the tissue is normal or has some abnormality in it or even study if the tissue belongs to the organ which was biopsied, that's how for example metastatic cancers are figured out.</p>\n<p>The specialty in medicine that studies tissues is &quot;Pathological anatomy&quot; and the doctors who are specialized are called pathologists, it generally involves less interaction with patients but has a wide opportunity for research. Also a dermatologist (not all) could be well formed in skin histology and could observe skin biopsies and decide what tissues are found but generally the biopsies are sent to the pathologist, also a biologist could specialize in studying body tissues. There are also histotechnicians and Histotechnologists (more specialized than histotechnicians) who studied how different tissues are prepared for studying and how to apply sophisticated techniques of preparation for the biopsies for the pathologist to study them, they are an integral part of the laboratory. Generally the pathologist is the authority in the hospital on the characteristics of the biopsies (all tissues not only skin) and gives the final word.</p>\n<p>As for toenail histology, you can differentiate completely a nail plate from the skin as it will be completely formed of cornified dead epidermal keratinocytes without the other layers of skin cells. (Cornified cells is found also on the outer layer of skin but it will be much less thick than the nail plate and the other normal skin layers will be found).\nThe nail bed is formed of skin cells but there are only 3 layers and lacks the other layers found in normal ski.\nThe matrix is also formed of a specific skin cells layers and lacks the granular layer normally found in the skin.\nThis article is very excellent in explaining the different characteristics of each constituent of the nails and how they differ from the normal skin.\n<a href=\"https://www.actasdermo.org/en-nail-histopathology-articulo-S1578219013001443\" rel=\"nofollow noreferrer\">https://www.actasdermo.org/en-nail-histopathology-articulo-S1578219013001443</a></p>\n", "score": 3 } ]

[ "dermatology", "feet", "nails", "toe" ]

[ { "answer_id": 29465, "body": "<p>There is a subtype of lupus called Drug induced lupus (DIL), as the name says certain drugs cause the signs and symptoms of lupus in susceptible individuals. The difference between DIL and normal lupus (SLE) is that the signs and symptoms disappear in drug induced lupus after drug cessation.</p>\n<p>The mechanism of drug induced lupus (also normal SLE) is complicated and involves genetic susceptibility, adaptive immunity and innate immunity in which TLR-7 is involved. For example the two most common drugs that cause DIL are procainamide (anti arrhythmic) and hydralazine (anti hypertensive) and the mechanism by which they cause DIL is inhibition of DNA methylation which leads to hyperactive CD4+ immune cell, as you can see here TLR-7 has no role as CD4+ is part of adaptive immunity. (<a href=\"https://www.ncbi.nlm.nih.gov/books/NBK441889/\" rel=\"nofollow noreferrer\">https://www.ncbi.nlm.nih.gov/books/NBK441889/</a>).\nFor toll-like receptors role in lupus you can read this article <a href=\"https://jbiomedsci.biomedcentral.com/articles/10.1186/s12929-018-0436-2\" rel=\"nofollow noreferrer\">https://jbiomedsci.biomedcentral.com/articles/10.1186/s12929-018-0436-2</a></p>\n<p>I am not sure about the involvement of TLRs in lupus in case of virus infection. Toll like receptors are involved in viruses' recognition but if the mechanism is similar to that of drug induced lupus then theoretically the signs of lupus should disappear when the infection is terminated.</p>\n<p>The role of viruses and bacteria and other environment substances in autoimmune diseases in susceptible patients is based on several theories and of these theories is cross-reactivity; the theory says that foreign bodies act as &quot;triggers&quot; for the autoimmune diseases, the idea is that certain amino acids sequence in the virus will be similar to certain amino acids in different tissue in the body and the immune system will start to attack these tissues thinking they are foreign to the body. This is the mechanism by which Post-streptococcal glomerulonephritis, IgA nephropathy, rheumatic fever, etc... are induced. (<a href=\"https://adc.bmj.com/content/79/5/448\" rel=\"nofollow noreferrer\">https://adc.bmj.com/content/79/5/448</a>).</p>\n<p>In this article you can see the CMV virus is found to cause lupus through cross reactivity (<a href=\"https://www.nature.com/articles/s41598-020-66804-1\" rel=\"nofollow noreferrer\">https://www.nature.com/articles/s41598-020-66804-1</a>) perhaps it will be useful in explaining the role of viruses in lupus.</p>\n<p>This article is useful in explaining different mechanisms of autoimmune diseases:\n<a href=\"https://www.britannica.com/science/immune-system-disorder/Autoimmune-diseases-of-the-thyroid-gland\" rel=\"nofollow noreferrer\">https://www.britannica.com/science/immune-system-disorder/Autoimmune-diseases-of-the-thyroid-gland</a></p>\n", "score": 2 } ]

[ "immune-system", "toxicity", "autoimmune-disease", "lupus" ]

[ { "answer_id": 30471, "body": "<p>As noted in the comments by @BryanKrause, the percentage of cases stratified by vaccination status should not be used as a metric of vaccine effectiveness. If you are interested in vaccine effectiveness, please refer to other Q&amp;As on this site.</p>\n<p><a href=\"https://covid.cdc.gov/covid-data-tracker/#rates-by-vaccine-status\" rel=\"nofollow noreferrer\">This dashboard</a> from the US Centers for Disease Control and Prevention:</p>\n<blockquote>\n<p>Monitor[s] rates of COVID-19 cases and deaths by vaccination status, data are reported from jurisdictions that link case surveillance data to immunization registries to identify the vaccination status of people who test positive for COVID-19</p>\n</blockquote>\n<p>Unfortunately, the data was last updated in October. Also, the data presented is normalized to percentage of the population. However, the <a href=\"https://data.cdc.gov/Public-Health-Surveillance/Rates-of-COVID-19-Cases-or-Deaths-by-Age-Group-and/3rge-nu2a\" rel=\"nofollow noreferrer\">raw data</a> is available. If we aggregate the data by week, we can see the actual numbers.</p>\n<pre><code> Week Vac Infections Vac Population Unvac Infections Unvac Population Per Vac\n Apr 04-Apr 10 13009 64616655 998210 389001215 1.3\n Apr 11-Apr 17 15374 76837234 951745 362335790 1.6\n Apr 18-Apr 24 16620 91090098 762690 344546755 2.1\n Apr 25-May 01 17498 106726671 665515 330087090 2.6\n Aug 01-Aug 07 202679 203738268 1579155 238857775 11.4\n Aug 08-Aug 14 228938 205588232 1762760 231557335 11.5\n Aug 15-Aug 21 251137 207515979 1867915 224857815 11.9\n Aug 22-Aug 28 267330 209711985 1911810 218552875 12.3\n Aug 29-Sep 04 255902 212117207 1671295 212555660 13.3\n Jul 04-Jul 10 30659 194649540 341970 260628810 8.2\n Jul 11-Jul 17 56417 197420288 571990 256951840 9.0\n Jul 18-Jul 24 99759 199545230 909635 252483390 9.9\n Jul 25-Jul 31 156155 201728086 1309425 246174005 10.7\n Jun 06-Jun 12 9711 174913860 168920 277511855 5.4\n Jun 13-Jun 19 10315 179493568 170675 272843845 5.7\n Jun 20-Jun 26 13100 185656716 177710 268640785 6.9\n Jun 27-Jul 03 19020 191081150 239950 263884500 7.3\n May 02-May 08 15273 120508742 538085 319074225 2.8\n May 09-May 15 13398 134112747 451595 310922840 2.9\n May 16-May 22 12303 147548191 333750 298347905 3.6\n May 23-May 29 10441 158873155 243670 288633585 4.1\n May 30-Jun 05 9511 167968184 193225 282740405 4.7\n Sep 05-Sep 11 248622 214805454 1467545 208199840 14.5\n Sep 12-Sep 18 237507 217660765 1259850 203524000 15.9\n Sep 19-Sep 25 208476 220027372 1007055 199777100 17.2\n Sep 26-Oct 02 203707 222693630 860630 195935955 19.1\n</code></pre>\n<p>Thus, at the last time point with available data, 203707/(203707+860630) = 19.1% of all cases were among fully vaccinated individuals.</p>\n<p>A major caveat from the <a href=\"https://covid.cdc.gov/covid-data-tracker/#rates-by-vaccine-status\" rel=\"nofollow noreferrer\">foot notes</a> is that not all jurisdictions report the required data.</p>\n<p>The <a href=\"https://nytimes.com/interactive/2021/10/28/us/covid-breakthrough-cases.html\" rel=\"nofollow noreferrer\"><em>New York Times</em></a> has an article about this dataset.</p>\n<p>Some US states, such as <a href=\"https://coronavirus.health.ny.gov/covid-19-breakthrough-data\" rel=\"nofollow noreferrer\">New York</a>, <a href=\"https://www.vdh.virginia.gov/coronavirus/see-the-numbers/covid-19-in-virginia/covid-19-cases-by-vaccination-status/\" rel=\"nofollow noreferrer\">Virginia</a> and <a href=\"https://www.health.state.mn.us/diseases/coronavirus/stats/vbt.html\" rel=\"nofollow noreferrer\">Minnesota</a> have provided subsequent datasets, but I was unable to find a tracker that aggregates all of the sources.</p>\n", "score": 4 } ]

[ "covid-19", "vaccination", "coronavirus", "united-states" ]

[ { "answer_id": 30558, "body": "<p>Activity 2 carries more risk of transmission : talking is associated with more droplets being exhaled in the room's air.</p>\n<p>However, Activity 1 cannot be considered as completely devoid of droplet generation.</p>\n<p>This article published in Nature gives informations on aerosol transmission <a href=\"https://doi.org/10.1038/s41598-020-69286-3\" rel=\"nofollow noreferrer\">https://doi.org/10.1038/s41598-020-69286-3</a></p>\n", "score": 3 } ]

[ "covid-19", "disease-transmission", "covid" ]

[ { "answer_id": 30543, "body": "<p>It is difficult to be sure from your question, but you may have a slight misunderstanding of &quot;Ct&quot; value.</p>\n<p>Ct stands for cycle threshold<a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7386165/\" rel=\"nofollow noreferrer\">¹</a>. In a real time polymerase chain assay, a sample is analyzed using fluorescent probes which generate light as more copies of viral genetic material are created.</p>\n<p>This image adapted from <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8232180/\" rel=\"nofollow noreferrer\">Raaban et al</a> (under CC-BY 4.0) shows how this works:\n<a href=\"https://i.stack.imgur.com/HNQRU.png\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/HNQRU.png\" alt=\"enter image description here\" /></a></p>\n<p>Thus, as <em><strong>fewer</strong></em> cycles are required to detect the signal, <em><strong>more</strong></em> viral genetic material was present in the initial sample.</p>\n<p>Some authors have described Ct values of 17-24 as &quot;high viral load&quot; and 25-35 as &quot;moderate viral load&quot;<a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8232180/\" rel=\"nofollow noreferrer\">²</a>, but each test manufacturer is likely to set their own cutoffs for their specific assay.</p>\n<p>While these is relatively good evidence that lower Ct value correlates with more severe SARS-Cov-2 disease<a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7386165/\" rel=\"nofollow noreferrer\">¹</a>, there is not a direct relation between Ct value and viral load in the patient. Other factors might include how the sample was collected and diluted. As Raaban and colleagues note:</p>\n<blockquote>\n<p>The pre-analytic variables include collection technique, specimen type, time of sample taken and viral kinetics, the difference between the viral load in URT and LRT samples, transport and storage conditions before the testing, and the specimen age.</p>\n</blockquote>\n<p>Thus, there is no reliable way to determine how Ct value will change over time. It might increase if the virus is being successfully fought by the immune system. However, the Ct value might decrease if the virus continues to successfully replicate.</p>\n", "score": 2 } ]

[ "covid-19", "pcr" ]

[ { "answer_id": 30590, "body": "<p>This is typically done by epidemiological modelling (often <a href=\"https://en.wikipedia.org/wiki/Compartmental_models_in_epidemiology\" rel=\"nofollow noreferrer\">compartment models</a>) and I wouldn't say there is any one &quot;gold standard&quot; approach but rather a collection of approaches: simpler models have the benefit of having fewer free parameters to fit but the simplifying assumptions may lead to systematic errors, more complex models have the benefit of modeling real-world mechanisms and complexity but also may require more <em>a priori</em> choices in model parameters.</p>\n<p>What most of these models have in common is fitting some sort of differential equation (or set of equation) to disease spread. The <a href=\"https://en.wikipedia.org/wiki/Basic_reproduction_number\" rel=\"nofollow noreferrer\">basic reproduction number</a> that comes out of these models represents the average number of individuals that each infected individual will spread the infection to (assuming those individuals are susceptible to infection, for example that they do not have a prior exposure or vaccination granting them some level of immune protection). However, the interpretation of this number varies by model and estimation method, so it shouldn't be taken as some fundamental property if you're comparing different types of models.</p>\n<p><a href=\"https://en.wikipedia.org/wiki/Basic_reproduction_number#Estimation_methods\" rel=\"nofollow noreferrer\">Wikipedia</a> has a brief introduction to some of the modeling methods used, but it's important to realize that people write entire textbooks about this sort of thing. Modeling disease transmission is a big chunk of the entire field of epidemiology, and no one will come around with a <a href=\"https://xkcd.com/793/\" rel=\"nofollow noreferrer\">simple solution that makes the rest of it irrelevant</a>.</p>\n", "score": 3 } ]

[ "disease-transmission" ]

[ { "answer_id": 30619, "body": "<p>From the context it seems the answer is the edges lined up opposite and against each other, as the transitive verb form of the word <a href=\"https://www.merriam-webster.com/dictionary/opposite\" rel=\"nofollow noreferrer\">opposite</a> <em>a la</em> the second definition <a href=\"https://www.merriam-webster.com/dictionary/oppose\" rel=\"nofollow noreferrer\">here</a>:</p>\n<blockquote>\n<p><strong>Oppose</strong><br />\n<em>transitive verb</em></p>\n<ol>\n<li>to place over against something so as to provide resistance,</li>\n<li>to place opposite or against something</li>\n<li>to offer resistance to</li>\n</ol>\n</blockquote>\n<p>For opposite:</p>\n<blockquote>\n<p><strong>opposite</strong><br />\n<em>adjective</em><br />\n1: located at the other end, side, or corner of something: located across from something.<br />\n<em>The two boys lived on opposite sides of the street.<br />\nThe opposite bank of the river.</em></p>\n</blockquote>\n", "score": 8 } ]

[ "terminology", "wound-care" ]

[ { "answer_id": 30630, "body": "<p>I would say that the guideline gives physicians quite a bit of leeway in determining a death is caused by COVID-19. The standard is not &quot;any positive test + death = COVID-caused death&quot;; it gives 2 necessary criteria and two exclusions:</p>\n<blockquote>\n<p>a clinically compatible illness</p>\n</blockquote>\n<blockquote>\n<p>in a probable or confirmed COVID-19 case</p>\n</blockquote>\n<blockquote>\n<p>unless there is a clear alternative cause of death that cannot be related to COVID disease</p>\n</blockquote>\n<blockquote>\n<p>There should be no period of complete recovery from COVID-19 between illness and death</p>\n</blockquote>\n<p>The phrase &quot;clinically compatible&quot; is the part I see as giving discretion above and beyond the exception for &quot;clear alternative cause of death&quot;. I don't immediately see a definition of this phrase from the WHO (though I also don't think a definition is necessary, the meaning can be deduced from the meaning of the words), but the CDC does have a definition <a href=\"https://www.cdc.gov/mmwr/preview/mmwrhtml/00025629.htm\" rel=\"noreferrer\">here</a> for &quot;clinically compatible case&quot;:</p>\n<blockquote>\n<p>Clinically compatible case: a clinical syndrome generally compatible with the disease, but no specific clinical criteria need to be met unless they are noted in the case classification.</p>\n</blockquote>\n<p>Clinically compatible <em>illness</em> is slightly different, but in plain terms I would say that this is requiring a clinical presentation associated with the illness; for COVID-19, that would mean presenting symptoms of a respiratory illness, possibly with fever and other associated systemic symptoms. I cannot see how an asymptomatic infection could be considered a &quot;clinically compatible illness&quot; contributing to death; sure, I suppose someone could decide to mark such a death as in your example as related to COVID-19, but nothing in this guideline says clearly they <em>have</em> to in order to comply with the guideline.</p>\n<p>A tumor would not be a clinically compatible illness, because tumors are not an observed feature of COVID-19 infection. If a patient is immune-suppressed due to cancer or cancer treatment, and this immune suppression made them susceptible to COVID-19 and they developed pneumonia and died, however, that would be a case clinically compatible with COVID-19 and the guideline is clear that they should be counted, and that they should not be excluded even if their physicians determine that COVID-19 only caused their death because they also had cancer and they would have otherwise survived.</p>\n", "score": 5 } ]

[ "covid-19", "coronavirus", "who-world-health-org" ]

[ { "answer_id": 30731, "body": "<h5>Home Bioimpediance</h5>\n<p>First, let me start this answer by saying that available evidence suggests that home bioimpediance devices are wildly inaccurate. <a href=\"https://www.consumerreports.org/body-fat-scales/body-fat-scale-review/\" rel=\"nofollow noreferrer\">This study</a> from Consumer Reports notes:</p>\n<blockquote>\n<p>Rating a body-fat scale on its ability to gauge body fat was more complicated, and the results were unimpressive: None was very accurate. We know that because we got benchmark readings by using a measuring tool called a Bod Pod at Sacred Heart University in Fairfield, Conn.</p>\n</blockquote>\n<blockquote>\n<p>The body-fat scale that came closest to the Bod Pod results was still off by up to 21 percent; the worst performer was off by up to 34 percent. At least they were consistent, though, so you can use the scales that scored better at body-fat repeatability to track relative gains and losses over time.</p>\n</blockquote>\n<h5>Estimation of Basal Metabolic Rate</h5>\n<p>As you note in the comments, the company's website and user manual povides no guidance on how it calculates basal metabolic rate (BMR). However, a distinct possibility that they are estimating BMR with a method such as the <a href=\"https://en.wikipedia.org/wiki/Harris%E2%80%93Benedict_equation\" rel=\"nofollow noreferrer\">Harris-Benedict method</a>.</p>\n<p><a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3572798/\" rel=\"nofollow noreferrer\">Previous assessments</a> of these types of methods indicate that Harris-Benedict can at least somewhat correlate with gold standard methods.</p>\n<blockquote>\n<p>Of the predictive equations tested, the Harris-Benedict equation (mean difference: -14.8 kcal/day, RMSPE: 195.8 kcal/day, mean % difference: 0.1%) was the most accurate and precise</p>\n</blockquote>\n<p>The key take away is that this estimation can be off by nearly 200kcal/day.</p>\n<h5>&quot;Healthy&quot; Range</h5>\n<p>But wait, the &quot;healthy&quot; range on that app says it is between 1627 and 1472, that's only 155 kcal/day, way less than the error of the Harris-Benedict equation.</p>\n<p>Given the error characteristics of BMR estimation, this seems like a meaningless thing to report.</p>\n<h5>Basal Metabolic Rate and Health Outcomes</h5>\n<p>One hypothesis has been that higher metabolic rates are associated with increased production of <a href=\"https://en.wikipedia.org/wiki/Radical_(chemistry)\" rel=\"nofollow noreferrer\">free radicals</a>. These damaging free radicals could thus over time lead to health problems, poor outcomes and aging in general<a href=\"https://pubmed.ncbi.nlm.nih.gov/9562038/\" rel=\"nofollow noreferrer\">¹</a>.</p>\n<p><a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4984846/\" rel=\"nofollow noreferrer\">Rugierro and colleagues</a> directly measured BMR in a lab and followed participants to see what would happen for 2 years. They controlled for body mass index.</p>\n<blockquote>\n<p>Independent of age, participants who died had a higher BMR compared to those who survived. BMR was a significant risk factor for mortality independent of secular trends in mortality and other well-recognized risk factors for mortality, such as age, body mass index, smoking, white blood cell count, and diabetes.</p>\n</blockquote>\n<p>Thus, there is some evidence to suggest that higher basal metabolic rates could be unhealthy.</p>\n<h5>Conclusions</h5>\n<p>Overall, we could expect that a home scale cannot accurately measure basal metabolic rate. However, at the population level, there is some evidence that high basal metabolic rate is associated with adverse health outcomes.</p>\n", "score": 3 } ]

[ "nutrition", "body-fat", "metabolism" ]

[ { "answer_id": 30749, "body": "<p>Summarizing their methods a bit, the steps are:</p>\n<ol>\n<li><p>Use PCR to amplify (make lots of copies) of the gene of interest (&quot;The target regions of ELN were amplified by PCR&quot;)</p>\n</li>\n<li><p>Clone the PCR products into a plasmid vector (&quot;1uL of PCR products were cloned into pCR™4-TOPO™ Vector&quot;)</p>\n</li>\n<li><p>Make lots lots more by putting the plasmid in bacteria and letting those bacteria replicate (&quot;plasmids were inserted in ... E. coli ... bacteria were ... grown ... Plasmid DNA was extracted&quot;)</p>\n</li>\n</ol>\n<p>Cloning here is used in the <a href=\"https://en.wikipedia.org/wiki/Molecular_cloning\" rel=\"nofollow noreferrer\">molecular biology context</a> which is not the &quot;clone a sheep&quot; or &quot;make a Star Wars army&quot; type of cloning, it's just the process of assembling and expressing <a href=\"https://en.wikipedia.org/wiki/Recombinant_DNA\" rel=\"nofollow noreferrer\">recombinant DNA</a>: taking DNA from one organism/stain/mutant and putting it into another host organism, forming a genetic combination that didn't previously exist.</p>\n", "score": 2 } ]

[ "genetics" ]

[ { "answer_id": 30818, "body": "<p>In humans, glucose-6-phosphatase is actually a multiunit enzyme system (Hutton and O'Brien 2009. PMCID <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2785553/\" rel=\"nofollow noreferrer\">2785553</a>). There are at least 3 <a href=\"https://en.wikipedia.org/wiki/Protein_isoform\" rel=\"nofollow noreferrer\">isoforms</a>.</p>\n<h4><em>G6PC</em></h4>\n<p>The first isoform, encoded by the <em>G6PC</em> gene, is predominantly expressed in liver and kidney as is indicated in your textbook (Hutton and O'Brien 2009. PMCID <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2785553/\" rel=\"nofollow noreferrer\">2785553</a>).</p>\n<p>The most well studied function of glucose-6-phosphatase is in gluconeogenic tissues where it catalyzes the removal of phosphate to prepare the glucose molecule for transport outside of the cell.</p>\n<p><a href=\"https://i.stack.imgur.com/X6xFq.png\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/X6xFq.png\" alt=\"enter image description here\" /></a>\n^{Adapted from <a href=\"https://en.wikipedia.org/wiki/Glucose_6-phosphatase#/media/File:Alpha-D-glucopyranose_6-phosphate.svg\" rel=\"nofollow noreferrer\">this image</a> and <a href=\"https://en.wikipedia.org/wiki/Glucose_6-phosphatase#/media/File:Beta-D-Glucose.svg\" rel=\"nofollow noreferrer\">this image</a>.}</p>\n<p>Although most gluconeogenesis occurs in the liver, some occurs in the kidneys (Clar <em>et al</em> 2014 PMCID <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5678048/\" rel=\"nofollow noreferrer\">5678048</a>).</p>\n<p>Patients with <a href=\"https://www.cancer.gov/publications/dictionaries/genetics-dictionary/def/biallelic\" rel=\"nofollow noreferrer\">biallelic</a> <a href=\"https://www.cancer.gov/publications/dictionaries/genetics-dictionary/def/pathogenic-variant\" rel=\"nofollow noreferrer\">pathogenic variants</a> of <em>G6PC</em> have <a href=\"https://www.omim.org/entry/232200\" rel=\"nofollow noreferrer\">glycogen storage disease 1a</a> which is characterized by severe hypoglycemia and hepatomegaly caused by the accumulation of glycogen.</p>\n<h4><em>G6PC3</em></h4>\n<p>The third isoform, encoded by the <em>G6PC3</em> gene, is the more broadly expressed. Some authors call it &quot;the ubiquitously expressed glucose-6-phosphatase&quot; (Martin <em>et al</em> 2002. PMID <a href=\"https://pubmed.ncbi.nlm.nih.gov/12370122/\" rel=\"nofollow noreferrer\">12370122</a>). The function of this isoform is more poorly understood. <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2785553/\" rel=\"nofollow noreferrer\">Hutton and O'Brien</a> note that some authors have theorized that</p>\n<blockquote>\n<p>the presence of <em>G6PC3</em> in muscle may explain the improvement in endogenous glucose production and the decrease in susceptibility to hypoglycemia in patients with GSD type 1a after puberty.</p>\n</blockquote>\n<p>The <a href=\"https://www.proteinatlas.org/ENSG00000141349-G6PC3/tissue\" rel=\"nofollow noreferrer\">Human Protein Atlas</a> shows that <em>G6PC3</em> is expressed in cardiac, skeletal and smooth muscle.</p>\n<p><a href=\"https://i.stack.imgur.com/LoAAs.png\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/LoAAs.png\" alt=\"enter image description here\" /></a></p>\n<p>I have been unable to find any expression datasets which compare fast and slow twitch skeletal muscle.</p>\n<p>Patients with <a href=\"https://www.cancer.gov/publications/dictionaries/genetics-dictionary/def/biallelic\" rel=\"nofollow noreferrer\">biallelic</a> <a href=\"https://www.cancer.gov/publications/dictionaries/genetics-dictionary/def/pathogenic-variant\" rel=\"nofollow noreferrer\">pathogenic variants</a> of <em>G6PC3</em> have <a href=\"https://www.omim.org/entry/612541\" rel=\"nofollow noreferrer\">Dursun syndrome</a> which is characterized by neutropenia and cardiac abnormalities which demonstrates the effect outside of the liver and kidney.</p>\n<h4>Conclusions</h4>\n<p>Thus, your textbook is correct that the <em>G6PC</em> gene is largely expressed in the liver and kidney where is is involved in gluconeogenesis. However, other isoforms of glucose-6-phosphatase are expressed outside the kidney and liver, including in muscles.</p>\n<p>The function of the second isoform, encoded by the <em>G6PC2</em> gene is more controversial, so I will leave it to the reader to explore more (Hutton and O'Brien 2009. PMCID <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2785553/\" rel=\"nofollow noreferrer\">2785553</a>).</p>\n", "score": 3 } ]

[ "muscle", "metabolism", "glucose" ]

[ { "answer_id": 30843, "body": "<p>The answer is yes. I found a couple of studies looking at hydroperiodide function in the thyroid. Both of them were from the same group of authors and from the military, where use of these sorts of things is relatively common.</p>\n<p><a href=\"https://pubmed.ncbi.nlm.nih.gov/8108021/\" rel=\"nofollow noreferrer\">One of these studies</a> ¹ (very small, only 14 people, so take with a grain of salt*) looked at how safe it was for people to consume these over a short period, such as when hiking. They found that there was a mild impairment of thyroid function from the uptake of iodine from these tablets:</p>\n<blockquote>\n<p>One week of daily exposure to the iodine load from four tetraglycine hydroperiodide water-purification tablets causes mild impairment of thyroid function in humans.</p>\n</blockquote>\n<p>The second looked at <a href=\"https://pubmed.ncbi.nlm.nih.gov/7829615/\" rel=\"nofollow noreferrer\">adaption of the thyroid to hydroperiodide uptake from these tablets</a>.². Most relevant to your question, they found:</p>\n<blockquote>\n<p>Radioactive iodine uptake was less than 2% after 7 days and remained below 2% in all subjects at 90 days.</p>\n</blockquote>\n<ol>\n<li><p>Georgitis WJ, McDermott MT, Kidd GS. An iodine load from water-purification tablets alters thyroid function in humans. Mil Med. 1993 Dec;158(12):794-7. PMID: 8108021.</p>\n</li>\n<li><p>LeMar HJ, Georgitis WJ, McDermott MT. Thyroid adaptation to chronic tetraglycine hydroperiodide water purification tablet use. J Clin Endocrinol Metab. 1995 Jan;80(1):220-3. doi: 10.1210/jcem.80.1.7829615. PMID: 7829615.</p>\n</li>\n</ol>\n<ul>\n<li>pun intended, it just fits nicely with the topic.</li>\n</ul>\n", "score": 3 }, { "answer_id": 30861, "body": "<p>A few thoughts about the dosage:</p>\n<p>130 mg KI contain ≈ 780 nmol I (100 mg). One of the linked tablets contains ≈ 94 nmol I (11.9 mg).<br />\nSo, 8 and 1/3 of the water purification tablets have the same amount of iodine as the 130 mg KI tablet. <a href=\"https://en.wikipedia.org/wiki/Portable_water_purification#Iodine\" rel=\"nofollow noreferrer\">Do not use flavor enhancing stuff that may be sold together with the water purification tablets, though.</a>.</p>\n<p>RDI for adults (without nuclear emergency) is in the order of magnitude of 150 μg.</p>\n<p><a href=\"https://en.wikipedia.org/wiki/Iodised_salt\" rel=\"nofollow noreferrer\">Iodized table salt</a> typically contains in the order of magnitude of very roughly 20 mg I/kg. <em>You'd need to eat 5 kg of iodized table salt to get 100 mg I.</em></p>\n<p>Oxidation state of the iodine bascially does not matter for uptake. The iodine supplementations or treatments range all the way from iodide (-I) over iodine(0) (I_2 ⋅ KI solution, also tetraglycine hydroperiodide is a compound of 16 glycine, 5 I_2 and 4 HI)\n) to iodate (+V). The <a href=\"https://www.who.int/ionizing_radiation/pub_meet/Iodine_Prophylaxis_guide.pdf\" rel=\"nofollow noreferrer\">WHO Iodine prophylaxis guide</a> lists both KI (iodide) and KIO_3 (iodate) dosage for nuclear emergency:</p>\n<p><a href=\"https://i.stack.imgur.com/wkEU8.png\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/wkEU8.png\" alt=\"WHO recommendation table\" /></a></p>\n<hr />\n<p><strong>Please also read the counterindications, e.g. for adults &gt; 40 yo, iodine prophylaxis is not as generally recommended</strong> due to both higher risk of side effects and lower risk of thyroid cancer (see e.g. the CDC page in the question or the WHO recommendation linked above).</p>\n<p>The WHO guideline spells out very clearly that the subpopulation that most importantly needs iodine prophylaxis in a nuclear emergency (newborns) are also most/more difficult to properly dose.</p>\n<hr />\n<p>Also keep in mind that uptake of iodine (radioactive or not) is low if you are not iodine deficient in the first place. <a href=\"https://en.wikipedia.org/wiki/Iodine_deficiency#Pathophysiology\" rel=\"nofollow noreferrer\">The [adult] human body contains about 15 - 20 mg I in total</a>, so 100 days' RDI or 1 - 2 weeks of Japanese daily input. Or purification tablets for 1.5 l water.</p>\n", "score": 2 } ]

[ "emergency", "thyroid", "radiation", "iodine", "nuclear-radiation" ]

[ { "answer_id": 30870, "body": "<p>Leptospirosis is a bacterial infection spread through contact with animal urine or water and soil contaminated by animal urine.[1]</p>\n<p>Rain falling from the sky isn't contaminated by animal urine, so it's safe in that regard.</p>\n<p>On the other hand, the rainwater could cause existing contamination in pools and soil to spread over a larger area, increasing risk of contact.\nIn urban areas rain is typically drained away quickly into stormdrains or the sewer*, so I expect it's likely to leave things cleaner rather than more contaminated.</p>\n<p>However, if it rains so much the sewers overrun, then the risk of leptospirosis adds another reason not to play in the water. [1][2]\nBut I suspect none of us really needn't an extra reason not to play in sewer water.</p>\n<p>*) While not recommended by the WHO[3], combined systems that handle both rainwater and sewage still exist in many places.</p>\n<hr />\n<p>To address the updated question about rain puddles, we probably need to get a bit speculative, since I can't find research directly addressing it.</p>\n<p>One part of the equation is the likelihood that a rain puddle would be contaminated. In a city this will mostly depend on the presence of rats, which are the most common cause of transmission[4]. Places where they live or eat are at high risk of contamination (presumably the places in between less so). So puddles in a park might be at risk, because parks are a good place for rats to make burrows. And places with a lot of litter/garbage are a risk, because that's where they can feed.</p>\n<p>The other part of the equation is the likelihood of infection from interacting with a contaminated puddle. The bacteria can enter your body through open wounds or mucous membranes (eyes, nose, mouth)[4]. I don't think this is likely to happen when running through puddles, except perhaps if a car splashes you top to bottom. I suspect the biggest risk in this scenario is after getting home and taking off your wet running shoes, forgetting to wash your hands, and then eating something.</p>\n<p>To give some sense of the total risk: in New York City there were 44 locally acquired cases between 2006 and 2020, and 13 in 2021 up to September [4] (and an increasing trend). So on a population of over 8 million the risk is fairly small, but not zero. Using that last number, it's roughly as likely as getting struck by lightning [5].</p>\n<hr />\n<p>[1] <a href=\"https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC4241785/\" rel=\"nofollow noreferrer\"><em>&quot;Leptospirosis from water sources&quot;</em> PMID: 25348115</a><br />\n[2] <a href=\"https://www.cdc.gov/leptospirosis/exposure/hurricanes-leptospirosis.html\" rel=\"nofollow noreferrer\">CDC: <em>&quot;Hurricanes, Floods and Leptospirosis&quot;</em></a><br />\n[3] <a href=\"https://www.who.int/water_sanitation_health/hygiene/plumbing16.pdf\" rel=\"nofollow noreferrer\">WHO on storm water drainage</a><br />\n[4] <a href=\"https://www1.nyc.gov/assets/doh/downloads/pdf/han/advisory/2021/leptospirosis-cases-increase.pdf\" rel=\"nofollow noreferrer\">NYC Health, <em>&quot;2021 Advisory #35:\nIncrease in Leptospirosis Cases in New York City&quot;</em></a><br />\n[5] <a href=\"https://www.cdc.gov/disasters/lightning/victimdata.html\" rel=\"nofollow noreferrer\">CDC, <em>&quot;Lightning: Victim Data&quot;</em></a></p>\n", "score": 4 } ]

[ "physical-health", "walking" ]

[ { "answer_id": 31041, "body": "<p>The physiological concentrations for K⁺ is ~120mmol intracellularly and ~4mmol extracellularly. This means that you have a large driving force (1:30 extra vs intracellular) of positive charge to the outside of the cell, creating a negative potential across the cell membrane. Using the Nernst equation, you can calculate that this equilibrium potential of K⁺ is somewhere around -90mV (<code>-60*log10(4/120)</code>).</p>\n<p>If the blood potassium concentration (which is similar to the extracellular potassium concentration) increases from ~4mmol to ~6mmol, the ratio of extra vs intracellular decreases to around 1:20 and accordingly the equilibrium potential of K⁺ is now somewhere around -80mV (<code>-60*log10(6/120)</code>). This means that - all things else being equal - the cell depolarises and is easier to excite¹.</p>\n<hr />\n<p>¹:You can calculate the membrane potential of a cell with the <a href=\"https://en.wikipedia.org/wiki/Goldman_equation\" rel=\"nofollow noreferrer\">Goldman-Hodgkin-Katz</a> equation, which basically is the sum of all equilibrium potentials times membrane conductance of all ions. Because cells are mostly permeable for potassium ions, the membrane potential very closely follows the equilibrium potential for potassium ions:</p>\n<p><a href=\"https://i.stack.imgur.com/EjZhT.png\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/EjZhT.png\" alt=\"enter image description here\" /></a></p>\n<p>where P_k is the membrane conductance, and [X]_in is the intracellular ion concentration and [X]_out is the extracellular concentration.</p>\n", "score": 2 } ]

[ "electrolytes" ]

[ { "answer_id": 31053, "body": "<p>Monitoring of patient blood pressure is vital because anesthesia and surgery can cause rapid changes in vital functions. Even brief periods of hypotension are associated with poor post-operative outcomes (Walsh <em>et al</em> 2013. PMID <a href=\"https://pubmed.ncbi.nlm.nih.gov/23835589/\" rel=\"nofollow noreferrer\">23835589</a>).</p>\n<p>For the 80-90% of routine cases (Lam <em>et al</em> 2021. PMCID <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8483407/\" rel=\"nofollow noreferrer\">8483407</a>), standard intermittent non-invasive blood pressure using <a href=\"https://en.wikipedia.org/wiki/Blood_pressure_measurement#Oscillometric\" rel=\"nofollow noreferrer\">oscillometry via brachial cuff</a> is sufficient. In these cases, oscillometry blood pressures show relatively good correlation with invasively obtained blood pressures. However, when patients begin exhibiting hypotension or hypertension, non-invasive blood pressures appear to systematically over- or under- estimate blood pressures, respectively (Lehman <em>et al</em> 2013. PMCID <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3724452/\" rel=\"nofollow noreferrer\">3724452</a>).</p>\n<p>Thus, in the remaining 10-20% of cases, more acurate &quot;invasive&quot; blood pressure monitoring is implemented. One common procedure is radial artery catheterization where a plastic catheter is directly inserted into the artery. From here, blood pressure is transduced outside the body and converted into an electrical signal where it can be analyzed and continuously monitored (Saugel <em>et al</em> 2020. PMCID <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7183114/\" rel=\"nofollow noreferrer\">7183114</a>).</p>\n<p><a href=\"https://i.stack.imgur.com/wduVo.jpg\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/wduVo.jpg\" alt=\"Image of a distal radial artery catheter insertion\" /></a>\n^{Image of a radial artery catheter adapted from Xiong <em>et al</em> 2022 (PMCID <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8905752/\" rel=\"nofollow noreferrer\">8905752</a>).}</p>\n<p>Patients are selected as needing continuous blood pressure monitoring when they are critically ill, have major comorbidities, or are undergoing a major or extended procedure.</p>\n<h4>In sum, in the United States, it is estimated that 10-20% of surgical procedures involve continuous invasive blood pressure monitoring.</h4>\n", "score": 3 }, { "answer_id": 31052, "body": "<p>In certain cases an arterial line can be placed to allow continuous pressure monitoring.</p>\n<p>Tiru, B., J. A. Bloomstone, and W. T. McGee. &quot;Radial artery cannulation: a review article.&quot; J Anesth Clin Res 3.5 (2012): 1000209.</p>\n", "score": 1 } ]

[ "surgery", "blood-pressure" ]

[ { "answer_id": 31087, "body": "<p>I agree with the comment from @CareyGregory.</p>\n<ol>\n<li><p>Maybe, but wound treatment often includes <a href=\"https://en.wikipedia.org/wiki/Debridement\" rel=\"nofollow noreferrer\">debridement</a> to remove the dead/dying/damaged tissue anyway. This also physically lowers the number of bacteria at the site of infection</p>\n</li>\n<li><p>Pus certainly isn't a barrier to bacteria, if anything it'll provide a nice moist, nutrient-rich environment for the bacteria to multiply in. In addition, some pathogenic species of bacteria are <a href=\"https://en.wikipedia.org/wiki/Bacterial_motility\" rel=\"nofollow noreferrer\">motile</a>, so they can effectively swim though the pus to spread.</p>\n</li>\n<li><p>Pus generally isn't solid, so it can't hold the wound open as packing would. It is a liquid, which will conform to the shape of the container (wound).</p>\n</li>\n<li><p>Yes, toxins are present in pus from both dying (<a href=\"https://pubmed.ncbi.nlm.nih.gov/31186281/\" rel=\"nofollow noreferrer\">apoptotic, necrotic, pyroptotic</a>) cells, immune response producing <a href=\"https://en.wikipedia.org/wiki/Respiratory_burst\" rel=\"nofollow noreferrer\">oxidative burst</a>, cytokine release, as well as bacterially produced toxins such as <a href=\"https://en.wikipedia.org/wiki/Hemolysin\" rel=\"nofollow noreferrer\">haemolysins</a> or <a href=\"https://en.wikipedia.org/wiki/Cytolysin\" rel=\"nofollow noreferrer\">cytolysins</a>. Removing these is better than leaving as it prevents further damage to the wound and reduces the likelihood of <a href=\"https://en.wikipedia.org/wiki/Disseminated_disease\" rel=\"nofollow noreferrer\">disseminated infection</a>.</p>\n</li>\n<li><p>Yes, pus could hide the wound and further infectious processes that are happening.</p>\n</li>\n<li><p>Maybe, I don't really know about this, pus generally isn't solid, but can accumulate behind a solid core, such as in the case of pimples/comedones that can progress to full-blown infections.</p>\n</li>\n</ol>\n", "score": 2 } ]

[ "wound-care", "wound", "ulcers" ]

[ { "answer_id": 31113, "body": "<p>Principally by making the body not feel the pain, but in some situations they actually help with the underlying cause.</p>\n<p>Nonsteroidal anti-inflammatory drugs (NSAIDs) such as <a href=\"https://www.ncbi.nlm.nih.gov/books/NBK547742/\" rel=\"nofollow noreferrer\">Ibuprofen work by blocking cyclo-oxygenase enzymes</a> that are involved in the production of the inflammatory mediators prostaglandins. Having less prostaglandins means you get less inflammation, and pain is part of the inflammatory responce so we get less pain in pretty much all situations.</p>\n<p>In some situations the inflammation is part of the problem. Your example of muscle pain is one such. This is frequently caused by a build up of lactic acid in the muscle, and is exacerbated by reduced blood flow caused by the inflammation caused by the acidosis. Treatment with NSAIDs can reduce the inflammation, improve blood supply and therefore treat the underlying cause of the pain.</p>\n", "score": 4 } ]

[ "anti-inflammatory" ]

[ { "answer_id": 31167, "body": "<p>According to the <a href=\"https://ods.od.nih.gov/factsheets/Zinc-HealthProfessional/\" rel=\"nofollow noreferrer\">Office of Dietary Supplements of the US National Institutes of Health</a>, the upper tolerable limit for Zinc is as follows:</p>\n<blockquote>\n<h5>Table 3: Tolerable Upper Intake Levels (ULs) for Zinc</h5>\n<div class=\"s-table-container\">\n<table class=\"s-table\">\n<thead>\n<tr>\n<th>Age</th>\n<th>Male</th>\n<th>Female</th>\n<th>Pregnant</th>\n<th>Lactating</th>\n</tr>\n</thead>\n<tbody>\n<tr>\n<td>0–6 months</td>\n<td>4 mg</td>\n<td>4 mg</td>\n<td></td>\n<td></td>\n</tr>\n<tr>\n<td>7–12 months</td>\n<td>5 mg</td>\n<td>5 mg</td>\n<td></td>\n<td></td>\n</tr>\n<tr>\n<td>1–3 years</td>\n<td>7 mg</td>\n<td>7 mg</td>\n<td></td>\n<td></td>\n</tr>\n<tr>\n<td>4–8 years</td>\n<td>12 mg</td>\n<td>12 mg</td>\n<td></td>\n<td></td>\n</tr>\n<tr>\n<td>9–13 years</td>\n<td>23 mg</td>\n<td>23 mg</td>\n<td></td>\n<td></td>\n</tr>\n<tr>\n<td>14–18 years</td>\n<td>34 mg</td>\n<td>34 mg</td>\n<td>34 mg</td>\n<td>34 mg</td>\n</tr>\n<tr>\n<td>19+ years</td>\n<td>40 mg</td>\n<td>40 mg</td>\n<td>40 mg</td>\n<td>40 mg</td>\n</tr>\n</tbody>\n</table>\n</div></blockquote>\n<p>As the Office of Dietary Supplements notes, the tolerable upper intake level is the</p>\n<blockquote>\n<p>maximum daily intake unlikely to cause adverse health effects.</p>\n</blockquote>\n<p>Thus, 30mg per day is a tolerable dose of zinc as defined by the NIH for males or females age 14 or older.</p>\n<p>However, as noted by <a href=\"https://medicalsciences.stackexchange.com/users/24872/timeskull\">timeskull</a> in the comments, this daily intake must <em>also</em> include the zinc one receives from other dietary sources. One study from a few decades ago found the average zinc intake of US adults to be 13mg/day (Briefel <em>et al</em> 2000. PMID <a href=\"https://pubmed.ncbi.nlm.nih.gov/10801945/\" rel=\"nofollow noreferrer\">10801945</a>). Thus, more than half of the US population would be exceeding the UL by taking a 30mg dose of elemental zinc daily.</p>\n<p>Zinc toxicity is rare (Agnew and Slesinger 2022. NBKID <a href=\"https://www.ncbi.nlm.nih.gov/books/NBK554548/\" rel=\"nofollow noreferrer\">554548</a>). However, chronic doses of 100-150mg/day of elemental zinc have been reported in association with secondary copper defficiency (Plum <em>et al</em> 2010. PMCID <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2872358/\" rel=\"nofollow noreferrer\">2872358</a>). Higher daily doses have been associated with gastrointestinal symptoms including anorexia, vomiting, and diarrhea (<a href=\"https://www.merckmanuals.com/professional/nutritional-disorders/mineral-deficiency-and-toxicity/zinc-toxicity\" rel=\"nofollow noreferrer\">2021 Merck Manual</a>).</p>\n<h5>As always, individuals should consult with their personal physician before starting any supplement or medication.</h5>\n", "score": 5 } ]

[ "supplement", "zinc" ]

[ { "answer_id": 31171, "body": "<p>Local anesthetics like <a href=\"https://en.wikipedia.org/wiki/Lidocaine\" rel=\"nofollow noreferrer\">lidocaine</a> work by blocking voltage-gated sodium channels; these channels are the biological basis of <a href=\"https://en.wikipedia.org/wiki/Action_potential\" rel=\"nofollow noreferrer\">action potentials</a> and therefore neurotransmission. Exposure to any typical axons in sufficient dose will completely block all neurotransmission down those axons, whether in the CNS or peripherally.</p>\n<p>Although it's common to talk of local anesthesia &quot;putting to sleep&quot; some body part, there's very little in common with sleep (unlike general anesthesia, which, depending on the anesthetic agent, can sometimes share some features with sleep). Brain neurons are not merely &quot;disconnected&quot; from each other during sleep, instead, brain networks are in a different state of function, for example with cortical neurons sharing periods of activity and quiescence that produces the &quot;slow waves&quot; of <a href=\"https://en.wikipedia.org/wiki/Slow-wave_sleep\" rel=\"nofollow noreferrer\">slow-wave sleep</a>.</p>\n<p>Local anesthesics &quot;leaking&quot; into the brain is potentially a big problem when it happens. Hamilton, 1992, discusses the specific issue of local anesthetics ending up in the brain stem during eye surgery. Since the brain stem controls important things like breathing, stopping neural activity there is an emergency situation.</p>\n<p>That said, when done properly, local anesthesia in the head is common and generally safe. Medical personnel performing local anesthesia need to be aware of the local anatomy where they are working to avoid off-target effects.</p>\n<p>Local anesthetics as well as regional cooling have been used in neuroscience experiments (for example see Boehnke &amp; Rasmusson 2001), in both animal models and humans, to create &quot;temporary lesions&quot; in the brain and investigate function of brain region. So, yes, if used in a targeted manner, local anesthetics can be used to temporarily interfere with local brain function without necessarily causing loss of consciousness.</p>\n<hr />\n<p><a href=\"https://www.sciencedirect.com/science/article/pii/S0165027000003484\" rel=\"nofollow noreferrer\">Boehnke, S. E., &amp; Rasmusson, D. D. (2001). Time course and effective spread of lidocaine and tetrodotoxin delivered via microdialysis: an electrophysiological study in cerebral cortex. Journal of Neuroscience Methods, 105(2), 133-141.</a></p>\n<p><a href=\"https://pubmed.ncbi.nlm.nih.gov/1490240/\" rel=\"nofollow noreferrer\">Hamilton, R. C. (1992). Brain-stem anesthesia as a complication of regional anesthesia for ophthalmic surgery. Canadian journal of ophthalmology. Journal canadien d'ophtalmologie, 27(7), 323-325.</a></p>\n", "score": 5 } ]

[ "brain", "anesthesia" ]

[ { "answer_id": 31178, "body": "<h2>Short answer:</h2>\n<p>The time scales in your two diagrams are different by a couple orders of magnitude. There's something like a &quot;local potential&quot; in the second trace, it's just so steep you can only see that its height is sufficient to reach threshold, not see the duration.</p>\n<h2>Longer answer:</h2>\n<p>The thing labeled &quot;local potential&quot; in your first picture, depicting a neuron, is in my experience more often called a <a href=\"https://en.wikipedia.org/wiki/Receptor_potential\" rel=\"nofollow noreferrer\">&quot;receptor potential&quot; or &quot;generator potential&quot;</a>, or in the context of inter-neuronal communication a <a href=\"https://en.wikipedia.org/wiki/Postsynaptic_potential\" rel=\"nofollow noreferrer\">post-synaptic potential</a>. However, it is in fact &quot;local&quot; if you think of the full geometry of a neuron that has a long axon. Specifically, if you record in an axon you're not going to really see this &quot;local&quot; potential, caused by current through some sort of receptor channel on the dendrites or in the vicinity of the soma. Instead, any small segment of axon is getting a really big input from ions flowing in the cytoplasm inside the axon, very quickly reaching local threshold and accompanied by further opening of channels and propagation of the signal. You could get the same effect if you just produced a really strong input at the soma, for example if you use your amplifier to deliver a stimulus in a cell you have under <a href=\"https://en.wikipedia.org/wiki/Patch_clamp\" rel=\"nofollow noreferrer\">patch-clamp</a> (which is how you get these recordings in the first place).</p>\n<p>The specific diagram you show doesn't have a scale on the time axis, or you've inadvertently cut it off, but for an approximation, a typical action potential width in a mammalian neuron is around 1 ms. Have a look at the time scale of your second image, though: 100s of milliseconds. Note that I wouldn't call this a &quot;ventricular action potential&quot; but rather a &quot;<a href=\"https://en.wikipedia.org/wiki/Cardiac_action_potential\" rel=\"nofollow noreferrer\">cardiac action potential</a>&quot;. Cardiac action potentials are <em>sllloowww</em>.</p>\n<p>Cardiac muscle cells are also not connected to each other through chemical synapses, like typical neurons where a neurotransmitter diffuses across a synapse to reach a receptor on the post-synaptic cell; instead, they're connected via <a href=\"https://en.wikipedia.org/wiki/Gap_junction\" rel=\"nofollow noreferrer\">gap junctions</a>. These are protein &quot;shunts&quot; between the intracellular space of two neighboring cells, that let them share voltage changes directly, almost as if they are all one big cell. That's what's happening here. There <em>is</em> a potential before the cardiac action potential that's triggering the whole thing, but it's a very strong signal similar in dV/dT to the action potential itself. If you expanded the x-axis a lot you might be able to see some inflection there, but it's not something you're going to see with a scale on the order of 100s of milliseconds.</p>\n", "score": 4 } ]

[ "health-education", "physiology", "nerves", "heartbeat", "cardiac-physiology" ]

[ { "answer_id": 31181, "body": "<p>There are a couple of terms you could use. You don't need to be technical with a doctor or anyone else. &quot;<a href=\"https://www.tabers.com/tabersonline/view/Tabers-Dictionary/766687/all/edema\" rel=\"nofollow noreferrer\">Edema</a>&quot; means (from link):</p>\n<blockquote>\n<p>A local or generalized condition in which body tissues contain an excessive amount of tissue fluid in the interstitial spaces.</p>\n</blockquote>\n<p>This can be one of the symptoms of a <a href=\"https://www.tabers.com/tabersonline/view/Tabers-Dictionary/766748/all/sprain\" rel=\"nofollow noreferrer\">sprain</a>, so you could be correct in using this. As noted on <a href=\"https://www.webmd.com/heart-disease/heart-failure/edema-overview\" rel=\"nofollow noreferrer\">WebMD</a> (emphasis is mine):</p>\n<blockquote>\n<p>Causes of Edema:\nThings like a <strong>twisted ankle</strong>, a bee sting, or a skin infection will cause edema. In some cases, like an infection, this may be helpful. More fluid from your blood vessels puts more infection-fighting white blood cells in the swollen area.</p>\n</blockquote>\n<p>In this context it would be called &quot;<a href=\"https://www.tabers.com/tabersonline/view/Tabers-Dictionary/766687/all/edema#24\" rel=\"nofollow noreferrer\">traumatic edema</a>&quot; or &quot;post-traumatic edema&quot;, depending on the duration and state of healing of the injury. However, sprains are often also accompanied by &quot;bruising&quot;, which is the purple discoloration you see with blood-vessel damage.</p>\n<p>You could always just call it swelling...</p>\n", "score": 4 } ]

[ "injury", "edema" ]

[ { "answer_id": 31220, "body": "<p>Whether it's ethical or not is a moot question because in the US it would be illegal under federal law to do so unless the doctor has the patient's written permission to inform the others.</p>\n<p>The law that prohibits this is known as the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Specifically, the Privacy Rule of HIPAA identifies Protected Health Information (PHI) as follows:</p>\n<blockquote>\n<p><strong>Protected Health Information.</strong> The Privacy Rule protects all &quot;individually identifiable health information&quot; held or transmitted by\na covered entity or its business associate, in any form or media,\nwhether electronic, paper, or oral. The Privacy Rule calls this\ninformation &quot;protected health information (PHI).&quot;</p>\n</blockquote>\n<p><a href=\"https://www.hhs.gov/hipaa/for-professionals/privacy/laws-regulations/index.html#:%7E:text=The%20Privacy%20Rule%20protects%20all,health%20information%20(PHI).%22\" rel=\"nofollow noreferrer\">Source</a></p>\n<p>The specific restriction is as follows (<em>same link, emphasis is mine</em>):</p>\n<blockquote>\n<p><strong>Basic Principle.</strong> A major purpose of the Privacy Rule is to define and limit the circumstances in which an individual’s protected heath\ninformation may be used or disclosed by covered entities. <strong>A covered\nentity may not use or disclose protected health information, except\neither: (1) as the Privacy Rule permits or requires; or (2) as the\nindividual who is the subject of the information (or the individual’s\npersonal representative) authorizes in writing.</strong></p>\n</blockquote>\n<p>Nowhere in the Privacy Rule does it permit informing family or cohabitants about infectious diseases -- or any PHI at all -- without the patient's permission.</p>\n", "score": 3 }, { "answer_id": 31228, "body": "<p>Failure of ethics for whom?</p>\n<ul>\n<li>If the contagious <strong>patient</strong> does not disclose the risk for her/his family (and fails to protect them otherwise), endangering their health is a clear unethical violation.</li>\n<li>For <strong>medical staff</strong>: at least depending on the jurisdiction, there are areas where all patient data is highly confidential unless the patients wants the medical staff to talk, with the exception of the patient directly endangering herself/himself or others. A classical examples is a patient in an altered mental state who cannot understand that driving quite is likely to kill himself or a child on the road, or a HIV positive patient who is not willing to inform and protect partners. This is always a balance of the thread to confidentiality vs. thread to life of the patient and third parties, and requires a real and direct danger that cannot be resolved otherwise. In these cases medical staff is allowed (and required) to prevent immanent danger, and if necessary break confidentiality - as much as really necessary.</li>\n</ul>\n<p>In addition, there are common obligations to tell about serious infections (depending on the disease for clinical practitioneer and/or diagnostic lab, either anonymously or by name), to allow health care authorities to monitor outbreaks and possibly take countermeasures for the endangered public.</p>\n<p>In cases of doubt and when time allows, fellow team members (e.g. your supervising professor, clinic attorney) or a medical ethics board my be involved in the decision.</p>\n<p>Regarding your example: if the disease causes substantial harm and is likely to be transmitted, it would be unethical (and unlawful depending on the jurisdiction) to force the family to suffer.</p>\n", "score": 0 } ]

[ "disease-transmission", "medical-ethics" ]

[ { "answer_id": 31272, "body": "<p>The <a href=\"https://open.fda.gov/data/datadictionary\" rel=\"nofollow noreferrer\">FDA API data dictionary</a> defines <code>active_ingredient</code> as:</p>\n<blockquote>\n<p>A list of the active, medicinal ingredients in the drug product.</p>\n</blockquote>\n<p>The FDA also has a helpful <a href=\"https://www.fda.gov/drugs/drug-approvals-and-databases/drugsfda-glossary-terms\" rel=\"nofollow noreferrer\">glossary</a>:</p>\n<blockquote>\n<p><strong>Active Ingredient</strong><br>\nAn active ingredient is any component that provides pharmacological activity or other direct effect in the diagnosis, cure, mitigation, treatment, or prevention of disease, or to affect the structure or any function of the body of man or animals.</p>\n</blockquote>\n<p>In contrast the data dictionary defines <code>generic_name</code> as:</p>\n<blockquote>\n<p>Generic name(s) of the drug product.</p>\n</blockquote>\n<p>The glossary notes:</p>\n<blockquote>\n<p><strong>Generic Drug</strong><br>\nA generic drug is the same as a brand name drug in dosage, safety, strength, how it is taken, quality, performance, and intended use. Before approving a generic drug product, FDA requires many rigorous tests and procedures to assure that the generic drug can be substituted for the brand name drug. The FDA bases evaluations of substitutability, or &quot;therapeutic equivalence,&quot; of generic drugs on scientific evaluations. By law, a generic drug product must contain the identical amounts of the same active ingredient(s) as the brand name product. Drug products evaluated as &quot;therapeutically equivalent&quot; can be expected to have equal effect and no difference when substituted for the brand name product.</p>\n</blockquote>\n<p>The difference is easily apparent when you consider one of the many <a href=\"https://en.wikipedia.org/wiki/Combination_drug\" rel=\"nofollow noreferrer\">combination drugs</a>. These are two or more active ingredients in one.</p>\n<p>For example, consider <a href=\"https://api.fda.gov/drug/drugsfda.json?search=products.brand_name:%22Hyzaar%22\" rel=\"nofollow noreferrer\">Hyzaar</a>. This brand-name drug is an attempt by a drug company to market a combination of two generically available drugs and jack up the price (Sacks <em>et al</em> 2018. PMCID <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6142946/\" rel=\"nofollow noreferrer\">PMC6142946</a>). The API lists the generic name as:</p>\n<blockquote>\n<p>&quot;generic_name&quot;: &quot;LOSARTAN POTASSIUM AND HYDROCHLOROTHIAZIDE&quot;</p>\n</blockquote>\n<p>While the active ingredients are listed in an array:</p>\n<pre><code> {\n &quot;name&quot;: &quot;HYDROCHLOROTHIAZIDE&quot;,\n &quot;strength&quot;: &quot;12.5MG&quot;\n },\n {\n &quot;name&quot;: &quot;LOSARTAN POTASSIUM&quot;,\n &quot;strength&quot;: &quot;50MG&quot;\n }\n</code></pre>\n<p>Consider the API results for <a href=\"https://api.fda.gov/drug/drugsfda.json?search=products.brand_name:%22Zegerid%22\" rel=\"nofollow noreferrer\">Zegerid</a>, which is a combination of omeprazole and sodium bicarbonate. The active ingredients list both, but there is in fact no generic listed, probably because there is no other company trying to market omeprazole together with Tums.</p>\n", "score": 3 } ]

[ "medications" ]

[ { "answer_id": 31285, "body": "<p>On this site we can not provide medical advice to anyone. However, as with any disease, you should monitor for symptoms and if concerned visit a health professional for diagnosis and treatment.</p>\n<p>However, I don't think your core question is personal medical advice - you are asking about the sensitivity of the tests and whether someone could test negative on a test but still be infectious.</p>\n<p>I'm assuming that you and the others in your group were using <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4986465/\" rel=\"nofollow noreferrer\">Rapid Antigen Tests (RATs, AKA Lateral Flow Assays [LFA])</a>.</p>\n<p>If so, this infographic from <a href=\"https://www.mdpi.com/1660-4601/18/13/7037\" rel=\"nofollow noreferrer\">Dankova <em>et al</em></a>. might be of some use to you:</p>\n<p><a href=\"https://i.stack.imgur.com/e0d3R.jpg\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/e0d3R.jpg\" alt=\"Timeline\" /></a></p>\n<p>In this picture, you can see the dotted line for the viral infection going though 3 main phases of infection, incubation (grey), infectious (pink/peach) and post-infectious (green). Note that the timing of the infection is an idealized model, and not necessarily what is experienced in real-life. Most people will have an infectious process with roughly the same timing, but for some the phases may be longer or shorter. It is entirely possible to have a very short incubation, long infectious and long post-infectious phases.</p>\n<p>On the X-axis there is a box showing the relative sensitivities for the RAT/LFA (red) and PCR tests (cyan). As you can see the RAT/LFA have a fairly short window in which they will detect the virus, and that this window does not completely overlap the infectious phase, missing the early part of this phase.</p>\n<p>So, it is possible that transmission can occur from a person who has tested negative by a RAT/LFA, but this is less likely from a qPCR test.</p>\n<p>References:</p>\n<ul>\n<li>Dankova, Z.; Novakova, E.; Skerenova, M.; Holubekova, V.; Lucansky,\nV.; Dvorska, D.; Brany, D.; Kolkova, Z.; Strnadel, J.; Mersakova, S.;\nJanikova, K.; Samec, M.; Pokusa, M.; Petras, M.; Sarlinova, M.;\nKasubova, I.; Loderer, D.; Sadlonova, V.; Kompanikova, J.; Kotlebova,\nN.; Kompanikova, A.; Hrnciarova, M.; Stanclova, A.; Antosova, M.;\nDzian, A.; Nosal, V.; Kocan, I.; Murgas, D.; Krkoska, D.; Calkovska,\nA.; Halasova, E. Comparison of SARS-CoV-2 Detection by Rapid Antigen\nand by Three Commercial RT-qPCR Tests: A Study from Martin University\nHospital in Slovakia. Int. J. Environ. Res. Public Health 2021, 18,\n7037. <a href=\"https://doi.org/10.3390/ijerph18137037\" rel=\"nofollow noreferrer\">https://doi.org/10.3390/ijerph18137037</a></li>\n</ul>\n<p>Other articles you might be interested in:</p>\n<ul>\n<li>Johansson MA, Quandelacy TM, Kada S, et al. SARS-CoV-2 Transmission From People Without COVID-19 Symptoms. JAMA Netw Open. 2021;4(1):e2035057. doi:10.1001/jamanetworkopen.2020.35057</li>\n<li>Krumkamp R, Kreuels B, Jaeger VK, May J, Mikolajczyk R, Karch A. Negative SARS-CoV-2 PCR or rapid antigen test result and the subsequent risk of being infectious: a mathematical simulation study. BMC Med Res Methodol. 2021 Aug 10;21(1):165. doi: 10.1186/s12874-021-01361-3. PMID: 34376152; PMCID: PMC8353420.</li>\n</ul>\n", "score": 4 } ]

[ "covid-19", "epidemiology", "infection-control" ]

[ { "answer_id": 31349, "body": "<p>There are a number of variables which introduce quite some variability in the answers; such as the patient tolerance to pain, level of control of the disease, duration of the lack of insulin, etc.\nAs the questions asks about denial of insulin, the symptoms of hyperglycemia are:</p>\n<ul>\n<li>Extreme thirst</li>\n<li>Headache</li>\n<li>Mental and physical fatigue</li>\n</ul>\n<p>Prolonged periods in a hyperglycemic state can lead to ketoacidosis, potentially leading to coma. Symptoms can include:</p>\n<ul>\n<li>Shortness of breath</li>\n<li>Nausea and vomiting</li>\n<li>Blurred vision</li>\n</ul>\n<p>It's not a localized pain, but more of a general poor condition related to the physiological state of the patient.</p>\n<p><a href=\"https://www.diabetes.org/healthy-living/medication-treatments/blood-glucose-testing-and-control/hyperglycemia\" rel=\"nofollow noreferrer\">Source 1</a></p>\n<p><a href=\"https://www.mayoclinic.org/diseases-conditions/hyperglycemia/symptoms-causes/syc-20373631\" rel=\"nofollow noreferrer\">Source 2</a></p>\n", "score": 4 } ]

[ "type-1-diabetes" ]

[ { "answer_id": 31361, "body": "<p>I'm not sure that there is any situation, outside of a projectile designed to stay inside the body or <a href=\"https://www.merriam-webster.com/dictionary/ablate\" rel=\"nofollow noreferrer\">ablate</a> (if such a thing is possible), that there would ever be a situation where the exit wound was smaller than the entry. For a round designed to fragment and stay inside the body (e.g. <a href=\"https://en.wikipedia.org/wiki/Expanding_bullet\" rel=\"nofollow noreferrer\">&quot;dumdum&quot; rounds</a>), then there would be massive internal damage from the cavitation and shrapnel by the momentum change of the round. If the round were something like a shotgun, which has lots of small projectiles in one shot. For these, the loss of momentum from each results in extensive bruising and tissue destruction over a wide area, but not to great depth as each individual shot has a relatively small momentum.</p>\n<p>At a minimium, given maintenance of the projectile shape, the exit wound should be at least the same size as the entry wound (i.e. can't be smaller because the bullet is the same size as when it went in), or larger through cavitation from the pressue that expands through the tissue and can exit the body. There are some images of the resulting wounds from projectiles <a href=\"https://www.asnr.org/neurographics/3/1/4/3.shtml\" rel=\"nofollow noreferrer\">here</a>. There's also the case where a projectile deforms and/or tumbles in passage through a target. This would result in a larger exit hole again.</p>\n", "score": 4 } ]

[ "gunshot-wounds" ]

[ { "answer_id": 31364, "body": "<p>A &quot;<a href=\"https://en.wikipedia.org/wiki/Committee#Steering_committee\" rel=\"nofollow noreferrer\">steering committee</a>&quot; consisting of 5 individuals, named by their initials, did a &quot;<a href=\"https://en.wikipedia.org/wiki/Systematic_review\" rel=\"nofollow noreferrer\">systematic review</a>&quot;, presumably of literature related to pediatric NMDAR antibody encephalitis, the topic of the working group. Since they write &quot;<em>the</em>&quot; systematic review, I presume the details of this review (such as dates and keywords) are provided elsewhere, but maybe not.</p>\n<p>The steering committee used experts found in this review or those nominated by professional societies to identify &quot;lead clinical researchers in the field&quot; and form a larger &quot;panel&quot; of 27 (they actually probably first found a larger group, as items 2 &amp; 3 would further narrow it down, particularly item 3 which is basically &quot;they agreed to participate&quot;).</p>\n<p>This systematic review was &quot;conducted before the consensus recommendations project&quot;, that is, the project that came to a consensus on a guideline.</p>\n", "score": 4 } ]

[ "terminology", "guidelines" ]

[ { "answer_id": 31423, "body": "<p>According to a <a href=\"https://sierrarescue.com/tag/wilderness-first-aid/#:%7E:text=Wilderness%20medicine%20guidelines%20suggest%20that,minimize%20the%20risk%20of%20infection.\" rel=\"nofollow noreferrer\">reputable wilderness rescue training organization</a>, these are the guidelines taught in wilderness medicine that you should follow for impalements:</p>\n<blockquote>\n<p><strong>Core impalement.</strong> Impalements to the head, face, trunk and other core\nparts of the body are usually left in place. Primary focus should be\non bleeding control and secondary efforts to stabilize the object in\nplace with sterile bulky dressing. Minimizing movement of the\nimpalement will help to reduce subsequent damage. In some cases when\nthe impalement is from a larger object, consider reducing the size of\nthe object to facilitate evacuation. Impalements to the eyes get\nspecial attention. Not only does the object require stabilization in\nplace over the affected eye, but the unaffected eye needs to be\ncovered since movement of one eye is linked to the other.</p>\n<p><strong>Extremity Impalement.</strong> Wilderness medicine guidelines suggest that\nimpalements to the extremities can be removed to facilitate\nevacuation. If your patient can or needs to self evacuate, prior\nremoval of the impaled object can help. Proper wound management will\nhelp minimize the risk of infection. In some cases extremity\nimpalements remain stabilized in place.</p>\n<p><strong>Basic Life Support.</strong> Any impalement that interferes with a basic life\nsupport intervention can be removed. For example, if CPR is indicated\nbased on patient assessment, and an impalement would impede proper\nCPR, the removal of the impalement is acceptable</p>\n</blockquote>\n<p>If you do remove the object, there will be external bleeding, and at least some degree of internal bleeding you can't see. There's nothing you can do about internal bleeding, so focus on external bleeding. The first step should always be direct pressure. Use whatever absorbent cloth you can get your hands on (a t-shirt will work well). Elevate the body part above the level of the heart if possible and apply forceful, continuous pressure on the wound for at least 15 minutes. If that doesn't stop the bleeding or at least slow it significantly and the wound is in an extremity, consider a tourniquet. But make this choice as a last resort because you are very likely sacrificing the limb. You cannot remove the tourniquet after about 2 hours even if you think the bleeding has stopped permanently because the limb will be full of toxic waste products and flushing that blood back into the systemic circulation could kill the patient. You can, however, slowly begin to loosen the tourniquet after about an hour to see if the bleeding has stopped. If it has, go ahead and release it but otherwise it probably needs to remain on until medical help can be reached.</p>\n", "score": 4 } ]

[ "first-aid", "emergency" ]

[ { "answer_id": 31445, "body": "<p>I don't think it's especially clear what they meant by this item in the consensus statement because the document does not include much in the way of motivation or discussion of this statement, but I believe the meaning you suggest is wrong.</p>\n<p>I think the clearest interpretation is that they are saying that &quot;success&quot; depends on how you define &quot;success&quot;, and they are proposing that you should only consider efficacy of immunotherapy (&quot;assessment of improvement following immunotherapy&quot;) when properly managing these symptoms with other drugs if needed (&quot;contingent on optimization of treatments...&quot;). An example might be that it's not reasonable to define &quot;success&quot; based only on control of seizures while ignoring sleep and mood, and also that it's not fair to consider immunotherapy as having &quot;failed&quot; if you didn't bother to also use other medications to treat symptoms.</p>\n<p>The rest of section 3.3 involves other drugs given to control particular symptoms:</p>\n<blockquote>\n<p>Use of antipsychotics and management of\npsychiatric symptoms should be undertaken in\ncollaboration with a child psychiatrist</p>\n</blockquote>\n<blockquote>\n<p>In descending order of recommendation,\nthe following agents can be useful in the\nsymptomatic management of agitation</p>\n</blockquote>\n<blockquote>\n<p>In descending order of recommendation,\nthe following agents can be useful in the\nsymptomatic management of dyskinesia and\nstereotypy</p>\n</blockquote>\n<p>Therefore, presumably by &quot;optimizing treatments&quot; they mean use of these other agents along with immunotherapy in treating anti-NMDAR encephalitis.</p>\n", "score": 3 } ]

[ "terminology" ]

[ { "answer_id": 31599, "body": "<p>You are almost spot on!</p>\n<p>Children usually do not have exactly the same DNA as their parents, because it is evolutionarily wise to allow some new traits to emerge.</p>\n<p>So, there can be spontaneous mutations in the DNA of a child that their parents did not have. In the case of Huntington‘s disease, <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3795589/\" rel=\"nofollow noreferrer\">approximately 10% of cases</a> are actually such new („de novo“) mutations that are not inherited. They are uncommon, but not extremely rare.</p>\n<p>These changes in the DNA happen to the sperm and the egg which become you, so once you are born (or actually once the zygote has been formed), you either have the mutation or you don’t.</p>\n", "score": 3 } ]

[ "genetics", "heredity" ]

[ { "answer_id": 31646, "body": "<p>Dextromethorphan and dextromethorphan HBr are the same as are dextromethorphan and dextromethorphan HCL</p>\n<p>HCL (hydrochloride) is a salt added to medicine to ease in digestion or absorption. HBr (hydrobromide) is used for the same purpose. These salts are sometimes included on labels, but <a href=\"https://www.ismp.org/resources/guidelines-safe-electronic-communication-medication-information\" rel=\"nofollow noreferrer\">it is recommended</a> that they be excluded in most cases to reduce confusion.</p>\n", "score": 1 } ]

[ "medications" ]

[ { "answer_id": 31633, "body": "<blockquote>\n<p>Let's say that the families of partner 1 and partner 2 have no history of similar autosomal recessive disorders and we can therefor assume but not exclude (by natural mutation chance) they are not a carrier.</p>\n</blockquote>\n<p>is inconsistent with:</p>\n<blockquote>\n<p>The chances of the grandchildren being a carrier is still 33% as they are not affected but the carrier status of the partners is unknown.</p>\n</blockquote>\n<p>If you're assuming this is a rare enough condition that it's reasonable to assume that partners with no family history are not carriers, you should be consistent with that assumption. In that case, if child 2 is not a carrier there is no way their offspring can inherit the carrier status from them.</p>\n<p>So, 0.66 * .50 + 0.33 * 0 = 33% chance that they are carriers.</p>\n<p>You may want to consider <em>de novo</em> mutation or that partner 1/2 are carriers depending on expected frequencies of those events, and not all genetic conditions are quite so perfectly Mendelian so that may also affect estimates a bit.</p>\n", "score": 3 } ]

[ "genetics", "dna", "genetic-predisposition", "carrier-genetic", "recessive-gene" ]

[ { "answer_id": 31665, "body": "<p>The <a href=\"https://web.archive.org/web/20081122053845/http://www.aha.org/aha/advisory/2003/030201-media-adv.html\" rel=\"nofollow noreferrer\">guidelines for these terms</a> seem purposefully vague; they are meant to maintain patient privacy while releasing a minimum of information for newsworthy cases. <strong>The American Hospital Association does not provide further definitions for these terms</strong>.</p>\n<p>&quot;Acute&quot; in a medical context roughly means &quot;immediate&quot; or &quot;in the short term&quot;; it isn't ordinarily an indicator of <em>intensity</em> in a medical context. Someone who is &quot;acutely ill&quot; must be ill <em>now</em>: it's not that they're at risk of being ill in the future, there is <em>something</em> about their vital signs that is off <em>now</em>. Compared to &quot;critical&quot;, someone in &quot;serious&quot; condition is seen to have a better likelihood of good outcomes; compared to &quot;fair&quot; they are seen to have a worse likelihood of good outcomes. Besides that, there is no quantitative definition for any of these terms, they're based on physicians' opinions about a given case. You can expect the labels to vary from person to person, hospital to hospital.</p>\n", "score": 2 } ]

[ "physical-health", "hospital", "guidelines", "stable-condition" ]

[ { "answer_id": 31763, "body": "<p>According to Cowart and Stachura (1990 NBK <a href=\"https://www.ncbi.nlm.nih.gov/books/NBK245/\" rel=\"nofollow noreferrer\">245</a>):</p>\n<blockquote>\n<p>Techniques for measuring glucosuria are based upon either glucose oxidase (specific for glucose) or copper sulfate reduction (nonspecific: detects reducing substances including glucose, fructose, lactose, pentoses, galactose, homogentisic acid, and ascorbic acid). ... In the glucose oxidase-based technique, hydrogen peroxide is generated and reacts with horseradish peroxidase to produce nascent oxygen. It in turn oxidizes orthotoluidine to produce the blue or purple color that is read. In [some reactions], oxidized orthotoluidine is reacted with the yellow dye tartrazine to produce a greater range of color development</p>\n</blockquote>\n<p>As <a href=\"https://medicalsciences.stackexchange.com/users/805/carey-gregory\">Carey Gregory</a> notes in the comments, <a href=\"https://en.wikipedia.org/wiki/Sucrose\" rel=\"nofollow noreferrer\">sucrose is a dimer of glucose and fructose</a>. Thus, to react with glucose oxidate, it would first need to be broken down (ie by <a href=\"https://en.wikipedia.org/wiki/Sucrase\" rel=\"nofollow noreferrer\">sucrase</a>).</p>\n<p>Regardless, it seems unwise to attempt to mix up a positive control for your medical test equipment from table sugar.</p>\n<p>If necessary, use positive controls from vendors with traceable lot numbers and material safety data sheets. For example, <a href=\"https://quantimetrix.com/product/dropper-urinalysis-dipstick-control/\" rel=\"nofollow noreferrer\">this product</a> includes positive controls for glucose (I have no affiliation with the company and cannot confirm it actually works).</p>\n", "score": 4 } ]

[ "test", "glucose" ]

[ { "answer_id": 31819, "body": "<p>I think I know what you mean - they're different <strong>color maps</strong> in lieu of the usual grayscale. I've very rarely seen them used by physicians and it is impossible to find screenshots online (sadly these days I don't have access to an ultrasound station).</p>\n<p>From the GE Vivid 7/Vivid 7 PRO <a href=\"http://medicalstore.hu/hasznalt_ultrahangok/GE%20VIVID%207/GE%20Vivid%207%20ultrasound%20-%20Users%20guide.pdf\" rel=\"nofollow noreferrer\">User's Manual</a>:</p>\n<p><a href=\"https://i.stack.imgur.com/D4ltX.png\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/D4ltX.png\" alt=\"Page 93\" /></a></p>\n<p>Same manual, page 94</p>\n<blockquote>\n<p>Color maps Displays a color map menu to optimize the greyscale\npresentation. The menu enables an option from a list of nonlinear\ngray-curves or different 2D-colorized curves to be selected.</p>\n</blockquote>\n", "score": 3 } ]

[ "radiology" ]

[ { "answer_id": 31842, "body": "<p>There is ongoing debate about the impact of a high protein diet on kidney health in adults. Some studies have suggested that high protein intake may be associated with an increased risk of kidney disease, particularly in people with pre-existing kidney damage or other risk factors for kidney disease, such as diabetes or obesity. For example, a meta-analysis of prospective cohort studies published in the American Journal of Kidney Diseases in 2016 found that high protein intake was associated with an increased risk of incident kidney disease and progression of kidney disease in people with pre-existing kidney damage (Song et al., 2016).</p>\n<p>Other studies have suggested that high protein intake may have a protective effect on kidney health, particularly when the protein is derived from plant sources. For example, a systematic review and meta-analysis of randomized controlled trials published in the Journal of Renal Care in 2019 found that high protein intake, particularly from plant sources, was associated with a reduced risk of incident kidney disease and a slower decline in kidney function in people with pre-existing kidney damage (Zhou et al., 2019).</p>\n<p>It is generally accepted that a high protein diet can lead to increased glomerular filtration rate (GFR) and glomerular hyperfiltration in healthy individuals. Glomerular hyperfiltration is a physiological response to increased protein intake that can lead to an increase in the filtration of solutes, including amino acids, through the glomerulus. This can lead to an increase in the load on the kidneys and may potentially contribute to the development of kidney damage over time, especially in individuals with pre-existing kidney damage or other risk factors for kidney disease. This has been demonstrated in several studies, including a study published in the American Journal of Physiology - Renal Physiology in 2003 (Mak et al., 2003).</p>\n<p>However, it is important to note that the relationship between high protein intake and kidney health is complex and not fully understood. There are several factors that may influence the impact of high protein intake on kidney health, including the source of the protein, the overall quality of the diet, and the presence of other risk factors for kidney disease.</p>\n<p>In conclusion, while it is generally recommended that people with chronic kidney disease (CKD) limit their protein intake to prevent further kidney damage, the evidence on the impact of high protein intake on kidney health in healthy adults is mixed. More research is needed to fully understand the potential risks and benefits of high protein intake on kidney health in different population groups.</p>\n<p>References:</p>\n<ul>\n<li><p>Mak RH, Cheung AK, Mak NO, et al. (2003). Glomerular hyperfiltration in healthy humans after high protein intake. American Journal of Physiology - Renal Physiology, 284(6), F1226-F1231.</p>\n</li>\n<li><p>Song Y, Ning N, Chen J, et al. (2016). Protein intake and risk of incident chronic kidney disease: a meta-analysis. American Journal of Kidney Diseases, 67(5), 651-660.</p>\n</li>\n<li><p>Zhou J, Wang L, Chen J, et al. (2019). The effects of high protein intake on kidney function in patients with chronic kidney disease: a systematic review and meta-analysis. Journal of Renal Care, 45(4), 283-293.</p>\n</li>\n</ul>\n", "score": 3 } ]

[ "nutrition" ]

[ { "answer_id": 31912, "body": "<p>Vaccine efficacy refers to some relationship between a vaccinated and unvaccinated group; there are multiple ways to measure this, see for example this Q&amp;A on Biology: <a href=\"https://biology.stackexchange.com/questions/96941/what-does-vaccine-efficacy-mean\">https://biology.stackexchange.com/questions/96941/what-does-vaccine-efficacy-mean</a></p>\n<p>A quote from the specific article you reference is:</p>\n<blockquote>\n<p>The HR was used to calculate vaccine effectiveness using the following\nformula: vaccine effectiveness=(1 – HR) × 100%</p>\n</blockquote>\n<p>HR here is &quot;<a href=\"https://en.wikipedia.org/wiki/Hazard_ratio\" rel=\"noreferrer\">hazard ratio</a>&quot;, from a Cox regression. HR = 1 would mean that the control and treated population have the same hazard (events per unit time); HR &lt; 1 would mean the treated population has a lower hazard; HR &gt; 1 would mean the treated population has a higher hazard.</p>\n<p>As you can see in the formula above, that means that HR &gt; 1, where the treated population has higher hazard, would give a negative number for &quot;vaccine effectiveness&quot;, because <em>1 - (some number greater than 1)</em> is a negative number.</p>\n<p>In the figure you reference, note that there is a shaded region. From the figure caption:</p>\n<blockquote>\n<p>The association is shown using proportional hazards models with 95% CIs\n(shaded areas) and restricted cubic splines</p>\n</blockquote>\n<p>95% CIs are a measure of uncertainty; the correct interpretation is that 95% of the time, the range indicated by the 95% CI will include the true value. You'll see that in their figure, this shaded area includes 0 at 9 months, so even though the line is below zero, there is not enough evidence to conclude that the hazard is different in vaccinated vs. unvaccinated at 9 months.</p>\n<p><a href=\"https://en.wikipedia.org/wiki/Smoothing_spline\" rel=\"noreferrer\">Cubic splines are a smoothing method</a>; restricted means that the algorithm forces a linear relationship at the edge knots. In this case, you should be cautious that lines drawn at the edges may exaggerate trends earlier in the data; imagine if you just drew a straight line through a function that is asymptotic towards zero: it would eventually cross zero even though the true function never does.</p>\n<p>Another reason that you might see higher hazards in vaccinated individuals would be if those individuals suspected they were vaccinated (for example, they experienced side effects) and therefore changed their behavior to take more risks (like occupying crowded spaces). If vaccine efficacy wanes while behavior remains changed, those individuals might get sick more often.</p>\n<p>In plain language, I would interpret this figure as indicating &quot;vaccine efficacy declines over time; by around 7 months the infection risk is not distinguishable between those vaccinated and unvaccinated&quot;</p>\n", "score": 5 } ]

[ "vaccine", "covid" ]

[ { "answer_id": 31971, "body": "<p>As you are talking about non smoked nicotine containing products, I think the hypercritical among us may find ways of questioning it, but it seems possible.</p>\n<p>It is pointed out by <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2956962/\" rel=\"nofollow noreferrer\">Rajput (2010)</a> that:</p>\n<blockquote>\n<p>Avoidance of smoking can be beneficial in hair loss, as nicotine is known to decrease blood flow to the hair follicles by causing vasoconstriction and also leads to accumulation of free radicals in the hair roots thus damaging hair roots.[27]</p>\n<ol start=\"27\">\n<li>Spencer, D. K. (1998). The hormonal effects of diet on hair loss. In: <em>The Bald Truth</em>. New York: Simon and Schuster Inc, pp37-54.</li>\n</ol>\n</blockquote>\n<p>But, this talks about smoking nicotine containing products.</p>\n<p>With <a href=\"https://doi.org/10.1016/j.lfs.2012.03.041\" rel=\"nofollow noreferrer\">Galitovskiy, et al. (2012)</a>, an experimental group of mice received subcutaneous injections of the LD50 dose of (−)nicotine hydrogen tartrate of 3mg/kg/day, 5 days per week for 24 months, and:</p>\n<blockquote>\n<p>We demonstrate for the first time that chronic nicotine treatment can induce the development of muscle sarcomas as well as transient hair loss.</p>\n</blockquote>\n<p>But then, mice are not humans. Is it certain that the results with mice would be the same in humans?</p>\n<p><em>&quot;While the mechanism responsible for hair loss in subjects exposed to nicotine or tobacco smoke is unknown&quot;</em> (<a href=\"https://www.karger.com/Article/FullText/512865\" rel=\"nofollow noreferrer\">Babajoni, et al., 2021</a>):</p>\n<blockquote>\n<p>it is thought to be similar to the mechanism by which smoking increases skin aging. Nicotine is known to cause constriction of dermal hair papilla and local ischemia, accumulation of DNA damage, dysregulation of protease/antiprotease systems involved in the hair growth cycle, and upregulation of local pro-inflammatory cytokines implicated in follicular inflammation and fibrosis [40, 41]. A hypothesis exists that exogenous nicotine from smoking can cause overstimulation of the cellular nicotinic acetylcholine receptors leading to desensitization of the receptor. This in turn contributes to hair follicle destruction by activation of programmed cell death pathways present in keratinocytes [42-44].</p>\n<ol start=\"40\">\n<li>Trüeb RM. Association between smoking and hair loss: another opportunity for health education against smoking? Dermatology. 2003 [cited 2019 Jun 10];206(3):189–91.</li>\n<li>Freiman A, Bird G, Metelitsa AI, Barankin B, Lauzon GJ. Cutaneous effects of smoking. J Cutan Med Surg. 2004 Nov 5 [cited 2019 Jun 10];8(6):415–23.</li>\n<li>Yang X, Buccafusco JJ. Effect of chronic central treatment with the acetylcholine analog methylcarbamylcholine on cortical nicotinic receptors: correlation between receptor changes and behavioral function. J Pharmacol Exp Ther. 1994 Nov [cited 2019 Jun 19];271(2):651–9.</li>\n<li>Zia S, Ndoye A, Nguyen VT, Grando SA. Nicotine enhances expression of the alpha 3, alpha 4, alpha 5, and alpha 7 nicotinic receptors modulating calcium metabolism and regulating adhesion and motility of respiratory epithelial cells. Res Commun Mol Pathol Pharmacol. 1997 Sep [cited 2019 Jun 19];97(3):243–62.</li>\n<li>Nguyen VT, Ndoye A, Hall LL, Zia S, Arredondo J, Chernyavsky AI, et al. Programmed cell death of keratinocytes culminates in apoptotic secretion of a humectant upon secretagogue action of acetylcholine. J Cell Sci. 2001 Mar [cited 2019 Jun 10];114(Pt 6):1189–204.</li>\n</ol>\n</blockquote>\n<h2>References</h2>\n<p>Babadjouni, A., Foulad, D. P., Hedayati, B., Evron, E., &amp; Mesinkovska, N. (2021). The effects of smoking on hair health: a systematic review. <em>Skin Appendage Disorders, 7</em>(4), 251-264. <a href=\"https://doi.org/10.1159/000512865\" rel=\"nofollow noreferrer\">https://doi.org/10.1159/000512865</a></p>\n<p>Galitovskiy, V., Chernyavsky, A. I., Edwards, R. A., &amp; Grando, S. A. (2012). Muscle sarcomas and alopecia in A/J mice chronically treated with nicotine. <em>Life sciences, 91</em>(21-22), 1109-1112. <a href=\"https://doi.org/10.1016/j.lfs.2012.03.041\" rel=\"nofollow noreferrer\">https://doi.org/10.1016/j.lfs.2012.03.041</a></p>\n<p>Rajput, R. J. (2010). Controversy: is there a role for adjuvants in the management of male pattern hair loss?. <em>Journal of cutaneous and aesthetic surgery, 3</em>(2), 82. <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2956962/\" rel=\"nofollow noreferrer\">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2956962/</a></p>\n", "score": 3 } ]

[ "nicotine" ]

[ { "answer_id": 32042, "body": "<p>Yes, damage to the alveolar walls or the reduction in surface area for gaseous exchange can be reversible. Additionally, acute (non-chronic) conditions can cause these circumstances. For example, in salt or freshwater drowning¹ victims, wash out and destroy surfactant, disrupt the alveolar-capillary membrane, and increase its permeability.^2,3,4</p>\n<p>In the case of drowning from freshwater or saltwater, some patients with mild lung injury will require supplemental (non-mechanical) oxygen for 6-48 hours.⁵ Other patients may need invasive (intubation with mechanical support ventilation) or non-invasive (mechanical support ventilation like CPAP or BiPAP).⁵ The time required to regenerate surfactant is approximately 48 hours,⁵ and therefore, that is likely how long they will require mechanical ventilatory support to reverse the injury.⁵</p>\n<p>Another condition you may want to research that has a similar, reversible cause to the collapse of alveoli is <strong>atelectasis</strong>.⁶ Additionally, you can research acute spontaneous <strong>pneumothorax</strong> as another condition that is related to your description.⁷</p>\n<p><strong>References</strong></p>\n<ol>\n<li>Van Beeck EF, Branche CM, Szpilman D, Modell JH, Bierens JJ. A new definition of drowning: towards documentation and prevention of a global public health problem. Bull World Health Organ. 2005;83(11):853-856.</li>\n<li>Olshaker JS. Near drowning. Emerg Med Clin North Am. 1992;10(2):339-350.</li>\n<li>DeNicola LK, Falk JL, Swanson ME, Gayle MO, Kissoon N. Submersion injuries in children and adults. Crit Care Clin. 1997;13(3):477-502. doi:10.1016/s0749-0704(05)70325-0</li>\n<li>Bierens JJ, Knape JT, Gelissen HP. Drowning. Curr Opin Crit Care. 2002;8(6):578-586. doi:10.1097/00075198-200212000-00016</li>\n<li>Chandy D, Richards D. Drowning (submersion injuries). UpToDate. <a href=\"https://www.uptodate.com/contents/drowning-submersion-injuries?search=drowning\" rel=\"nofollow noreferrer\">https://www.uptodate.com/contents/drowning-submersion-injuries?search=drowning</a>&amp;source=search_result&amp;selectedTitle=1~78&amp;usage_type=default&amp;display_rank=1. January 23, 2023. Accessed March 9, 2023.</li>\n<li>Muller, NL, Fraser, et al. Radiologic diagnosis of diseases of the chest, Saunders, Philadelphia 2001.</li>\n<li>Gupta D, Hansell A, Nichols T, Duong T, Ayres JG, Strachan D. Epidemiology of pneumothorax in England. Thorax. 2000;55(8):666-671. doi:10.1136/thorax.55.8.666</li>\n</ol>\n", "score": 3 } ]

[ "lungs", "disease", "respiratory-system", "pulmonology" ]

[ { "answer_id": 32041, "body": "<p>If you want to understand how a drug works, a helpful phrase is &quot;mechanism of action&quot;. Pairing that keyword with the drug you mentioned, the first Google result is this one:</p>\n<p><a href=\"https://www.ncbi.nlm.nih.gov/books/NBK545223/\" rel=\"nofollow noreferrer\">https://www.ncbi.nlm.nih.gov/books/NBK545223/</a></p>\n<blockquote>\n<p>The primary mechanism of action of methimazole is to block thyroid hormone production from the thyroid gland. It interferes with the step that causes the iodination of tyrosine residues in thyroglobulin, mediated by the enzyme thyroid peroxidase, thus preventing the synthesis of thyroxine (T4) and triiodothyronine(T3).</p>\n</blockquote>\n<blockquote>\n<p>However, this drug does not affect the existing thyroxine (T4) and triiodothyronine (T3) in the circulation or stored in the thyroid gland. Similarly, there have been no observations of alterations in the effectiveness of exogenously administered thyroid hormones.</p>\n</blockquote>\n<p>That said, I would not recommend anyone ignore warnings in the instructions for use of some drug without consulting with their doctor, and it seems very unlikely to me that this specific set of circumstances has been tested because there are no medical benefits to being less careful with your cat's drugs.</p>\n", "score": 4 } ]

[ "hyperthyroid", "hypothyroid" ]

[ { "answer_id": 32073, "body": "<p>Nothing is really &quot;invariant&quot;, especially if you include the very young and very old. All of the most common causes of death are strongly age dependent:</p>\n<p><a href=\"https://www.cdc.gov/injury/wisqars/pdf/leading_causes_of_death_by_age_group_2018-508.pdf\" rel=\"nofollow noreferrer\">https://www.cdc.gov/injury/wisqars/pdf/leading_causes_of_death_by_age_group_2018-508.pdf</a></p>\n<p>&quot;Unintentional injury&quot; as a fairly broad category is pretty constant from ages 15-64; I assume a substantial fraction of these are due to car accidents. Above age 65 death rates from injury increase quite a bit, since older people are more likely to die in the same circumstance that a younger person survives, and start to encounter more age-related injuries (e.g., &quot;falls&quot;).</p>\n<p>There are some injury causes that are fairly constant for, say, children through adulthood (from <a href=\"https://injuryfacts.nsc.org/all-injuries/deaths-by-demographics/deaths-by-age/data-details/\" rel=\"nofollow noreferrer\">https://injuryfacts.nsc.org/all-injuries/deaths-by-demographics/deaths-by-age/data-details/</a> )</p>\n<p>Drowning:</p>\n<blockquote>\n<p>While relatively stable and low for all ages, the death rates for drowning showed peaks in the first few years of life and again at some very old ages</p>\n</blockquote>\n<p>Fire:</p>\n<blockquote>\n<p>Slightly elevated at very young ages; death rate peaked at age 95, with a rate of 8.2 per 100,000 population</p>\n</blockquote>\n", "score": 4 } ]

[ "statistics", "death" ]

[ { "answer_id": 32106, "body": "<p>According to <a href=\"https://doi.org/10.1002/ca.23006\" rel=\"nofollow noreferrer\"><em>Prostate-induced orgasms: A concise review illustrated with a highly relevant case study</em></a>, it appears there is no scientific evidence supporting or refuting the existence of prostate-induced orgasm, or at least there wasn't in 2017.</p>\n<blockquote>\n<p>Because there have been no published laboratory-conducted\ninvestigations of the orgasms induced by prostate stimulation alone,\ninformation about them has to be gathered from the various websites\ndedicated to such orgasms. While unsatisfactory in that the vast\nnumber are obviously anecdotal they represent the only available\nsource.</p>\n</blockquote>\n<p>However, the anecdotal evidence seems compelling:</p>\n<blockquote>\n<p>Unlike the sparsity of academic literature on prostate-induced orgasms\nthere appears to be an enormous number of internet sites involving\nsuch activity.</p>\n</blockquote>\n<p>My own searches using similar but not identical search terms confirms there are a large number of people out there who claim to be able to induce orgasm with prostate stimulation. The paper I cited includes a detailed case history of one such man. Frankly, I see no reason not to believe them, or at least the ones who aren't selling something.</p>\n<p>And a paper does exist [<em>Do men have a G-spot</em> JF Perry - Aust Forum, 1988] that claims men have an area functionally similar to the G-spot in women, and it is located where the prostate is located. Unfortunately, even though the paper is widely cited I can't find a copy, not even the abstract.</p>\n<blockquote>\n<p>Perry (1988) suggested that this area of the rectal wall was similar\nto the so-called ‘G-spot’ of the female in that it activated orgasm\nwhen stimulated so it has been called ‘the male G-spot’, it is\nanatomically incorrect but a widely used description.</p>\n</blockquote>\n<p>So the answer to your question appears to be there is little, if any, scientific evidence supporting the notion of prostate-induced orgasms.</p>\n", "score": 3 } ]

[ "brain", "sexuality", "prostate" ]

[ { "answer_id": 32181, "body": "<p>It is possible and it would depend highly on what sort of sample you were taking, but in general, yes.</p>\n<p>The reasons for this are that a smear on a slide should only (through statistical odds) pick up common organisms, which, assuming you have sampled correctly should be the disease causing ones. Contaminants should, <em>in theory at least</em>, be at a lower abundance, so less likely to be sampled</p>\n<p>In addition, because a Gram stain is differential only really for Gram +/- (size can play into it too, but differentiating the species of say <em>Streptococcus</em> is impossible by Gram stain), you can't necessarily tell if two or more species are present in the sample.</p>\n<p>For example, say you took a throat swab sample from someone complaining of a sore throat. You put some onto a blood plate and do a quick Gram slide too. On the slide you see small spherical Gram + bacteria. You think great - <em>Streptococcus</em>. However in culture you also see small greyish-white, non-hemolytic colonies and larger white, B-hemolytic colonies. In this example, the grey, non-hemolyitc colonies would be <em><a href=\"https://en.wikipedia.org/wiki/Staphylococcus_epidermidis\" rel=\"nofollow noreferrer\">Staphylococcus epidermidis</a></em> and the hemolytic colonies would be Group A <em><a href=\"https://en.wikipedia.org/wiki/Streptococcus_pyogenes\" rel=\"nofollow noreferrer\">Streptococcus</a></em>. <em>S. epidermidis</em> is normal skin microflora that wouldn't normally be found in the throat, and is usually only pathogenic around things like ports and lines, so a likely contaminant.</p>\n", "score": 1 } ]

[ "bacteria", "diagnostics", "microbiology" ]

[ { "answer_id": 32240, "body": "<p>In the states (US) where laws restrict the number of hours a resident can work, there is a common &quot;workaround&quot; - e.g. a minimum number of hours off to rest - and a return to duty, in effect legally complying (e.g. if the law states no more than 13 consecutive hours, the resident might get a 2-hour break after 8 hours, only to return for another 8 hours.) It's not enough for true compliance. Furthermore, they do not include the increasing number of hours that doctors are charting from home due to the complex and time consuming requirements of Electronic Medical Records. (Even the majority of older, experienced physicians do at least an hour of charting during &quot;off duty&quot; hours/workday. I'm not sure about other countries.</p>\n<p>If you're looking for a residency where there is compliance with the spirit of the law, I'd look at the Scandinavian countries, esp Sweden and Denmark.</p>\n<p>_{<a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4304287/\" rel=\"nofollow noreferrer\">Resident duty hours around the globe: where are we now?</a>}</p>\n", "score": 2 } ]

[ "lifestyle" ]

[ { "answer_id": 32253, "body": "<p>Without going into the psych of behavior, (OCD)\n<strong>from pure scientific aspect</strong>, your query may be answered by Locard's exchange principle. <a href=\"https://en.wikipedia.org/wiki/Locard%27s_exchange_principle\" rel=\"nofollow noreferrer\">1</a>\n<strong>from micro-biologic &amp; pathologic aspect</strong> of query the bacterial counts of urine sample may range upto 100000 CFU to be labelled UTI. i.e. bacteriuria is not an infection. IDSA estimated asymptomatic bacteriuria prevalence of 1% to 5% in healthy, premenopausal women and 1.9% to 9.5% in pregnant women. Lactobacillus spp. predominate in female infants. from about 1 month of age to puberty diphtheroids, S. epidermidis, streptococci, and E. coli predominate. At puberty, women acquire an adult flora in which L. acidophilus, corynebacteria, peptostreptococci, staphylococci, streptococci, and Bacteroides predominate. After menopause, Yeasts (Torulopsis and Candida) are occasionally found. In the anterior urethra of humans, S. epidermidis, enterococci, and diphtheroids are found frequently; E. coli, Proteus, and Neisseria (nonpathogenic species) are reported occasionally (10 to 30 percent). Thus distal urethra contains a sparse mixed flora; these organisms are present in urine specimens (10000/ml).<a href=\"https://www.ncbi.nlm.nih.gov/books/NBK482276/\" rel=\"nofollow noreferrer\">2</a> <a href=\"https://www.ncbi.nlm.nih.gov/books/NBK7617/\" rel=\"nofollow noreferrer\">3</a></p>\n<p>Now the <strong>decontamination &amp; sterilization aspect</strong>, you may follow\nbiosafety level which in this scenario which would be (BSL-1). you can dig deeper on your own.</p>\n<p>But as <strong>essential nature of bacteria</strong>, consider this - estimated total number of bacteria in the 70 kg &quot;reference man&quot; is <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4991899/\" rel=\"nofollow noreferrer\">3.8·10^13</a>.</p>\n<p>As <strong>prudent</strong> individual,there is <strong>nothing to worry</strong> about- this is what be 1 line answer.</p>\n", "score": 1 } ]

[ "obsessive-compulsive" ]

[ { "answer_id": 32308, "body": "<p>I understand and I might be wrong, <a href=\"https://www.yalemedicine.org/conditions/skin-lymphoma#:%7E:text=What%20is%20skin%20lymphoma%3F,also%20present%20in%20the%20skin.\" rel=\"nofollow noreferrer\">from this article</a>, that Skin Lymphoma is a group of rare, usually slow-growing skin cancers that are being caused by cancerous lymph nodes creating cancerous lymphocytes.<br>\nWhile most lymphocytes reside in the lymph nodes, they also effect the skin and may cause some dermatological symptoms finally recognized as Skin Lymphoma or one or more different Lymphoma/s.</p>\n<p>I didn't find any traces for the root term <code>lymph</code> in any of the pages of <a href=\"https://www.cdc.gov/cancer/skin/basic_info/index.htm#:%7E:text=Basal%20and%20squamous%20cell%20carcinomas,cancer%2C%20begins%20in%20the%20melanocytes.\" rel=\"nofollow noreferrer\">This article</a> with &quot;basic information&quot; about skin cancers.<br>\nI assume that Melanoma or Carcinoma are more common types of skin cancer. This is my personal assumption and it might be wrong.</p>\n", "score": 0 }, { "answer_id": 32309, "body": "<p>Cancer is Abnormal <em><strong>Cell</strong></em> <em><strong>Growth</strong></em>.\nAll tumor cells show the six hallmarks of cancer.</p>\n<ol>\n<li>Cell growth and division absent the proper signals (<strong>Dys-regulated</strong>)</li>\n<li>Continuous growth and division even given contrary signals (<strong>Autonomous</strong>)</li>\n<li><strong>Avoid</strong>ance of programmed cell <strong>death</strong></li>\n<li>Limitless number of <strong>cell divisions</strong></li>\n<li>Promoting <strong>blood vessel</strong> construction</li>\n<li><strong>Invasion</strong> of tissue and formation of metastases\nNow this can apply to any cell of body to produce distinct syndromes producing clinical syndromes based on site of abnormal growth and type of cell undergoing neoplastic change. In case of skin as tissue any cell can undergo neoplastic change - <a href=\"https://i.stack.imgur.com/cSLDf.png\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/cSLDf.png\" alt=\"cell &amp; Tissue Organization\" /></a>\nskin lymphoma is a neoplastic transformation of immune cells which are found in all sites of body but also have discrete organs like lymph nodes which are sites of naive cells &amp; sites of immune reactions. therefore skin can also host immune cells which can be</li>\n</ol>\n<ul>\n<li><strong>in-situ transformation</strong> (undergo neoplastic change at site) or</li>\n<li>may <strong>metastasi</strong>zed from distant lymph node or extranodal site after undergoing neoplastic transformation.</li>\n</ul>\n<p>Regarding Differences b/w two or any skin cancer- there are many at every level be it - pathology, clinical s/s, treatment &amp; prognosis. At every level there is difference b/w tumors originating from different cell types- So much so that even Lymphomas of skin are so many types that classification of lymphomas is evolving still.\nBut most basic difference is that immune cells may not considered be structural component of skin (even though they are) but other skin cancers are directly originating from skin cells per se.</p>\n<p>Regarding the incidence of skin cancer types - the cancer ,mentioned in your reference are really the most common types of skin cancers. cf lymphomas. another reference is <a href=\"https://www.aad.org/media/stats-skin-cancer\" rel=\"nofollow noreferrer\">https://www.aad.org/media/stats-skin-cancer</a></p>\n", "score": 0 } ]

[ "cancer" ]

[ { "answer_id": 32358, "body": "<p>From <a href=\"https://www.cancercenter.com/cancer-types/skin-cancer/risk-factors#:%7E:text=Can%20skin%20picking%20cause%20cancer,the%20symptoms%20of%20skin%20cancer%3F\" rel=\"nofollow noreferrer\">Skin cancer causes and risk factors</a> (cancercenter.com)</p>\n<blockquote>\n<p><strong>Can skin picking cause cancer?</strong></p>\n<p>Frequent skin picking, also called dermatillomania, may damage the skin, but researchers have not found a link between this habit and the development of skin cancer.</p>\n</blockquote>\n<p>So it looks like the answer is no.</p>\n<p>However I know of one skin condition <a href=\"https://en.wikipedia.org/wiki/Epidermolysis_bullosa\" rel=\"nofollow noreferrer\">Epidermolysis bullosa</a>, where the skin tends to get damaged a lot and they are at risk of getting Squamous Cell Carcinoma and other cancers.</p>\n", "score": 2 } ]

[ "medications", "dermatology", "disorders" ]

[ { "answer_id": 32339, "body": "<p>This is a common misbelief in many parts of the world. In the English speaking parts we have a similar one about being outside in the cold after which some illnesses are called - you might have heard of the &quot;common cold&quot;, which is actually caused by viral infection and nothing to do with the cold at all, though there is an association between the two that I will explain further down.</p>\n<p>One way to look at this is - do you bathe or otherwise immerse yourself in water? as in have a shower, or in a bath or swimming pool or river/lake/sea?</p>\n<p>If so - does this make you sick or do people think that it makes you sick? So what is the difference between a shower and rain? The answer here is not much - both are water you stand under. One might be warm (heated water in a shower), but could equally be cold with no noticeable difference in perception as to whether it might make you sick.</p>\n<p>What does make you sick is acquiring an infection. Infections are typically caused by <a href=\"https://en.wikipedia.org/wiki/Microorganism\" rel=\"nofollow noreferrer\">microorganisms</a>, such as bacteria and viruses (though not exclusively these types, you can also be infected by fungi and things like amoebae and mites), that once inside your body multiply, resulting in the illness.</p>\n<p>There are many different types of bacteria and viruses that can make you sick and you have probably heard of at least one - the recent &quot;COVID&quot; pandemic was caused by a virus called <a href=\"https://en.wikipedia.org/wiki/SARS-CoV-2\" rel=\"nofollow noreferrer\">SARS-CoV-2</a>, which is a member of the <a href=\"https://en.wikipedia.org/wiki/Coronavirus\" rel=\"nofollow noreferrer\">Coronavirus</a> family. Some other members of the coronavirus family cause &quot;common cold&quot; infections, though there are other viruses that also cause similar symptoms and are also grouped as common cold viruses.</p>\n<p>You might also have heard of the &quot;flu&quot; or <a href=\"https://en.wikipedia.org/wiki/Influenza_A_virus\" rel=\"nofollow noreferrer\">influenza</a>, which is another type of virus. Both COVID and influenza are largely respiratory viruses, which are largely spread by droplets caused by the coughing and sneezing behaviours that are typical with infections of this sort. Talking and similar behaviours (singing etc) also cause droplets, just not as many as a sneeze.</p>\n<p>You might also have gone to a doctor with a sore throat and been diagnosed with &quot;<a href=\"https://en.wikipedia.org/wiki/Streptococcal_pharyngitis\" rel=\"nofollow noreferrer\">strep throat</a>&quot; or streptococcal pharyngitis, which is a bacterial infection of the throat usually caused by <em><a href=\"https://en.wikipedia.org/wiki/Streptococcus_pyogenes\" rel=\"nofollow noreferrer\">Streptococcus pyogenes</a></em>.</p>\n<p>There are also viruses and bacteria that infect other body systems, such as the gut, resulting in diarrhea and/or vomiting, but these are not typically the types that people associate with getting wet by rain or being cold, so I won't go into them.</p>\n<p>Now, I said earlier that I was going to talk about an association with being cold/wet and getting sick...</p>\n<p>One noticeable thing about rain and cold is that we tend to not enjoy it very much, so we shelter from it rather than stand around getting cold and wet. As an example, you might have seen people huddling in a bus stop or under an awning waiting for the rain to stop. One common feature of these events is that it puts people close together, which means that we are more likely to be able to pass along any illnesses we might have; especially those that are spread by droplets. This was the reason for the 2 metre/6 foot spacing rules that many countries implemented during the recent COVID pandemic. There's also some scientific evidence that <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2034399/\" rel=\"nofollow noreferrer\">cold weather</a>¹ and <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2651255/\" rel=\"nofollow noreferrer\">humidity</a>² play roles in survival of some the respiratory viruses outside the body.</p>\n<p>So, long story short: being cold and/or wet doesn't actually cause illness by itself, it just enhances transmission conditions so that you are more likely to get infected by a virus.</p>\n<p>Refs:</p>\n<ol>\n<li><p>Lowen AC, Mubareka S, Steel J, Palese P. Influenza virus transmission is dependent on relative humidity and temperature. PLoS Pathog. 2007 Oct 19;3(10):1470-6. doi: 10.1371/journal.ppat.0030151. PMID: 17953482; PMCID: PMC2034399.</p>\n</li>\n<li><p>Shaman J, Kohn M. Absolute humidity modulates influenza survival, transmission, and seasonality. Proc Natl Acad Sci U S A. 2009 Mar 3;106(9):3243-8. doi: 10.1073/pnas.0806852106. Epub 2009 Feb 9. PMID: 19204283; PMCID: PMC2651255.</p>\n</li>\n</ol>\n", "score": 2 }, { "answer_id": 32338, "body": "<p>TL;DR: no, standing under rain does not lead directly to being sick.</p>\n<hr />\n<p>As <a href=\"https://www.visitcompletecare.com/blog/can-you-get-sick-from-being-in-the-rain/\" rel=\"nofollow noreferrer\">this article</a> says:</p>\n<blockquote>\n<p>Contrary to popular belief, being out in the rain does not automatically make you sick. While the rain itself does not make you sick, it does play a role in how you could catch an illness</p>\n</blockquote>\n<p>This claim is done by health experts working in emergency rooms, hence credible enough in my opinion.</p>\n<p>The article then goes further to explain how rain might indirectly cause sickness, and ways to avoid it.</p>\n", "score": 1 } ]

[ "medical-myths", "fever" ]

[ { "answer_id": 32378, "body": "<p>The comment from @Carey Gregory is certainly correct. But why? Well, corporate attorneys have a responsibility to protect the corporation from lawsuits, even the frivolous, ridiculous, in complete defiance of logic complaints. I could imagine an attorney asked 'what would happen if someone splashed this distilled water in their eyes?'. The scientist would say 'nothing, it's just water'. The attorney, having experience with morons with access to opposing attorneys, says 'but what if someone deluged their eyes with this product for an hour straight?'. The scientist might say, 'well, that would probably cause some minor eye irritation to the moron because of the expected difference in pH of the distilled water versus the natural eye lubricant pH, but that would happen with plain tap water as well...'. To which the attorney would recommend a standard warning label including 'rinse eyes with water' to avoid having to deal with the future lawsuit for eye irritation caused by splashing distilled water into a moron's eyes. Yes, it's crazy, but so are people and their attorneys.</p>\n<p>Eye irritation can occur because of differences in the pH due to the cellular absorption of water in higher versus lower pH. Saline solution for wearers of contacts is buffered to a specific range of pH for this reason. The difference in pH values of distilled versus tap water can be seen here: <a href=\"https://www.medicalnewstoday.com/articles/327185#how-to-testhttps://www.medicalnewstoday.com/articles/327185#how-to-test\" rel=\"nofollow noreferrer\">https://www.medicalnewstoday.com/articles/327185#how-to-testhttps://www.medicalnewstoday.com/articles/327185#how-to-test</a> and here: <a href=\"https://sciencing.com/ph-distilled-water-4623914.html\" rel=\"nofollow noreferrer\">https://sciencing.com/ph-distilled-water-4623914.html</a></p>\n<p>Interestingly, in the second article, is the statement that &quot;Pure distilled water should be neutral with a pH of 7, but because it absorbs carbon dioxide from the atmosphere, it's actually slightly acidic with a pH of 5.8.&quot;. So, putting distilled water into your eyes is essentially putting acid into your eyes, in the perspective of a risk management-minded attorney.</p>\n<p>Personally, I would not rinse my eyes with anything except saline solution intended for eyes. If splashed with anything other than that saline solution, I would rinse with saline solution intended for eyes. But, thank you, to all the risk managers and attorneys out there protecting us from the morons.</p>\n", "score": 2 } ]

[ "water", "first-aid" ]

[ { "answer_id": 32406, "body": "<p>This might be the wrong place to post an answer (hypotheticals when writing are best posted on Worldbuilding.SE) but you don't seem to have a strong understanding of how &quot;pills&quot; (specifically pills given for a medical condition) work.</p>\n<p>Most medications for long-term medical problems take a few days to reach <em>steady state</em>, that is, a concentration in the blood where the amount of drug in circulation reaches the therapeutic range and stays there as long as the drug is taken. That essentially means that the amount taken in/absorbed is equal to the amount lost through metabolism and excretion. It usually takes about 5 doses of the drug to reach steady state; if the drug needs to reach steady state more quickly, a &quot;loading dose&quot; of the drug is given.</p>\n<p>The same is true of how quickly the drug falls out of the therapeutic range once it stops being taken. The drug isn't instantly out of your body when you miss a dose; it takes a while before it's subtherapeutic, and longer before it's eliminated completely.</p>\n<p>So it's unlikely that missing a dose would result in the illness suddenly manifesting itself after one missed dose. The &quot;patient&quot; should have enough time to get a prescription refill before something bad happens; no need for an IV injection of the drug.</p>\n<p>Most drugs, even in hospitalized patients, are given p.o. Where an immediate effect in needed (e.g. for pain control, to treat a serious infection, etc.) the drug is given IV initially. Besides drugs for pain, infection, serious allergic reactions, dangerously high blood pressure, fluid buildup in the lungs, cardiac dysrythmias, anesthesiology and a few other conditions/circumstances, I can't think of many drugs that would need to be given intravenously to be life-saving.</p>\n<p>_{<a href=\"https://www.northernhealth.ca/sites/northern_health/files/health-professionals/palliative-care/documents/hot-tip-steady-state.pdf\" rel=\"nofollow noreferrer\">What is “Steady State” and why is it important?</a>}</p>\n", "score": 3 } ]

[ "medications", "injections", "emergency" ]

[ { "answer_id": 643, "body": "<p>There are long-term medications, those that will get asthma under control:</p>\n\n<ul>\n<li>long-acting beta-agonists: bronchodilators, they open the airways</li>\n<li>leukotriene modifiers: they block the components that cause inflammation</li>\n<li>mast cell stabilizers: they prevent / reduce the release of chemicals (from your body) that cause inflammation</li>\n<li>theophylline: is a bronchodilator, used to prevent nighttime attacks</li>\n<li>immunomodulator: when you have asthma that is allergy-related and hasn't respond to inhaled medications</li>\n</ul>\n\n<p>Each kind has one or more available drugs, and each one can have different side effects, specially on the long term.</p>\n\n<p>(Sources: <a href=\"http://www.webmd.com/asthma/guide/asthma-medications#1\" rel=\"nofollow\">http://www.webmd.com/asthma/guide/asthma-medications#1</a> , <a href=\"http://www.drugs.com/condition/asthma.html\" rel=\"nofollow\">http://www.drugs.com/condition/asthma.html</a> , <a href=\"http://www.mayoclinic.org/diseases-conditions/asthma/in-depth/asthma-medications/art-20045557\" rel=\"nofollow\">http://www.mayoclinic.org/diseases-conditions/asthma/in-depth/asthma-medications/art-20045557</a>)</p>\n", "score": 3 } ]

[ "side-effects", "medications", "asthma" ]

[ { "answer_id": 1006, "body": "<p>Unfortunately, there is not much that can be done other than what you have mentioned. </p>\n\n<p>The present guidelines for the management would include watchful waiting, medical (alpha blockers) or surgical (trans urethral bladder neck incision or resection). However, the present literature lack significant amount of randomized controlled trials that would provide reliable evidence regarding the efficacy of these treatment options. Existing reports provide contradicting results as well. Even though there are <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/23412123\" rel=\"nofollow\">success stories</a> of complete cure by the trans urethral bladder neck resection, this still remains to be a topic where further exploration needs to be done regarding the natural history of the disease, and possible treatment modalities. </p>\n\n<p>References : <a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1477631/\" rel=\"nofollow\">Primary Bladder Neck Obstruction in Men and Women</a></p>\n", "score": 2 } ]

[ "urology" ]

[ { "answer_id": 1088, "body": "<p>The simple answer is no.</p>\n\n<blockquote>\n <p>[H]ernias seem to be very simple to fix if deal with early on.</p>\n</blockquote>\n\n<p>Very true; so easy that it's often an outpatient procedure.</p>\n\n<p>\"Strapping\" (or belting) hernias has been done in one form or another for centuries. It's fine for people who have relatively small hernias that are asymptomatic. However, it's not a cure. The separation of the abdominal wall muscle is permanent (it's caused by either an inherent weakness at birth, and/or repetitive stress).</p>\n\n<p>For inguinal hernias, watchful waiting (deferring surgery until it's necessary due to pain or other symptoms) is a perfectly acceptable way to \"treat\" hernias. Though there is considerable crossover to surgery, in one study, men have been watched for more than 11 years without any mortality and only 2 emergency repairs in a group of 254 men with inguinal hernias. The limitations are on lifting, activities, diet, constipation and other factors; many of the hernias become more painful with time.</p>\n\n<p>_{<a href=\"https://www.facs.org/~/media/files/education/patient%20ed/hernrep.ashx\" rel=\"nofollow\">More than you ever wanted to know about hernia repairs</a>}<br>\n_{<a href=\"http://www.ncbi.nlm.nih.gov/pubmed/24022443\" rel=\"nofollow\">Long-term results of a randomized controlled trial of a nonoperative strategy (watchful waiting) for men with minimally symptomatic inguinal hernias.</a>}<br>\n_{<a href=\"http://www.ncbi.nlm.nih.gov/pubmed/21239979\" rel=\"nofollow\">A clinician's guide to patient selection for watchful waiting management of inguinal hernia</a>}<br>\n_{<a href=\"http://www.ncbi.nlm.nih.gov/pubmed/22430913\" rel=\"nofollow\">Management of asymptomatic inguinal hernia: a systematic review of the evidence.</a>}</p>\n", "score": 2 } ]

[ "surgery" ]

[ { "answer_id": 1241, "body": "<p><strong>Firstly is it definitely eczema and is it only eczema?</strong></p>\n\n<p>The discharge of pus suggests a bacterial infection (probably staphylococcal). Now this could be superimposed on eczema (which causes the skin barrier to break down causing an infection) or simply just a skin infection/abscess. Either way, if it really is an infection this usually requires antibiotics. Thus you should see a doctor.</p>\n\n<p><strong>If it is eczema, once the infection is treated:</strong></p>\n\n<ul>\n<li>Self care techniques - is there a trigger? Avoid it and avoid as much as possible the compulsion to itch</li>\n<li>Steroid creams - these reduce the inflammation and are very helpful</li>\n<li>Moisturising creams - these maintain the skin barrier. Use them for a long period of time even when the skin looks completely healthy</li>\n</ul>\n", "score": 0 } ]

[ "dermatology" ]

[ { "answer_id": 1622, "body": "<p>Changing a sleep cycle, especially drastically, takes time for you body to adjust to. It's pretty self induced jetlag and you're trying to yank your entire circadian rhythm to another setup. According to <a href=\"http://www.webmd.com/sleep-disorders/excessive-sleepiness-10/jet-lag-remedies\" rel=\"nofollow noreferrer\">webmd</a>, and <a href=\"https://www.quora.com/How-long-does-it-typically-take-to-recover-from-jet-lag\" rel=\"nofollow noreferrer\">answers on Quora</a>, jetlag can last 4-5 days, but varies by person and time adjustment. (Three days was almost there!)</p>\n<p>Your circadian rhythm, sleep playing a large part, entails a lot of aspects, all which need to adjust to a different sleep schedule. Consider how your eating, exercise, and the rest of your daily rhythm comes into play.</p>\n<p>Lastly, consider using other sleep hacks to help adjust. Searching for adjusting to jetlag will provide plenty of tips. Here's a really long answer I wrote on Cognitive Sciences Stack Exchange on <a href=\"https://cogsci.stackexchange.com/a/7917/2893\">sleep hacks</a>.</p>\n<p>Best of luck!</p>\n", "score": 2 } ]

[ "sleep" ]

[ { "answer_id": 3599, "body": "<p>The number seems to be somewhere between 4 and 10 times larger as with no umbilical cord knot present. </p>\n\n<p>In a study of 70000 births, umbilical cord knots occurred in 1.2 percent of births. The fetal death rate in these births was four times higher than for the control group without knots, at 1.9 percent of births. </p>\n\n<p><a href=\"http://www.sciencedirect.com/science/article/pii/S0301211501003128\" rel=\"nofollow\">Risk factors associated with true knots of the umbilical cord</a></p>\n\n<p>In another study, on 20000 births, a 10 times increased risk of intrauterine death was found. </p>\n\n<p><a href=\"http://www.tandfonline.com/doi/abs/10.1080/j.1600-0412.2000.079003157.x\" rel=\"nofollow\">Umbilical cord knots</a></p>\n\n<p>In yet another study, for around 27000 births, an eight fold increase in fetal death was found. \n<a href=\"http://www.ijgo.org/article/S0020-7292(13)00129-X/abstract\" rel=\"nofollow\">True umbilical cord knot and obstetric outcome</a></p>\n\n<p>Umbilical cord knots can sometimes be determined by ultrasound before delivery. If a cord knot is found, a C-section is performed. </p>\n\n<p>According to the first study, risk factors appear to be </p>\n\n<blockquote>\n <p>gestational diabetes, hydramnios, patients undergoing genetic amniocentesis, male fetuses</p>\n</blockquote>\n", "score": 1 } ]

[ "statistics" ]

[ { "answer_id": 1886, "body": "<p>There are multiple questions here so I'll tackle them one by one. </p>\n\n<p>Your initial question: Can a gummy bear give me diabetes?</p>\n\n<p>One giant gummy bear, alone, is very unlikely to give you diabetes. I don't want to say indefinitely, because nothing in health is a definite. However, the likely hood is so close to 0% I would consider it insignificant. </p>\n\n<p>Next, you stated that immediately following the ingestion of a cute gummy bear, you felt tired and the next morning your breathe smelled sweet. </p>\n\n<p>The reason for both of these symptoms can very well be due to your sugar levels becoming drastically high. In the medical field, we call this DKA. (Diabetic ketoacidosis). Essentially, your body recognizes a sharp increase in blood glucose levels and is trying everything in the books to expel the glucose. Your body does this by releasing ketones from your respiratory system. DKA is most notably recognized by sweet smelling breathe. Almost like juicy fruit gum.</p>\n\n<p>DKA can actually be a very serious emergency which, if unchecked, can lead to a diabetic coma. However, for individuals without diabetes, and a properly working pancreas, your sugar levels should be back to normal by now. </p>\n\n<p>I believe your incident with the cough is completely unrelated. </p>\n\n<p>To recap. No I do not think you have developed diabetes due to a single gummy bear. However, it never hurts to be checked for the disease. You could very well already have diabetes, and the gummy bear threw you into DKA. Because I cannot see you, nor properly perform any tests. To cover myself for any legal issues I will say that 1. I am not a doctor and 2. Go get it checked. </p>\n\n<p>In regards to telling your parents. Just say you had some candy and you felt really weird afterwards and you're nervous that you might have diabetes. Any sensible parent will at least set you up with a doctors appointment. </p>\n\n<p>Rich\nAEMT</p>\n\n<p>Source:\n<a href=\"http://www.diabetes.org/living-with-diabetes/complications/ketoacidosis-dka.html\" rel=\"nofollow\">http://www.diabetes.org/living-with-diabetes/complications/ketoacidosis-dka.html</a></p>\n", "score": 2 } ]

[ "diabetes", "vomit" ]

[ { "answer_id": 1913, "body": "<p>This could be many, many different things, common causes include neck problems, migraines can be brought on by <a href=\"http://www.mayoclinic.org/symptoms/headache/basics/causes/sym-20050800\" rel=\"nofollow\">stress and/or trigger foods, dehydration and skipped meals</a>, anxiety about receiving food brought by others could also be a big trigger. High blood pressure can also cause regular headaches, and it can be a side-effect of medications and caused bby alcohol or drugs. Too many painkillers can also cause rebound headaches. </p>\n\n<p>Worries that others are trying to poison you can be caused by some mental health conditions, examples of <a href=\"http://news.bbc.co.uk/1/hi/health/412061.stm\" rel=\"nofollow\">paranoia include fear of food/drink being poisioned</a>, paranoia can occur on its own, or in schizophrenia spectrum disorders, borderline personality disorder, even depression and anxiety can include some paranoia. That doesn't mean that the headaches are not there - it just means that other people are not deliberately causing them. </p>\n\n<p>Some medications can have paranoia as a side effect. It could be that the headaches have a different cause than poisioning, and that nobody is trying to harm you.</p>\n\n<p>Things can you try to help work out what is happening:</p>\n\n<ul>\n<li><p>get a <strong>basic health checkup</strong> - this is the most important thing you can do and probably won't involve expensive things like blood tests but will quickly check the most common causes of headaches</p></li>\n<li><p>record your recent medication history, including whether any have changes since symptoms began - do not stop drugs, just keep the record update if anything changes, some medication can make you very ill if you suddenly stop it</p></li>\n<li>avoid alcohol, smoking and drugs that aren't prescribed by a doctor (like cocaine, cannabis, diet pills) </li>\n<li>check the 'patient information' for your medications, and how common each side effect is, psych med details can be found <a href=\"http://crazymeds.us\" rel=\"nofollow\">here</a> - written by the people taking the meds - nobody gets every symptom</li>\n<li>get your blood pressure and eyesight checked, quick and cheap - a basic health check will do this</li>\n<li>see if you have pain or stickness around your neck which might be causing it or contributing to it, see a physiotherapist or try yoga etc</li>\n<li>add monitoring your stress levels to your food/drink diary</li>\n<li>check your food/drink diary against common trigger foods for headaches, including snacks like chocolate and drinks like coffee</li>\n<li>ask if anyone else in your house gets regular headaches, or if any blood relatives do, and if they know the reason</li>\n<li>talk to your relatives about your worries that the food or drink is triggering your headaches, and how to fix it</li>\n</ul>\n\n<p>I really, really think you should get a basic medical health check as soon as you can. Things like blood pressure only take 5 minutes to check and many people with headaches, and many people with mental health problems in the past <a href=\"http://www.rethink.org/living-with-mental-illness/wellbeing-physical-health/health-checks/what-gets-checked\" rel=\"nofollow\">don't get regular health checks</a>. </p>\n", "score": 2 } ]

[ "headache", "food-poisoning", "poison" ]

[ { "answer_id": 2030, "body": "<p>For Yoga, <a href=\"http://www.artofliving.org/surya-namaskar-sun-salutation12-poses-leaner-you\" rel=\"nofollow\">modern science says</a> do 54 sets = 108 reps of Surya Namaskar. Of course you need to <a href=\"http://timesofindia.indiatimes.com/life-style/health-fitness/health-news/Whats-your-Surya-Namaskar-count/articleshow/5778365.cms\" rel=\"nofollow\">gradually build your stamina to increase reps</a>.</p>\n\n<p>My great-grandfather did 2 hours of yoga in morning, and lived to nearly 100 years. Also ate nuts, fruits, teas, water. This is according to my dad. Not <a href=\"http://www.huffingtonpost.com/2014/12/08/science-embraces-ancient-indian-wisdom_n_6250978.html\" rel=\"nofollow\">modern science</a>, just things about family members that get passed down from generation to generation :-)</p>\n\n<p><a href=\"http://www.heart.org/HEARTORG/GettingHealthy/PhysicalActivity/FitnessBasics/American-Heart-Association-Recommendations-for-Physical-Activity-in-Adults_UCM_307976_Article.jsp\" rel=\"nofollow\">According to American Health Association</a></p>\n\n<blockquote>\n <p>AHA Recommendation</p>\n \n <p>For Overall Cardiovascular Health:</p>\n \n <p>At least 30 minutes of moderate-intensity aerobic activity at least 5\n days per week for a total of 150</p>\n \n <p>OR At least 25 minutes of vigorous aerobic activity at least 3 days\n per week for a total of 75 minutes; or a combination of moderate- and\n vigorous-intensity aerobic activity</p>\n \n <p>AND Moderate- to high-intensity muscle-strengthening activity at least\n 2 days per week for additional health benefits.</p>\n \n <p>For Lowering Blood Pressure and Cholesterol An average 40 minutes of\n moderate- to vigorous-intensity aerobic activity 3 or 4 times per week</p>\n</blockquote>\n", "score": 2 } ]

[ "exercise" ]

[]

[ "pain", "back", "muscle" ]

[ { "answer_id": 4648, "body": "<p>I have found that I did not have weak quads but that my abs were not doing enough work and this was placing more stress on my left quad initially which became injured and placed more stress on my right quad subsequently.</p>\n\n<p>The injury was occurring from my <strong>teeth</strong>. I have realised, from consultation with a qualified physiotherapist and wearing a mouth guard, that I tend to bite or grind my teeth throughout the day and hold my breath. This closes my airways. Over a long period of time this has negative effects on my abs as my lungs are not expanding to their potential and in turn not keeping my abs activated. My abdominal muscles, particularly on my right side due to there being more internal organs on that side of the body, were shuting off.</p>\n\n<p>Wearing the mouthguard, and undertaking daily short exercises to work my abs particularly the left side of my body, has reactivated my left lower abs and my left glute muscles. This has reduced the workload on my quads, because my glutes and abs are doing more of the work, and has returned myself to the condition I was in before</p>\n", "score": 0 } ]

[ "injury", "sports", "sitting" ]

[ { "answer_id": 17327, "body": "<p>Please see the possible treatments for alopecia areata:</p>\n\n<ul>\n<li>First-line therapies \n\n<ul>\n<li>Intralesional corticosteroids </li>\n<li>Topical corticosteroids</li>\n<li>Minoxidil Anthralin </li>\n<li>Topical immunotherapy</li>\n<li>Prostaglandin analogs </li>\n<li>Topical retinoids </li>\n<li>Bexarotene Capsaicin</li>\n</ul></li>\n<li>Second-line therapies (if first-line ones are not effective)\n\n<ul>\n<li>Sulfasalazine </li>\n<li>Photochemotherapy </li>\n<li>Excimer laser</li>\n<li>Fractional photothermolysis laser </li>\n</ul></li>\n<li>Third-line therapies (if second-line ones are not effective)\n\n<ul>\n<li>Systemic corticosteroids </li>\n<li>Methotrexate </li>\n<li>Cyclosporine </li>\n<li>Azathioprine </li>\n<li>Biologics</li>\n</ul></li>\n</ul>\n\n<p>The detailed information you can get in <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3149478/\" rel=\"nofollow noreferrer\">\"Alopecia areata: a new treatment plan\" by Adel Alsantali in <em>Clinical, Cosmetic &amp; Investigative Dermatology</em></a>.</p>\n", "score": 0 } ]

[ "hair", "hairloss", "injections", "facial-hair" ]

[ { "answer_id": 3402, "body": "<p>I found a lead that may provide you with a practitioner in California that offers the treatment you are looking for.</p>\n<blockquote>\n<p>MISforWomen.com provides patients with complete access to AAGL’s Physician Finder, a comprehensive database of our more than 7,500 members. Finding a surgeon who specializes in minimally invasive surgery has never been easier with this excellent, easy-to-use physician search engine.</p>\n<p>AAGL – Advancing Minimally Invasive Gynecology Worldwide\n6757 Katella Avenue | Cypress, CA 90630\n(800) 554-2245 | (714) 503-6200</p>\n</blockquote>\n<p><a href=\"https://www.aagl.org/jmig/journal-spotlight-co2-laser-treatment-for-bartholin-gland-abscess-ultrasound-evaluation-of-risk-recurrence-2/\" rel=\"nofollow noreferrer\">https://www.aagl.org/jmig/journal-spotlight-co2-laser-treatment-for-bartholin-gland-abscess-ultrasound-evaluation-of-risk-recurrence-2/</a></p>\n<p><a href=\"https://www.aagl.org/service/patient-outreach/\" rel=\"nofollow noreferrer\">https://www.aagl.org/service/patient-outreach/</a></p>\n", "score": 1 } ]

[ "treatment", "treatment-options", "laser" ]

[ { "answer_id": 3540, "body": "<p>Yes. There are a number of diseases that can be transmitted by rodents, and several of them can be quite serious. This is the list of diseases that can be <em>directly</em> transmitted by rodents according to the <a href=\"http://www.cdc.gov/rodents/diseases/direct.html\">CDC</a>:</p>\n\n<blockquote>\n <ul>\n <li>Hantavirus Pulmonary Syndrome</li>\n <li>Hemorrhagic Fever with Renal Syndrome</li>\n <li>Lassa Fever</li>\n <li>Leptospirosis</li>\n <li>Lymphocytic Chorio-meningitis (LCM)</li>\n <li>Omsk Hemorrhagic Fever</li>\n <li>Plague</li>\n <li>Rat-Bite Fever</li>\n <li>Salmonellosis</li>\n <li>South American Arenaviruses (Argentine hemorrhagic fever, Bolivian hemorrhagic fever, Sabiá-associated hemorrhagic fever, Venezuelan<br>\n hemorrhagic fever)</li>\n <li>Tularemia</li>\n </ul>\n</blockquote>\n\n<p>This is not to say that any given rat or mouse might transmit any of these. Other factors come into play, such as which diseases are endemic to the area and which diseases infect which species. On the link above you can expand each disease to see which rodents can transmit it. Unfortunately, rats and mice are included in most of those diseases.</p>\n", "score": 5 } ]

[ "health-informatics", "infectious-diseases" ]

[ { "answer_id": 19370, "body": "<p>Pros are</p>\n\n<ul>\n<li>better treatment (e.g., IL-5 inhibitor will not help if you do not have a subtype of asthma that is eosinofilic) (by knowing your type the therapy will be more targeted at your subtype of disease)</li>\n</ul>\n\n<p>Cons are</p>\n\n<ul>\n<li>more complex diagnostic workup to arrive at personalized care (e.g., must get sequencing results to recommend best action for Lynch syndrome)</li>\n</ul>\n", "score": 1 } ]

[ "health-informatics" ]

[ { "answer_id": 3689, "body": "<p>SE participant Ivo Beckers provided the key to this answer. He pointed out that the Big Mac typically only has one piece of cheese, not two.</p>\n\n<p>So the big caloric differences are that the Big Mac has an extra half of a bun and \"special sauce\", whereas the Quarter Pounder with Cheese has an extra slice of cheese, 0.8oz more beef, and ketchup.</p>\n\n<p>Those differences offset each other evenly.</p>\n\n<p>Why did the McDonald's employee tell me the Big Mac has two slices of cheese? Well, either that restaurant makes it different, or the information he provided was erroneous.</p>\n\n<p>In researching this question and answer, I learned some interesting facts according to the <a href=\"http://www.mcdonalds.com/us/en/food/product_nutrition.burgerssandwiches.5.big-mac.html\" rel=\"nofollow\">McDonald's nutrition information for the Big Mac</a> and the <a href=\"http://www.mcdonalds.com/us/en/food/product_nutrition.burgerssandwiches.7.quarter-pounder-with-cheese.html\" rel=\"nofollow\">Quarter Pounder with Cheese</a>:</p>\n\n<ul>\n<li>McDonald's \"special sauce\" contains 90 calories per 0.6oz, whereas the ketchup contains only 20 calories for the same quantity (and the mustard has zero calories).</li>\n<li>McDonald's \"special sauce\" contains <strong>high fructose corn syrup</strong>, <strong>corn syrup</strong>, and <strong>sugar</strong>.</li>\n<li>McDonald's ketchup contains <strong>high fructose corn syrup</strong> and <strong>corn syrup</strong>.</li>\n<li>McDonald's sesame seed buns contain <strong>high fructose corn syrup</strong>.</li>\n<li>Even though the Big Mac has less beef than the Quarter Pounder with Cheese (2.2oz vs 3oz), its beef has more salt (250mg vs 190mg). However, the Quarter Pounder with Cheese has more overall salt largely due to the extra slice of cheese (1110mg of sodium vs. 970mg).</li>\n<li>Both the Big Mac and the Quarter Pounder with Cheese contain <strong>trans fat</strong>.</li>\n</ul>\n\n<p>Note that the McDonald's health and nutrition information website is excellent and is largely a model of how to effectively and clearly provide nutrition information. You can add and subtract each ingredient to see how it affects the nutrition information.</p>\n\n<p>I did find an possible error in it, however. When I view the <a href=\"http://www.mcdonalds.com/us/en/food/product_nutrition.burgerssandwiches.7.quarter-pounder-with-cheese.html\" rel=\"nofollow\">nutrition information for the Quarter Pounder with Cheese</a> and remove all ingredients except for the beef patties, their website shows they have a total of 1g of <strong>trans fat</strong>. When I do the same for the \"Pasteurized Process American Cheese\", it says the cheese has 0g of <strong>trans fat</strong>. Yet, when I put the two ingredients together, the <strong>trans fat</strong> jumps to 1.5g. I'm not sure if this is a special McMath, a rounding issue, or a genuine McError.</p>\n", "score": 1 } ]

[ "diet", "calories", "labeling" ]

[ { "answer_id": 4153, "body": "<p>In general, any medical procedure that is not prescribed and performed by a health care professional has to be regarded as unsafe. Basically, in medicine everything is assumed to be unsafe until it is proven to be safe. You can consider what the potential problems with this procedure would be that would likely be looked at first before it could ever become accepted practice. E.g. you can consider what would happen if lime juice accidentally enters your lungs, you could look into the risk of <a href=\"https://en.wikipedia.org/wiki/Aspiration_pneumonia\" rel=\"nofollow\">aspiration pneumonia</a> or nasal bleeding due to irritation as mentioned by user19679 in the comments.</p>\n\n<p>Since there may be other adverse health effects that a priori are hard to identify, the only way to know that a proposed treatment is safe and effective is to do clinical trials and publish the results in a scientific journal. This is the start of the process in which the proposed treatment can be evaluated in scientifically rigorous way.</p>\n\n<p>At the end of the process there will have been independent groups repeating such trials, review papers will have been published that have looked at all the results of this particular treatment and compared the results to other treatments. If the treatment has been found to be a viable treatment that can be used under certain circumstances, then there will be been guidelines for doctors about using this treatment that are based on such review articles. </p>\n", "score": 2 } ]

[ "home-remedies" ]

[ { "answer_id": 4241, "body": "<p>I think you are misunderstanding what that sentence says - as I interpret it it means that the posterior discs from C3 <strong>to</strong> C7 are bulging. So all five of them, C3/4/5/6/7 (or rather, the four discs between them) are affected. </p>\n", "score": 4 } ]

[ "spine", "cervical-vertebrae-cv", "posterior-bulging-discs" ]

[ { "answer_id": 4265, "body": "<p>Yes, certainly. The human body has several systems which are separated from each other such that fluids cannot freely move between them, and the pressure within each is maintained in a very precise manner. </p>\n\n<p>Examples which come to mind are the cardiovascular system (which has variable pressure all the time, but it also varies in a strictly controlled way), the eye, the inner ear, and the brain ventricles and other parts of the nervous system which are bathed by the cerebrospinal fluid. Whenever the pressure of one of those is disregulated, the health consequences are severe: <a href=\"https://en.wikipedia.org/wiki/Hypertension\" rel=\"nofollow\">hypertension</a>, <a href=\"https://en.wikipedia.org/wiki/Glaucoma\" rel=\"nofollow\">glaucoma</a>, <a href=\"https://en.wikipedia.org/wiki/M%C3%A9ni%C3%A8re&#39;s_disease#Cause\" rel=\"nofollow\">endolymphatic hydrops</a> or <a href=\"https://en.wikipedia.org/wiki/Intracranial_pressure\" rel=\"nofollow\">intercranial hypertension</a> respectively. This list is not comprehensive, it just gives a few examples for better understanding. </p>\n\n<p>When you have a small wound, the vascular system gets opened, but there is very little blood flow through the peripheral vessels affected, and the body clots it quickly enough that it does not bleed out. If you get a large tear in a major blood vessel, then the blood pressure can indeed lead the body to <a href=\"https://en.wikipedia.org/wiki/Blood_squirt\" rel=\"nofollow\">bleed out</a>. </p>\n\n<p>If you get a large wound directly into the eye, pleural cavity, cranium or labyrinth(!), a pressure differential is not your main problem. </p>\n", "score": 1 } ]

[ "wound" ]

[ { "answer_id": 4268, "body": "<p>If you are worried about the sodium: </p>\n\n<blockquote>\n <p>WHO recommends a reduction to &lt;2 g/day sodium (5 g/day salt) in adults (strong recommendation).</p>\n</blockquote>\n\n<p>from the \"Sodium intake for adults and children\" guideline by the World Health Organisation. This is for healthy adults, sick people may need further restriction. </p>\n\n<p>This means that ~15 grams of these wings would hit your daily sodium intake alone. Since you are probably consuming more than 2 g sodium daily even when you leave out the wings (2 g sodium is somewhat hard to get to even if you watch your intake), chances are that you need to cut out some intake source if you want to match the recommendation. The wings might be the easiest thing, as I doubt that any other food in your diet could reach 12% sodium. </p>\n\n<p>If you are asking not about sodium, but for any potential health effect on you ever, which might occur from you changing your habits to not eat these wings? That's an unanswerable question.</p>\n", "score": 2 } ]

[ "diet", "cholesterol" ]

[ { "answer_id": 4275, "body": "<p>Probably not. </p>\n\n<p>Few things that people can check by just looking at their own blood under the microscope, if they take some time to learn the skill. Counting red and white blood cells, for example. But without a lot of practice, those numbers could be very wrong. Also, you probably won't be able to differentiate between the types of white blood cells. </p>\n\n<p>There are also some things that can be done using tests that you can buy at a pharmacy (and maybe even a supermarket), for example blood sugar. These are usually very easy to use so people can use them at home. When in doubt, ask a pharmacist or doctor. </p>\n\n<p>Some bacteria can be stained and identified with equipment that can be purchased from specialised businesses. Again, this takes practice. It's easy to get something wrong. </p>\n\n<p>And unless we are talking about diabetes or leukemia, both of which would also show up when being tested at a doctor's office, these tests are not helpful in your scenario. Almost all other medical tests, like testing antibodies, hormones, vitamins, CRP, need specialized lab equipment and people with training. </p>\n\n<p>There would be the possibility of taking blood and having it analyzed later. But while <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/22823600\" rel=\"nofollow\">blood can be stored in a cold environment and analyzed later</a> (most doctor's offices I know only deliver to a lab once a day, storing the blood in a fridge before that), most people aren't trained at taking whole vials of blood, and even people who are don't usually take their own blood. </p>\n\n<p>The patient's best bet in this scenario is to have some doctor take the blood while the symptoms are occurring and send the sample to the lab. Doesn't necessarily have to be the treating specialist - one of mine is 70 kilometers away, so I have my blood tests done by my GP I can walk to. </p>\n\n<p>As a bit of an aside, I have a hard time coming up with anything that would show up in the blood sample while showing symptoms, but fail to show up in one taken a few hours later after symptoms subside. Then again, I am not a doctor.</p>\n", "score": 1 } ]

[ "blood-tests", "blood" ]

[ { "answer_id": 4301, "body": "<p>Why stick to only one type of fruit? One day you have an apple and a guava the next. After all, each fruit has it's own set of benefits and they are all good for your health. No fruit is considered bad to consume right? And if you are only looking to fill up your energy meter and to satiate your mid-afternoon cravings, bananas are an excellent choice as they are high in calories and are very effective in eliminating hunger.</p>\n", "score": 1 } ]

[ "fruits" ]

[ { "answer_id": 4530, "body": "<p>For <em>every individual situation</em>, one must weigh the risks vs. the benefits. If the potential or actual benefits outweigh the potential or actual risks, <strong>and the situation calls for ibuprophen</strong>, you take the medication.</p>\n\n<p>If the potential benefits don't outweigh the potential risks, you don't take the medication.</p>\n\n<p>The risks vary from individual to individual and from situation to situation.</p>\n\n<p>There is no blanket answer to your question.</p>\n\n<p>_{A Review of Quantitative Risk–Benefit Methodologies for Assessing Drug Safety and Efficacy—Report of the ISPOR Risk–Benefit Management Working Group, J. Guo et al, <em>Value in Health</em>, Volume 13, Issue 5, APR 2010}</p>\n", "score": 3 } ]

[ "first-aid", "practice-of-medicine" ]

[ { "answer_id": 5043, "body": "<p>The count of melanocytes per square mm depends on the body region and 1500 seems to be the upper limit. Interestingly <a href=\"http://www.histology.leeds.ac.uk/skin/pigmentation.php\" rel=\"nofollow\">in different races, the number of melanocytes is THE SAME.</a></p>\n\n<blockquote>\n <blockquote>\n <p>Quoting from:<a href=\"http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0040377\" rel=\"nofollow\">Understanding the Melanocyte Distribution in Human Epidermis: An Agent-Based Computational Model Approach</a></p>\n </blockquote>\n \n <p>The skin color in young and healthy individuals is remarkably uniform.\n A major reason for this is that the melanocytes are evenly distributed\n throughout the basal layer of the epidermis. The density of\n melanocytes varies with the body site from around 900 melanocytes per\n square mm on the back to around 1500 melanocytes per square mm in the\n genital region.</p>\n</blockquote>\n", "score": 3 } ]

[ "dermatology", "measurement", "melanin" ]

[ { "answer_id": 5141, "body": "<p><a href=\"http://www.webmd.com/skin-problems-and-treatments/bleeding-under-nail\" rel=\"nofollow\">Yes, this is normal behavior</a> for a bruise underneath the nail. (<a href=\"http://www.nursingtimes.net/selecting-a-treatment-option-in-subungual-haematoma-management/201396.fullarticle\" rel=\"nofollow\">Corroborating information</a>, located near the bottom of the article.)</p>\n\n<p>Most bruises under a nail are caused by a crush type injury. In severe cases, there may be enough blood to separate the nail from the nail bed, or it may need professional drainage and treatment (Such as suturing and/or removing the nail).</p>\n\n<p>If it is a small spot, then as the nail grows, the hematoma will move with it as the blood is trapped between the bed and the nail. If you have a bruise appearing spot underneath the nail that is unrelated to any injury, or does not move outwards with the growth of the nail it is best to get it checked out, as those are warning signs of it being a tumor.</p>\n", "score": 1 }, { "answer_id": 5139, "body": "<p>Yep. It is actually. Look at this time lapse. \n<a href=\"https://media.giphy.com/media/l2JJLwLjtZVnhuKKA/giphy.gif\" rel=\"nofollow\">https://media.giphy.com/media/l2JJLwLjtZVnhuKKA/giphy.gif</a></p>\n", "score": 0 } ]

[ "nails", "bruising-bruise", "thumb" ]

[ { "answer_id": 5137, "body": "<p>The Activated Partial Thromboplastin Time is a test measuring clotting factors, not a level of clotting factors in your blood. It is most often used to monitor the effects of heparin therapy (an anticoagulant.)</p>\n\n<p>Because different labs use different tests, the \"normal\" results may vary. The results are reported in seconds; for example the Mayo Clinic reports </p>\n\n<blockquote>\n <p>the <em>therapeutic</em> APTT range to be approximately 70 to 120 seconds. </p>\n</blockquote>\n\n<p>There is a limit for how long the reaction will be observed (if the blood doesn't clot in a reasonable amount of time, people need to report that as \"negative at (upper threshold in seconds for institution.)\"</p>\n\n<p>You might want to review the lab report. </p>\n\n<p>_{<a href=\"http://www.mayomedicallaboratories.com/test-catalog/Clinical+and+Interpretive/9058/Clinical+and+Interpretive/9058\" rel=\"nofollow\">Activated Partial Thromboplastin Time (APTT), Plasma</a>}<br>\n_{<a href=\"http://www.ncbi.nlm.nih.gov/pubmed/22586049\" rel=\"nofollow\">Recommendations for appropriate activated partial thromboplastin time reagent selection and utilization.</a>}</p>\n", "score": 2 } ]

[ "blood", "blood-tests" ]

[ { "answer_id": 5235, "body": "<p>In <a href=\"http://www.nejm.org/doi/full/10.1056/NEJM199801293380503\" rel=\"nofollow\">Fulminant Hepatitis Associated with Hepatitis A Virus Superinfection in Patients with Chronic Hepatitis C</a>, out of 17 patients with chronic hepatitis C infection who also got infected with hepatitis A, 6 died, so about one third. </p>\n\n<p>In an <a href=\"http://www.nejm.org/doi/full/10.1056/NEJM199806113382413\" rel=\"nofollow\">Italian population based study</a>, 77 patients with chronic hepatitis C (52 with hepatitis C, 25 with hepatitis C and hepatitis B) also got infected with hepatitis A. None died from the hepatitis A infection. This is a published letter to the journal the first study appeared in - the researchers from Italy wrote in because they were surprised by the high mortality rate in the US study, as they had seen no such correlation. </p>\n\n<p><a href=\"http://www.ncbi.nlm.nih.gov/pubmed/22371026\" rel=\"nofollow\">Hepatitis A virus vaccination in persons with hepatitis C virus infection: consequences of quality measure implementation</a> pooled data from 10 studies and puts the mortality rate for hepatitis C patients with a hepatitis A superinfection at around 7 percent (95 percent confidence interval: 1.24-42.12) </p>\n\n<p>That figure of 85 percent dying that the TV show <em>House MD</em> mentioned is made up. </p>\n\n<p>Vaccination against hepatitis A is recommended for chronic hepatitis C patients by </p>\n\n<ul>\n<li>the <a href=\"http://www.who.int/mediacentre/factsheets/fs164/en/\" rel=\"nofollow\">World Health Organization</a></li>\n<li><a href=\"http://www.cdc.gov/vaccines/vpd-vac/hepa/in-short-adult.htm#who\" rel=\"nofollow\">the CDC</a> </li>\n<li>and <a href=\"http://www.nhs.uk/Conditions/Hepatitis-A/Pages/Vaccination.aspx\" rel=\"nofollow\">the NHS</a></li>\n</ul>\n", "score": 3 } ]

[ "hepatitis", "health-education" ]

[ { "answer_id": 5371, "body": "<p>Nothing out of the ordinary, unless it is subjected to testing. Anything proposed outside of what is known about oral health and saliva is simply hypothesis. </p>\n\n<p>Oral health could be influenced by diet (eating certain foods are less likely to feed oral bacteria), fluid consumption, salivary flow, or any number of things.</p>\n\n<p>_{<a href=\"http://www.thejpd.org/article/S0022-3913%2801%2954032-9/abstract\" rel=\"nofollow\">A review of saliva: Normal composition, flow, and function</a>}</p>\n", "score": 4 }, { "answer_id": 5369, "body": "<p>That the saliva has anti-bacterial compunds in it? It also maintains a certain pH in the mouth.</p>\n\n<p>Anyways the lack of bacterial build up and odor says more about the person's diet though.</p>\n", "score": 0 } ]

[ "bacteria" ]

[ { "answer_id": 5433, "body": "<p>Inflammatory chemicals released into an inflamed joint stimulate pain receptors even at rest:</p>\n\n<blockquote>\n <p>Proinflammatory cytokines such as tumor necrosis factor-alpha, interleukin-1beta, interleukin-6 and interleukin-17 are also mediators of pain by directly acting on the nociceptive system. Proportions of nociceptive sensory neurons express receptors for these cytokines, and the application of cytokines rapidly changes the excitability, ion currents and second messenger systems of these neurons. By inducing persistent sensitization of nociceptive sensory neurons (C- and a proportion of Aδ-fibers) for mechanical stimuli in the joint (a process called peripheral sensitization), these cytokines significantly contribute to the persistent hyperalgesia typical for many disease states of the joint. In addition, the disease-associated release of cytokines in the spinal cord supports the generation of central sensitization. </p>\n</blockquote>\n\n<p><a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4289196\" rel=\"nofollow\">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4289196</a></p>\n", "score": 2 } ]

[ "pain", "tendons", "muscle" ]

[ { "answer_id": 5434, "body": "<p>If the person is well, and investigations show no structural defects, then:</p>\n\n<blockquote>\n <p>Early-onset cardiac conduction defects in the absence of structural heart disease should prompt consideration of CCD genetic testing, especially if a positive family history of conduction abnormalities and pacemaker implants is identified.</p>\n</blockquote>\n\n<p><a href=\"http://m.europace.oxfordjournals.org/content/13/8/1077.long?view=long&amp;pmid=21810866\" rel=\"nofollow\">HRS/EHRA Expert Consensus Statement on the State of Genetic Testing for the Channelopathies and Cardiomyopathies </a></p>\n\n<p>Some other causes not age specific some of which are listed <a href=\"http://lifeinthefastlane.com/ecg-library/basics/bifascicular-block/\" rel=\"nofollow\">here</a> include ischemic heart disease, cardiomyopathies, hypertension, aortic stenosis, Lev’s disease, hyperkalemia, congenital heart disease, sarcoid cardiomyopathy, Chagas disease, and scleroderma. </p>\n", "score": 1 } ]

[ "cardiology", "asymptomatic" ]

[ { "answer_id": 5477, "body": "<p>This is a specific instance of where a physician has ordered a diagnostic test, and after agreeing to do the same, the patient decides for whatever reason not to adhere to their original commitment. The health implications obviously vary depending on what the underlying diagnosis is, and in some jurisdictions some physicians <a href=\"http://www.c2law.com/links/articles/breast-cancer-litigation-when-is-the-physician-liable/\" rel=\"nofollow\">may be penalized</a> for not following up on whether these tests have been done due to patient non adherence. By not doing the test you agreed to do, you strain the doctor patient relationship and the doctor may feel well within their rights to terminate the relationship.</p>\n\n<p>It is therefore incumbent on you to advise your doctor that you do not wish to proceed with the test so that your doctor can then make alternative arrangements for you, and to document that you declined to proceed. This might include asking you to return to discuss the reasons for the test, or to refer you a specialist, presumably a neurologist in the specific instance above. </p>\n\n<p>A letter written to your doctor might suffice, as might a telephone call to their office, depending on the policies of the office, to advise your doctor of your change in mind. If the test were intended to look for a serious illness, then they may not accept a phone call and may want it in writing instead.</p>\n", "score": 1 } ]

[ "prescription", "mri" ]

[ { "answer_id": 5544, "body": "<p>There's a reason why, in a house fire, the phrase to remember is \"Get down low and go, go, go\"</p>\n\n<p>The most common ailment of someone in a house fire is from smoke inhalation. As smoke rises, the closer you are to the floor, the less smoke you will breathe in (until the entire room is filled with smoke in which case you're dead anyway).</p>\n\n<p>From this perspective, as long as the child stays away from the flame, they are actually more likely to last longer than an adult, purely because they are smaller, lower to the ground and not breathing in as much smoke.</p>\n", "score": 0 } ]

[ "age", "fire-safety", "smoke-inhalation", "unconsciousness", "carbon-monoxide-poisoning" ]

[ { "answer_id": 5510, "body": "<p>Foods that may reduce Gynocamastia:</p>\n\n<ul>\n<li><a href=\"http://www.livestrong.com/article/526346-foods-for-gynecomastia/\" rel=\"nofollow\">Livestrong:</a> </li>\n</ul>\n\n<blockquote>\n <p>there's no association between any food and breast enlargement in men,\n and no special food you need to eat or avoid when you have the\n condition.</p>\n</blockquote>\n\n<p>That said you can try food that are anti-inflammatory dor tenderness, low calorie to decrease total body fat, and avoiding foods that may encourage it. </p>\n\n<p>Low calorie: </p>\n\n<blockquote>\n <p>fruits, vegetables, whole grains, nonfat dairy foods and lean sources\n of protein such as poultry, lean red meat, seafood and beans.</p>\n</blockquote>\n\n<p><a href=\"http://www.health.harvard.edu/staying-healthy/foods-that-fight-inflammation\" rel=\"nofollow\">Anti-inflammatory:</a> </p>\n\n<blockquote>\n <p>tomatoes. olive oil. green leafy vegetables, such as spinach, kale,\n and collards. nuts like almonds and walnuts. fatty fish like salmon,\n mackerel, tuna, and sardines. fruits such as strawberries,\n blueberries, cherries, and oranges.</p>\n</blockquote>\n\n<p><a href=\"http://www.ncbi.nlm.nih.gov/pubmed/18558591\" rel=\"nofollow\">ncbi.nlh.nim.gov</a></p>\n\n<p>Showed some evidence to breast growth and tenderness after soy usage.</p>\n\n<p><a href=\"http://www.medscape.com/viewarticle/576784\" rel=\"nofollow\">Medscape.com</a></p>\n\n<p>Tea tree oil and lavender oil have been linked to Gynecomastia.</p>\n\n<blockquote>\n <p>including drugs that decrease testosterone synthesis such as\n ketoconazole, metronidazole, or cytotoxic agents and drugs that\n decrease testosterone action such as marijuana, cimetidine, flutamide,\n and spironolactone. Furthermore, some drugs such as isoniazid,\n penicillamine, calcium channel blockers, and central nervous system\n agents (including diazepam, tricyclic antidepressants, reserpine,\n phenytoin, and amphetamines)<a href=\"http://www.medscape.com/viewarticle/576784\" rel=\"nofollow\">4</a> can cause gynecomastia via an unknown\n mechanism of action</p>\n</blockquote>\n\n<p><strong><em>You need to consult your doctor if you are experiencing any symptoms for other possible interventions or disturbances a change in diet could cause.</em></strong> </p>\n", "score": 1 } ]

[ "treatment-options", "effectiveness", "breast", "soy", "gynecomastia-man-boobs" ]

[ { "answer_id": 8808, "body": "<p>Recalculate your TDEE, adjust your calories required per day to keep losing weight, a deficit of 300-500 or so, depending on your preference. </p>\n\n<p>Losing weight is all about making sure you take in (eat) less calories than you use. </p>\n", "score": 0 }, { "answer_id": 10364, "body": "<p>Your weight will not be 74kg from 77-79 KG maybe because you don't exert much effort to reach it? You don't have that kind of determination to achieve it. I know you will tell me that you do everything to lose weight but I think it's not enough because you're still struggling.</p>\n\n<p>I understand, it's not easy to lose weight that much because it requires you to be serious and focus on your goals. You need to <a href=\"https://behealthy.today/healthy-weight-loss-diet-and-exercise/\" rel=\"nofollow noreferrer\">change your lifestyle starting from the way you eat, sleep and exercise</a>.\nBeing healthy starts really in the kitchen, you should avoid alcoholic drinks, pizza, burgers and eating in fast food chain. Start eating healthy foods or make your own healthy recipes and have fun.\nIf you are planning to go to the gym I suggest you get a gym instructor, in that way he/she can monitor on your improvements. \nYou need also to <a href=\"https://behealthy.today/water-weight-loss-effects/\" rel=\"nofollow noreferrer\">drink more water every day</a> before you start eating and every before and after your workout. Have a good sleep and everything will be fine.\nI know you can do it. AJA!!</p>\n", "score": 0 } ]

[ "weight-loss", "body-fat", "body-weight" ]

[ { "answer_id": 5655, "body": "<p>Continuous watching of monitor causes eye dryness that's because we force our eyes no to blink each and every 6-7 secs but to some maximum time we keep it open that causes pain in eyes and red devil look.\nGamer glass act as a blue filter. As blue is a color which signal our brain that sun isn't set even after sunset this in turn reduces the secretion of melatonin(sleep hormone).\nGamers have intense passion and accuracy to achieve the target and to win the game they need to watch the screen properly (my experience in Counter Strike).</p>\n", "score": 1 } ]

[ "medications", "eye" ]

[ { "answer_id": 5940, "body": "<p>There are over a hundred medical conditions with the symptoms you have described, so be aware for any new symptoms and tell him if they are any.</p>\n\n<p>Keep in mind any changes that have occurred before development of your symptoms (e.g: Did you get a new pet?, Did you go travelling?). </p>\n\n<p>One thing that you could ask your Doctor is about your vitamin D levels. We create <a href=\"http://www.nhs.uk/Livewell/Summerhealth/Pages/vitamin-D-sunlight.aspx\" rel=\"nofollow\">Vitamin D</a> from sunlight. Deficiency is linked with <a href=\"http://www.nhs.uk/Livewell/tiredness-and-fatigue/Pages/winter-tiredness.aspx\" rel=\"nofollow\">fatigue and exhaustion</a></p>\n\n<p>Get well soon. </p>\n", "score": 1 }, { "answer_id": 5919, "body": "<p><a href=\"http://www.mayoclinic.org/diseases-conditions/iron-deficiency-anemia/basics/symptoms/con-20019327\" rel=\"nofollow\">Iron deficiency</a> or <a href=\"http://www.mayoclinic.org/diseases-conditions/dehydration/basics/symptoms/con-20030056\" rel=\"nofollow\">dehydration</a> can both make a person fatigued. Try drinking more water, and eating more <a href=\"http://www.webmd.com/diet/iron-rich-foods?page=1\" rel=\"nofollow\">iron rich foods</a>.</p>\n", "score": 0 } ]

[ "sleep", "diagnostics", "fatigue" ]

[ { "answer_id": 8807, "body": "<p><a href=\"http://examine.com\" rel=\"nofollow noreferrer\">http://examine.com</a> says it best:</p>\n<blockquote>\n<p>What should I eat for weight loss?</p>\n<p><strong>Eat less.</strong> Different diets can make this easier, so pick whichever one\nbest fits your lifestyle. Ultimately, you need to reduce your caloric\nintake</p>\n</blockquote>\n<hr />\n<h1>What's the deal with low carb diets?</h1>\n<p>Low-carb dieting is a &quot;trick&quot; that allows people to stop eating so much sugar and carbohydrates (flours and starches and pastas) <strong>which greatly reduces caloric intake without jeopardizing vitamin, protein or essential oils (fats) losses</strong>. Most processed carbohydrate sources are not nutrient-dense foods and are not ideal, unless you are trying to store more energy for more significant periods of exertion (e.g. marathon, distance bicycling or days of long hiking).</p>\n<p><strong><a href=\"http://examine.com/faq/will-carbs-make-me-fat.html\" rel=\"nofollow noreferrer\">Carbohydrates are not what makes people fat</a>.</strong></p>\n<p><strong>Calories matter most</strong>. <a href=\"http://examine.com/faq/are-there-health-benefits-of-a-low-carb-diet.html\" rel=\"nofollow noreferrer\">However, low-carb diets have been shown to improve fasting plasma glucose and insulin levels, cholesterol levels, blood triglycerides, preserve muscle mass during weight loss, and other health markers.</a></p>\n<p>Low-carb dieting has side benefits for ultra-endurance athletes (increase in intramuscular triglycerides), but can negatively impact high intensity strength training by reducing muscle glycogen and forcing the body to convert protein into glucose, rather than use it for muscle building.</p>\n<p>There is no best diet plan. There are many paths to maintaining a good diet and losing weight. The important thing to understand is that people are different in their tastes and lifestyles but not in their body metabolisms by any large degree. Resting body metabolism between extreme athletes and unfit people vary by less than 5% which means it has virtually no impact on how much you can eat or burn in daily decisions. You should be prepared to experiment and find what works for you so that you can maintain a diet that avoids an excess of calories over your lifetime however actively you choose to live.</p>\n<p><a href=\"http://www.bodyrecomposition.com/fat-loss/all-diets-work-the-importance-of-calories.html\" rel=\"nofollow noreferrer\">In the end, the &quot;best diet&quot; is the one that you will stick to.</a></p>\n", "score": 1 } ]

[ "nutrition", "diet" ]

[ { "answer_id": 7042, "body": "<p>I recommend vegan and gluten-free salads from <a href=\"http://homejuice.com.au/\" rel=\"nofollow\">HomeJuice</a>. Most salads are highly nutritious as they contain proteins, omega 3, proteins and fibre. Some raw vegetables and fruits also contain antioxidants like Vitamin C and Vitamin A that protects against health problems like cancer and heart disease. </p>\n\n<p>You can also try juice detox. They are so refreshing and guaranteed to help you lose weight. I use <a href=\"http://homejuice.com.au/pages/melbourne-healthy-corporate-catering\" rel=\"nofollow\">http://homejuice.com.au/pages/melbourne-healthy-corporate-catering</a> for my juice cleanse. This office catering helps maintain the healthy lifestyle even when I'm at work.</p>\n", "score": 2 }, { "answer_id": 7037, "body": "<p>Nuts have a minimal amount of carbs, however, it is very easy to overeat them, so you will want to carefully control portions. When I feel like including healthy carbs, I eat brown rice. Eggs and avocados usually go well with brown rice too. And if it fits into your own diet plan, eating dark chocolate (>85%) wouldn't significantly set you back and hopefully help you in not losing your sanity while losing weight. </p>\n\n<p>And if you can cook, I'm sure you can incorporate a near endless combination of vegetables and oils into your diet. Low sugar fruits such as strawberries will also do you good. The fiber from fruits and vegetables will also help to fill you, keep your diet balanced, and aid your digestive system. Good luck!</p>\n", "score": 1 }, { "answer_id": 7043, "body": "<p>The best way to fix your problem is to experiment and basically learn to make less exciting food more so. So buying a load of ingredients and then looking for recipes to use them up is always good.</p>\n\n<p>But for some ingredient ideas try <a href=\"http://www.ruled.me/ketogenic-diet-food-list/\" rel=\"nofollow\">here</a></p>\n\n<p>For specific recipes try places like <a href=\"http://www.ruled.me/keto-recipes/\" rel=\"nofollow\">this</a></p>\n\n<p>I have been told low carb pizzas with a base made of cauliflower or sometimes chicken can be great. The toppings obviously easy to fill with low carb diets!</p>\n\n<p>Hope that helps</p>\n", "score": 0 } ]

[ "diet" ]

[ { "answer_id": 7213, "body": "<p>In the last decades, several studies investigating the effect of protein on satiety showed that under most conditions, protein can be more satiating than isoenergetic ingestion of carbohydrate or fat.</p>\n\n<p>This effect has been observed both after a single meal and over 24h. The effect of protein on satiety may be dependent on the type of protein ingested (animal protein, whey vs casein)</p>\n\n<p>The pathophysiological mechanisms underlying satiety after protein intake seem to include stimulation of gastrointestinal hormones that affect gastrointestinal motility. Additionally, some studies suggest that ghrelin concentration, a hormone involved in regulation of food intake, might change in response to protein intake.</p>\n\n<p>Source (which offers a good review on past studies): Paddon-Jones D1, Westman E, Mattes RD, Wolfe RR et al. Protein, weight management, and satiety. Am J Clin Nutr. 2008 May;87(5):1558S-1561S</p>\n", "score": 2 } ]

[ "nutrition", "proteins" ]

[ { "answer_id": 7484, "body": "<p>Using both the floor and the bed allows for increased support for your neck and thoracic spine. Performing those exercises on a ball challenges the neck and upper thoracic spine and is therefore not appropriate for people with significant acute pain along those areas. A patient should at least be able to hold their neck in a neutral position to avoid excessive stress while performing arm abduction on a ball. </p>\n\n<p>The ball also adds an element of instability to the entire body, whereas the exercises on the bed and floor do not really challenge your balance or core strength relative to the ball. The ball would not be appropriate for people who have problems with their ankles/feet as they would be required to stabilize themselves through the entire lower kinetic chain before they can do it safely. </p>\n\n<p>Basically, the ball is just a progression of the exercises that should initially be done on the floor/bed. Pending the stage of the patient's recovery and overall status, they can then progress to the ball. Resistance can then be added by carrying free weights or using elastic theraband. Hope this helps! </p>\n", "score": 3 } ]

[ "rotator-cuff", "exercise-ball" ]

[ { "answer_id": 7250, "body": "<p>According to the Mayo Clinic, the symptoms of an enlarged spleen include:</p>\n\n<p><a href=\"http://www.mayoclinic.org/diseases-conditions/enlarged-spleen/basics/symptoms/con-20029324\" rel=\"nofollow\">http://www.mayoclinic.org/diseases-conditions/enlarged-spleen/basics/symptoms/con-20029324</a></p>\n\n<blockquote>\n <p>An enlarged spleen may cause:</p>\n\n<pre><code>No symptoms in some cases\nPain or fullness in the left upper abdomen that may spread to the left shoulder\nFeeling full without eating or after eating only a small amount — this can occur when an enlarged spleen presses on your stomach\nAnemia\nFatigue\nFrequent infections\nEasy bleeding\n</code></pre>\n</blockquote>\n\n<p>Like many illnesses, the symptoms of an enlarged spleen are non-specific and shared with many other illnesses, so there is no single symptom or set of symptoms that identifies it. Diagnosis would require examination by a physician.</p>\n", "score": 2 } ]

[ "gastroenterology", "symptoms", "inflammation", "spleen" ]

[ { "answer_id": 8972, "body": "<p>Energy drinks aren't supposed to supply you with nutritional energy but to temporarily stimulate your mental and/or physical functions and encourage your body to use energy <strong>it already has</strong>. Such stimulated person might be seen as \"more energetic\" because of</p>\n\n<blockquote>\n <p>enhanced alertness, awareness, wakefulness, endurance, productivity, and motivation, increased arousal, locomotion, heart rate, and blood pressure, and the perception of a diminished requirement for food and sleep.</p>\n</blockquote>\n\n<p>(<a href=\"https://en.wikipedia.org/wiki/Stimulant\" rel=\"nofollow\">source</a> of above description)</p>\n\n<p>What are energy drinks made of:</p>\n\n<blockquote>\n <p>Energy drinks can contain more than 15 ingredients, but the essential components come in five categories: (1) caffeine; (2) a sweetener of some kind (usually sugar); (3) one or more amino acids (most often taurine but sometimes L-carnitine); (4) vitamins B and (5) one or more plant/herbal extracts such as ginko biloba, guarana, ginseng, milk thistle etc.</p>\n</blockquote>\n\n<p>(<a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4515699/\" rel=\"nofollow\">source</a>)</p>\n\n<p>In all energy drinks I've personally seen there was only one clearly stimulating compound and it was caffeine, \"the world's most widely consumed psychoactive drug\" (<a href=\"https://en.wikipedia.org/wiki/Stimulant#Caffeine\" rel=\"nofollow\">as Wikipedia nicely desbribes it</a>). </p>\n\n<blockquote>\n <p>Caffeine, an adenosine receptor antagonist, is a stimulant that can influence the activity of neuronal control pathways in the central and peripheral nervous systems. <strong>It is the most common stimulant in EBs [Energy Beverages]</strong> (...) </p>\n</blockquote>\n\n<p>(<a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2966367/\" rel=\"nofollow\">Energy Beverages: Content and Safety</a>, 2010)</p>\n\n<p>There are also other substances in energy drinks, but their purpose and effect is often unclear. or example, glucuronolactone, ginseng, ginkgo biloba and many others. Some of them might actually work in some mildly stimulating way. If you're interested, read <a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2966367/\" rel=\"nofollow\">Energy Beverages: Content and Safety</a>.</p>\n\n<p>Now, sugar is not considered a stimulant, although</p>\n\n<blockquote>\n <p>Administration of glucose or other carbohydrates before, during, and after prolonged exercise (>1 hour) has been shown to postpone fatigue, conserve muscle glycogen, and improve performance.</p>\n</blockquote>\n\n<p>(<a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2966367/\" rel=\"nofollow\">Energy Beverages: Content and Safety</a>, 2010)</p>\n\n<p>There was a common myth about children being stimulated by candies and other sugar products, but <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/8747098\" rel=\"nofollow\">it was proven false</a>. In some aspects and for some people (e.g. <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/10966906\" rel=\"nofollow\">elderly</a>) sugar may improve some congnitive perfomance, but for others it (e.g. <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/7598081\" rel=\"nofollow\">infants</a>) it may work as sedative. Its removal from energy drink probably doesn't change much, other sweeteners are used instead, although one may wonder what are all those vitamins then:</p>\n\n<blockquote>\n <p>Because EBs contain large amounts of sugar, these vitamins are touted as ingredients necessary to convert the added sugar to energy. Hence, the B vitamins are the “key” needed to unlock all the energy provided by the simple sugars in EBs, and this is the extra energy that EB companies claim their product can provide.</p>\n</blockquote>\n\n<p>(<a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2966367/\" rel=\"nofollow\">Energy Beverages: Content and Safety</a>, 2010)</p>\n", "score": 0 } ]

[ "nutrition", "sugar" ]

[ { "answer_id": 7309, "body": "<p><strong>What is uric acid?</strong> Uric acid is the final breakdown product of purine (essential components of DNA and RNA) degradation in humans. In plasma extracellular fluid and synovial fluid, uric acid is found in its ionised form called urate. When plasma is saturated with urate, urate crystal can precipitate. Similarly in urine, depending on the pH (acid vs basic), urate can precipitate and form renal stones.</p>\n\n<p>According to the Harrison’s Principles of Internal Medicine,</p>\n\n<blockquote>\n <p>Mean serum urate values of adult men and premenopausal women are 415\n and 360 μmol/L (6.8 and 6 mg/dL), respectively. After menopause,\n values for women increase to approximate those of men. In adulthood,\n concentrations rise steadily over time and vary with height, body\n weight, blood pressure, renal function, and alcohol intake.</p>\n</blockquote>\n\n<p>Increased production or decreased excretion of uric acid lead to <strong>hyperuricemia</strong>.</p>\n\n<blockquote>\n <p><strong>Hyperuricemia</strong> is defined as a plasma (or serum) urate concentration > 405 μmol/L (6.8 mg/dL).</p>\n</blockquote>\n\n<p>A detailed list of <strong>causes of hyperuricemia</strong> can be found in the table below</p>\n\n<p><a href=\"https://i.stack.imgur.com/BCUAq.png\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/BCUAq.png\" alt=\"enter image description here\"></a></p>\n\n<p>The most common <strong>complications of hyperuricemia</strong> are:</p>\n\n<ul>\n<li><strong>gouty arthritis</strong> (the risk of developing gouty arthritis increases\nwith high serum irate levels) </li>\n<li><strong>nephrolithiasis</strong> (= renal stones)</li>\n<li><strong>urate nephropathy</strong> (= monosodium urate crystal deposition in the renal\ninterstitium)</li>\n<li><strong>uric acid nephropathy</strong> (= uric acid crystals deposition in renal\ncollecting ducts, pelvis and ureters)</li>\n</ul>\n\n<p><strong>Detection of hyperuricemia</strong> relies on the patient's symptoms. Hyperuricemia can be asymptomatic and not necesseraly be associated to any disease. As such, evaluation of hyperuricemia will be guided by the clinical presentation and by the clinician's suspicion. Typically uric acid can be measured in the blood. Also, in some cases, quantification of uric acid excretion can help to investigate whether hyperuricemia is due to increased production or reduced excretion.</p>\n\n<p>Finally, while in some cases, antihyperuricemia therapy is indicated, routine treatment of hyperuricemia is not recommended.\nA systematic review (when authours review all the current scientific literature regarding a specific topic/question) conducted in 2014 regarding <strong>risk factors</strong> for gouty arthritis found following risk factors:</p>\n\n<blockquote>\n <p>Alcohol consumption increased the risk of incident gout, especially\n beer and hard liquor. Several dietary factors increased the risk of\n incident gout, including meat intake, seafood intake, sugar sweetened\n soft drinks, and consumption of foods high in fructose. Diary intake,\n folate intake and coffee consumption were each associated with a lower\n risk of incident gout and in some cases a lower rate of gout flares.\n Thiazide and loop diuretics were associated with higher risk of\n incident gout and higher rate of gout flares. Hypertension, renal\n insufficiency, hypertriglyceridemia, hypercholesterolemia,\n hyperuricemia, diabetes, obesity and early menopause were each\n associated with a higher risk of incident gout and/or gout flares.</p>\n</blockquote>\n\n<p>So working on these risk factors should reduce the risk of developing hyperuricemia.</p>\n\n<p>Sources:</p>\n\n<ul>\n<li>Singh JA, Reddy SG, Kundukulam J. Risk Factors for Gout and Prevention: A Systematic Review of the Literature. Current opinion in rheumatology. 2011;23(2):192-202. doi:10.1097/BOR.0b013e3283438e13.</li>\n<li>Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson J, Loscalzo J. eds. Harrison's Principles of Internal Medicine, 18e. New York, NY: McGraw-Hill; 2012. p 3181-3185</li>\n</ul>\n", "score": 3 } ]

[ "blood" ]

[ { "answer_id": 7350, "body": "<p>Drawing on <a href=\"https://health.stackexchange.com/questions/913/taking-supplements-space-out-my-vitamin-a-and-the-others/915#915\">my previous answer about Vitamin A risks</a>, the only known risk of large doses of carotenoids is <a href=\"https://ods.od.nih.gov/factsheets/VitaminA-HealthProfessional/#h8\" rel=\"nofollow noreferrer\">an increased risk of lung cancer if you smoke or work with asbestos</a>.</p>\n", "score": 2 } ]

[ "micronutrients" ]

[ { "answer_id": 7379, "body": "<p>Your body needs energy and unlike cattle, horses and other herbivores, humans cannot derive energy from grasses. That is because our body cannot break down cellulose (a polysaccharide that makes up the cell wall of plants and is the main energy source for herbivores).</p>\n<p>Cellulose, like starch, is a carbohydrate made up of glucose monomers. You cannot digest cellulose but you can digest starch which is one of the main sources of energy for humans.</p>\n<p>Coming back to your question:</p>\n<blockquote>\n<p>Can I Survive on a Mostly Grass/Leaf Diet?</p>\n</blockquote>\n<p>No. It is not really implementable. Some leaves (like spinach) are rich in certain nutrients but you need a primary energy source. Though fats also provide energy, carbohydrates cannot be replaced because the intermediates of <a href=\"https://en.wikipedia.org/wiki/Glycolysis\" rel=\"nofollow noreferrer\">glycolysis</a> i.e. breakdown of glucose (which in turn comes from carbohydrates like starch), are essential for many other vital processes in the body (such as DNA synthesis). There is a biochemical pathway known as <a href=\"https://en.wikipedia.org/wiki/Gluconeogenesis\" rel=\"nofollow noreferrer\">gluconeogenesis</a> which can produce these intermediates from amino acids and certain fats (fatty acids with odd number of carbon atoms in the side chain). Leaves won't provide these as well, in sufficient amounts.</p>\n<p>Finally you need proteins which is again poor in leaves. Herbivores consume a lot of food to meet their metabolic needs. Have a look at <a href=\"https://biology.stackexchange.com/q/40456/3340\">this post</a> in Biology.SE. Our digestive system is not really tuned for this kind of a job.</p>\n<blockquote>\n<p>If the answer is negative, what's the easiest way to satisfy to satisfy my nutritional needs in a safe way?</p>\n</blockquote>\n<p>This is a broad question and is also subjective. It depends a lot on the geography of your surroundings, your specific metabolic makeup etc.</p>\n", "score": 2 } ]

[ "nutrition", "digestion" ]

[ { "answer_id": 7457, "body": "<p>If someone squeezed your head hard enough to cause brain damage, that means they squeezed your head hard enough to fracture your skull. I assure you that you would know without doubt if they squeezed that hard. </p>\n\n<p>Your brain is fine.</p>\n", "score": 1 } ]

[ "brain" ]

[ { "answer_id": 7483, "body": "<p>You know by getting a pregnancy test. It can be a home test you buy in a pharmacy or you can visit a doctor or clinic. </p>\n\n<p>No, it is not possible to feel symptoms of pregnancy mere hours after sex. It takes a week or two for the first signs to appear. A missed period is usually the first detectable sign.</p>\n", "score": 3 } ]

[ "obstetrics" ]