Vaccinated Neuron

Science, medicine, academia and building a better world for all. PhD now and (hopefully) MD in 2-3 years

[Keith Siau @drkeithsiau]

This was a case report from Vietnam of a hepatic ectopic pregnancy involving a 23 week old fetus. The patient was 27 years old with a history of fallopian tube surgery (which may explain the ectopic implantation). An ultrasound scan 2 months prior had not found the fetus. A repeat scan found a viable fetus in the liver with a beating heart. CT imaging found a placenta invading the right liver with blood supply from the right hepatic artery.

Unfortunately, surgery was complicated by massive haemorrhage and neither baby nor mother survived.

Hepatic ectopic pregnancies are extremely rare with <50 cases reported. This occurs when a fertilised egg escapes outside the reproductive system (eg by rupturing through the Fallopian tube into the abdominal cavity) and attaches onto the liver surface. Risk factors include ovarian or tubal pathology and pelvic inflammatory disease.

Although abdominal ectopic pregnancies have occasionally been viable, the condition carries a high mortality rate with no successful deliveries of hepatic ectopic pregnancies reported.

Case: https://t.co/newBdBO8EM

[Jonatan Pallesen @jonatanpallesen]

Incredibly, the placebo effect is (mostly) not real.

It is a result of statistical confusion. Whenever you have a group with extreme values, they tend to exhibit regression to the mean. Eg. on average, sick people tend to become more healthy over time.

Thus if you give one group medicine, and one group placebo, the placebo group will also tend to get better over time, because of regression to the mean.

People have then misinterpreted this to think that it is the placebo pill that actively does this.

If you want to demonstrate a placebo effect, you have to construct a study where there are three groups:
• A. treatment
• B. placebo
• C. no treatment, no placebo

If B and C get different outcomes, that would demonstrate a placebo effect.

When this has been tried, mainly there has been no provable placebo effect. See the paper in the screenshot. (There is some evidence for an effect for pain, but this get's into a slightly different debate.)

The fact that the placebo effect is mainly not real, fortunately frees us from having to come up with convoluted explanations, as to why the placebo effect would work even when we tell the patient that it is a placebo, as in the quoted tweet.

[The Orchard Keeper @keeper_orchard]

#WendellBerry
Sabbath Poems

[Josh Ellis @jzellis]

As far as online shouting goes, I will point out that I spent years screaming at y'all about imminent climate collapse and people acted like I was crazy to think it would happen so quickly. But I was right about everything down the line. So here's another freebie of horror:

[Ashley Winter MD || Urologist @AshleyGWinter]

If you know anyone who is going to turn 65 soon remind them to enroll in regular Medicare &amp; not a Medicare advantage plan. A family member recently needed acute rehab &amp; the social workers delight at not needing prior auth bc they had straight Medicare was an excellent reminder.

[CIDRAP @CIDRAP]

CDC issues malaria advisory as Florida posts statewide alert

The CDC said malaria infection is a medical emergency that requires rapid testing and treatment.

https://t.co/zJmU4q9fmK

Photo: Ed Uthman /Flickr cc

[Armand Domalewski @ArmandDoma]

This Wagner group situation is a lesson about the dangers of outsourcing core government functions to outside consultants instead of doing them in-house

[Alex D. Bibbey, MD @thats_bone]

Patient in the ED with post-operative pain, discharged from the hospital yesterday, called surgeon's office this morning and nobody called back so they were forced to go to the ED. Don't be this surgeon, y'all.

[your other mom @difficultpatty]

My autistic/ADHD 18 yo son who didn’t talk until he was nearly 4 registered for college this morning if you need a reason to have hope today.

[poorly drawn lines @PDLComics]

complain

[Cedric🧬➰🧬Feschotte @CedricFeschotte]

🐙 ALERT! So when you put an octopus in cold water it recodes 13,000 codons (1/3 of all recoding sites!) via massive RNA editing in the brain!! And this apparently alters the function of synaptic proteins! 🤯🤯🤯 That’s insane (but not for the octopus)
https://t.co/GZr2JddPoj

[NWS New York NY @NWSNewYorkNY]

Check out this almost unbelievable time-lapse of wildfire smoke consuming the World Trade Center and the New York City skyline.

Those vulnerable to poor air quality, including seniors and young children, should limit time outdoors if possible.

More: https://t.co/ChRuWv7X6E

[Eileen Clancy @clancynewyork]

Incel ideology accepted by a court as motivating terrorism.He said the killing was retribution and identified as part of the incel movement.

"Canadian govt defines it as an 'online subculture or community in which members express a gender-driven, violent misogynist worldview.'"

[Damian Carrington @dpcarrington]

Too late now to save Arctic summer ice, climate scientists find

- Ice-free summers inevitable even with sharp emissions cuts and likely to result in more extreme heatwaves and floods

#ClimateCrisis
Story by me
🧵1/3
https://t.co/3Ba9spJ1dS

[Drug Monkey @drugmonkeyblog]

This is approximately 1,300 full modular R01 years. Or a 10% cut to approximately 13,000 grants for this year.

[Justin Wolfers @JustinWolfers]

The non-partisan CBO has "scored" the debt ceiling deal (ie estimates its likely effects).

The most striking point: The "work requirements" that Republicans insisted on would INCREASE federal spending by billions.

[Timothy Snyder @TimothyDSnyder]

2/3. Russians bring war to a city, then offer terrified parents a "recreation camp" where kids will be safe, and then refuse to return the kids to the parents and hand the kids over to Russian families.

[Roger Mosey @rogermosey]

On a park bench in Cambridge.