Neurologist

joined 4 months ago
 
[–] Neurologist@mander.xyz 1 points 3 weeks ago (1 children)

if youve got to any, could you tell me what you think? It’s always useful to know what I should recommend to my patients to show their friends and family.

[–] Neurologist@mander.xyz 2 points 4 weeks ago* (last edited 4 weeks ago) (3 children)

This channel has a bunch of short (5 mins long videos) about ME to educate people.

There’s also a slightly outdated (but still worth the watch) oscar nominated documentary about it, which has been made free and put on youtube recently It’s Unrest by Jennifer Brea

One of my patients also runs this excellent website with a bunch of resources about the disease.

[–] Neurologist@mander.xyz 5 points 4 weeks ago* (last edited 4 weeks ago) (1 children)

I’m sorry I really shouldn’t be giving medical advice. It’s been a long time since I studied neurology. I’ve spent the past decade only on post viral diseases like ME.

But please please find yourself a doctor that listens and cares if that is possible. Because it clearly sounds like you need tests and you need a doc thats available for you. Maybe join some local MS support groups and ask if anyone has docs that do a really good job and try from there.

I’ll tell you this as a doctor. I would stay the hell away from some of my colleagues. Not every doctor is anywhere near good at their jobs. Some don’t care, some barely passed and don’t want to learn anything new, some like to always assume their patients have psychological problems. Find yourself a good doctor who is proactive and cares, and everything will be so much easier. Sending you good luck.

[–] Neurologist@mander.xyz 1 points 4 weeks ago (5 children)

For you to help your friend. Or for your friend themselves?

[–] Neurologist@mander.xyz 4 points 4 weeks ago* (last edited 4 weeks ago)

Hopefully it’s something immunomodulators can fix. Fingers crossed.

[–] Neurologist@mander.xyz 4 points 4 weeks ago (2 children)

Probably triggered. But we don’t really know.

[–] Neurologist@mander.xyz 29 points 1 month ago* (last edited 4 weeks ago) (12 children)

Hey I’m a researcher who works on ME (in the past called CFS).

ME/CFS is currently classified as a disease/biological illness according to the CDC.

ME is a disease state in itself. We don’t know much about it, but it can’t be explained by other diagnoses, as the defining factor, neuro-immune abnormalities including immune activation showing up post exertion is unique to it. You’re completely right that we don’t yet have a reliable biomarker. We have a test that differentiates from healthy controls, but it was discontinued for ethical reasons because conducting the test leads to a sometimes permanent worsening of the illness.

In the past it’s been mixed up and jumbled a lot, but the picture is getting clearer.

There have been a few case reports of degenerative forms of the illness. But in general it takes a more classical relapsing remitting pattern. Although even in less bad stages some patients are severely functionally disabled, even bedridden and tubefed. It has a really wide range of severities with the least severely affected able to work part time and walk and travel, while the most severe might not even be able to communicate.

[–] Neurologist@mander.xyz 27 points 1 month ago* (last edited 1 month ago)

Couldn’t have said it better. And yes, science journalism often is basically repeating and dumbing down what a study says, but in science, and especially in medicine, a lot of studies tend to be wrong, make false assumptions, or overstate their findings, while journalists tend to take them for their word. There’s a reason you hear of a new cancer treatment in the news every other week but few actually make it past FDA approval.

[–] Neurologist@mander.xyz 4 points 1 month ago* (last edited 1 month ago) (2 children)

I agree this meme is bullshit but you’re comparing two sources that shouldn’t be compared.

Your number for Gaza’s children is from the (hamas run) Gaza health ministry. While your number from Ukraine is from the UN has confirmed.

The Ukrainian government has a much higher estimate for dead children than the UN. And the UN has confirmed far far low children deaths than the gaza health ministry.

[–] Neurologist@mander.xyz 15 points 1 month ago

What? Initiated by Israel you mean?

Yeah a lot of people are ignoring Russian war crimes and I agree that’s a problem. But I don’t think you really understand what’s happening in Gaza given the meme you made.

[–] Neurologist@mander.xyz 4 points 1 month ago

I mean there’s a lot of ways to interpret it that’s for sure. But if you look at the entire response that quote is located in, it’s in the beginning of the debate when he’s really nervous and kind of all over the place. He somehow continues after that sentence talking about Trump crowd sizes. It’s almost gibberish to make any sense from his response there. But I think the message of it was something along the lines of Israel should defend itself against Iran and the US will support it in that endeavour.

 

ELI12 TLDR: Decent accuracy was found ~80% when using these to differentiate between people with Long COVID versus people who had recovered. People with Long COVID tend to have high Artemin which is linked to nerve cell communication problems and the elevated levels found may provide a clue into the cognitive problems many of these patients have. High Galectin-9 levels (which were also found here) are often associated with immune issues such as overactivation, which seems to fit well with all the immune abnormalities we see in these patients.

Abstract: This study aimed to assess plasma galectin-9 (Gal-9) and artemin (ARTN) concentrations as potential biomarkers to differentiate individuals with Long COVID (LC) patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) from SARS-CoV-2 recovered (R) and healthy controls (HCs). Receiver operating characteristic (ROC) curve analysis determined a cut-off value of plasma Gal-9 and ARTN to differentiate LC patients from the R group and HCs in two independent cohorts. Positive correlations were observed between elevated plasma Gal-9 levels and inflammatory markers (e.g. SAA and IP-10), as well as sCD14 and I-FABP in LC patients. Gal-9 also exhibited a positive correlation with cognitive failure scores, suggesting its potential role in cognitive impairment in LC patients with ME/CFS. This study highlights plasma Gal-9 and/or ARTN as sensitive screening biomarkers for discriminating LC patients from controls. Notably, the elevation of LPS-binding protein in LC patients, as has been observed in HIV infected individuals, suggests microbial translocation. However, despite elevated Gal-9, we found a significant decline in ARTN levels in the plasma of people living with HIV (PLWH). Our study provides a novel and important role for Gal-9/ARTN in LC pathogenesis.

 

Nearly 200 health professionals have written to the health secretary saying that patients with the illness are being left to ‘languish behind closed doors’

The Times (UK)

Doctors have said that NHS patients with myalgic encephalomyelitis (ME) risk starving to death because of unsafe and “unconscionable” standards of care. 

The letter calls for the government to take action to address the “serious patient safety concerns” for patients with ME, an illness which affects about 250,000 people in the UK.

More than 200 health professionals including GPs, hospital consultants and nurses have written to Wes Streeting, the health secretary, saying that patients with the illness are being left to “languish behind closed doors” because specialist NHS services to provide safe care “do not exist”.

ME, also known as chronic fatigue syndrome, is a complex neurological disorder that leads to symptoms including extreme exhaustion. Severe cases can be fatal, with patients bedridden and unable to eat or drink, but these patients currently “fall through the cracks” as there is no specialist NHS care provision. 

A letter signed by 202 doctors and NHS staff calls on ministers to convene an ME clinical task force providing “emergency specialist guidance in cases where patients are hospitalised”, as well as to commit to holding NHS trusts “accountable” for care.

They write: “There is little access to truly specialist ME care or treatment within the NHS and paradoxically, the sicker a patient is, the less care they receive.

“Even if doctors and healthcare professionals are knowledgeable and willing to treat patients, the infrastructure to provide safe and appropriate care does not exist.”

[…]

 

Background

A considerable number of patients who contracted SARS-CoV-2 are affected by persistent multi-systemic symptoms, referred to as Post-COVID Condition (PCC). Post-exertional malaise (PEM) has been recognized as one of the most frequent manifestations of PCC and is a diagnostic criterion of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Yet, its underlying pathomechanisms remain poorly elucidated.

Results

Upon physical activity, affected patients exhibit a reduced systemic oxygen extraction and oxidative phosphorylation capacity. Accumulating evidence suggests that these are mediated by dysfunctions in mitochondrial capacities and microcirculation that are maintained by latent immune activation, conjointly impairing peripheral bioenergetics. Aggravating deficits in tissue perfusion and oxygen utilization during activities cause exertional intolerance that are frequently accompanied by tachycardia, dyspnea, early cessation of activity and elicit downstream metabolic effects. The accumulation of molecules such as lactate, reactive oxygen species or prostaglandins might trigger local and systemic immune activation. Subsequent intensification of bioenergetic inflexibilities, muscular ionic disturbances and modulation of central nervous system functions can lead to an exacerbation of existing pathologies and symptoms

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submitted 3 months ago* (last edited 3 months ago) by Neurologist@mander.xyz to c/science_memes@mander.xyz
 

If you’re confused: Birds are dinosaurs, crocodiles aren’t; note the “closest living relatives

 
 
 
 
 
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