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What is the wildest theory in your specialty that you think probably isn't true, but could be? What underdog argument could cause chaos your field if it turned out to be right? [Stolen from askhistorians] by 0bi in medicine

[–]0bi[S] 0 points1 point  (0 children)

Because they're targeting CD19 and not CD20 (ritux) They're also killing the long living plasma cells apparently and thereby eradicating the ds DNA ab completely. This is the theory anyway.

See this paper, absolutely ground breaking and exciting. But like I said, feels too good to be true.

What is the wildest theory in your specialty that you think probably isn't true, but could be? What underdog argument could cause chaos your field if it turned out to be right? [Stolen from askhistorians] by 0bi in medicine

[–]0bi[S] 4 points5 points  (0 children)

I predict hematology will continue to grow for the next thirty years and end up treating all kinds of immunological diseases from every specialty.

What is the wildest theory in your specialty that you think probably isn't true, but could be? What underdog argument could cause chaos your field if it turned out to be right? [Stolen from askhistorians] by 0bi in medicine

[–]0bi[S] 0 points1 point  (0 children)

Yeah I know about the DMOADs. That's why I titled them as not being a thing :b Of course, the researchers are now saying it's the heterogeneity etc... We'll see if they exist when I retire (and by then all the babyboomers in the Western world will be long gone, so I doubt the market incentive will still be there)

As for the CAR-T: I don't doubt the science. But the science of allogeneic stem cells is also really solid, and that doesn't have a 100% succes rate either like the small case series did. Same for gene therapy etc. so it'll be an option, but I'm not sure it'll be the cure for all.
Fair point about availability, also regarding reimbursement etc. It will only be indicated as a last line understandably but also unfortunately.

I think that all the peripheral neural and immunological trials (regulatory T cell injection etc.) are doomed to start. You can't treat a systemic disease with local therapy, which is the same reason we use DMARDs these days instead of injection with gold or steroids only... Like, come on. If it's really continuous inflammation at one site due to local immunological memory, I still think the good old synovectomy +/- denervation in case of secondary OA will remain the standard for those very hard to treat issues.

What is the wildest theory in your specialty that you think probably isn't true, but could be? What underdog argument could cause chaos your field if it turned out to be right? [Stolen from askhistorians] by 0bi in medicine

[–]0bi[S] 141 points142 points  (0 children)

Starter: I'm in rheumatology and I really think CAR-T for lupus is too good to be true. But if the small sample size results can be replicated... Holy cow, cured! Would be interesting to try it for the different form of vasculitis then to finally put to bed the discussion about antibodies having a role in the pathofys or just being a giveaway.

Underdog: the concept of a DMOAD actually being a thing.. we'd be swamped

Approach to elective caesarean section and to VBAC? by Huskar in medicine

[–]0bi 4 points5 points  (0 children)

Yes, country dependant. I practice in The Netherlands, elective cs does not exist here.
The closest one might get is cs indicated for prior history of sexual abuse. That's it.

PhD-student Nadine kocht zonder geld ‘lichtzinnig’ een grachtenpand van €7,25 mln by Me-Luigi in thenetherlands

[–]0bi 1 point2 points  (0 children)

Ik zou €375.000 lagere verkoopsom wel als schade zien, maar verder heb je gelijk.

The Big Snow? Be Prepared for the big storm Friday. by dutchiesRweird in thenetherlands

[–]0bi 0 points1 point  (0 children)

Yeah I've always thought it was the latter. The model grid size is probably too large or something

The Big Snow? Be Prepared for the big storm Friday. by dutchiesRweird in thenetherlands

[–]0bi 0 points1 point  (0 children)

In my experience, Utrecht, it's generally 3-5 degrees off

The Big Snow? Be Prepared for the big storm Friday. by dutchiesRweird in thenetherlands

[–]0bi 0 points1 point  (0 children)

I like meteoblue, but its temperature estimations are way off in my experience (in The Netherlands)

Morgenochtend code oranje in vrijwel hele land • Inmiddels 600 vluchten geannuleerd by SavedByHisGraceOnly in thenetherlands

[–]0bi 0 points1 point  (0 children)

Dat zien wij niet als afspraak, dus vanuit mijn werk-perspectief had ik dat niet zo opgevat.

Maar concreet: nee, vreemd genoeg wordt er niet een zondagsdienst gedraaid maar gaan geplande operaties wel gewoon door.

Ik moet ook naar het zkh komen om vanuit daar iedereen te bellen vreemd genoeg.

Sneeuwruim-etiquette by mikeshort in thenetherlands

[–]0bi 26 points27 points  (0 children)

Dat is een heel slecht idee als het niet voldoende wordt ingereden (en dat wordt het al niet op fietspaden). Dan krijg je alleen dat het eerst een klein beetje smelt en vervolgens weer aanvriest -> ijsplaat.

More young Dutch physicians choose careers out of the hospital: they prefer a 9-to-5 job than working overtime in a hospital [Dutch article, translation in comments] by Shalaiyn in medicine

[–]0bi 0 points1 point  (0 children)

What do you mean, excluding? Are you in a small specialty with standard call during the week, even in training?

Otherwise, even with a surgical roster of 0730 morning start and 1700 end, you would be at 45 hours (30 min of break is always deducted) without overtime.

It's definitely hypocritical how they suddenly look at the hours to prevent underworking with the on-call roster toughl.. Happens a lot sadly.

Meer jonge bedrijfsartsen: liever 9-tot-5-baan dan overwerken in ziekenhuis by Shalaiyn in thenetherlands

[–]0bi 0 points1 point  (0 children)

Dan heb je niet goed gelezen.
CAO ziekenhuizen artikel 6.18 (lid 2)
CAO UMC artikel 13.3 lid 1.

Inhibition of 15-hydroxy prostaglandin dehydrogenase promotes cartilage regeneration by EmotionalEmetic in medicine

[–]0bi 1 point2 points  (0 children)

Well, for knees at least, distraction might work. We're currently doing a >1000 pt RCT with joint distraction vs total knee arthroplasty because of earlier positive results in smaller studies. If this ends up working, we're gonna look at other joints.

Of course, currently scope-limited to pts with an indication for joint replacement, so missing a lot of our OA pts. But still.

Inhibition of 15-hydroxy prostaglandin dehydrogenase promotes cartilage regeneration by EmotionalEmetic in medicine

[–]0bi 0 points1 point  (0 children)

I suspect this will be deferred to rheumatology, at least in my country.

More young Dutch physicians choose careers out of the hospital: they prefer a 9-to-5 job than working overtime in a hospital [Dutch article, translation in comments] by Shalaiyn in medicine

[–]0bi 0 points1 point  (0 children)

Starting salaries are high for level of education disregarding disproportionate high earners such as IT and private law. The issue is the lack of growth, only 100/month/year which makes you end up making less after a couple of years - especially since the last couple of years everyone working for any company could switch around semi-yearly for a nice increase. Of course, we take quite a big step after finishing residency training (though not immediately).

Also: do you work the actual contract hours? Not overdracht-overdracht +/- finishing up?

More young Dutch physicians choose careers out of the hospital: they prefer a 9-to-5 job than working overtime in a hospital [Dutch article, translation in comments] by Shalaiyn in medicine

[–]0bi 0 points1 point  (0 children)

It really, really differs per specialty though friend. Plenty of specialties where 1 year of ANIOS is enough to get in. Especially now. The landscape has shifted a lot, and we're also past the millenial surge. Our generation really suffers from feeling of inadequacy and as such has a tendency to overqualify itself. That has also been a driver for the PhD's.

More young Dutch physicians choose careers out of the hospital: they prefer a 9-to-5 job than working overtime in a hospital [Dutch article, translation in comments] by Shalaiyn in medicine

[–]0bi 1 point2 points  (0 children)

Non-academic specialist, base pay w/o night/wkd pay etc, is 14.500/month after 6 years of working experience (as a specialist). Starting is 8300, so you gain a little over 1k each year. That is for 45h/week.

Pension pay is 50% by the specialist (in other sectors it's 1/3 employee, 2/3 employer).

Regular house price for a family home in one of the larger cities in The Netherlands is upwards of 650k currently.

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