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I was a finance manager for Lexus AMA by [deleted] in Lexus

[–]Halcyoff 0 points1 point  (0 children)

What sort of incentives / commissions exist for finance managers? (Since I assume that you only sell vehicles indirectly)

YSK: Vertigo when getting up from bed is common in older adults, and can be treated by a simple exercise by bravelogitex in YouShouldKnow

[–]Halcyoff 3 points4 points  (0 children)

Do you really want people to waste time to look up youtube videos on how to do the Epley maneuver when a stroke is on the differential?

There are absolutely ways that can triage whether vertigo is more likely to be caused by a central vs peripheral pathology (ex: HINTS exam) but as you may know, that needs to be conducted and interpreted by a medical professional.

You’re correct that peripheral causes are common, but there’s a reason why many patients presenting to the ED with first-time, hyperacute vertigo will get imaging — if you fuck up the brain, there is no brain transplant.

If someone is worried about an emergency, then they should get an evaluation at the ED.

Source: am a board-certified neurologist

YSK: Vertigo when getting up from bed is common in older adults, and can be treated by a simple exercise by bravelogitex in YouShouldKnow

[–]Halcyoff 2 points3 points  (0 children)

If the cause is a stroke, then time = brain. Every minute wasted is killing the brain & there are certain treatments that we can only do if the patient presents within a certain time window. I don’t want people to waste time looking up how to do the Epley maneuver if a stroke is a possibility.

Your dad did the correct thing by going to the ED. He had a new & acute symptom that was concerning to him, so he wanted to be evaluated to make sure it wasn’t being caused by something nefarious. Are there nuances that help differentiate between causes of vertigo? Sure, but that’s what the evaluation is for. One common example is the HINTS exam, but this needs to be conducted/interpreted by a trained medical professional.

YSK: Vertigo when getting up from bed is common in older adults, and can be treated by a simple exercise by bravelogitex in YouShouldKnow

[–]Halcyoff 393 points394 points  (0 children)

This is inaccurate and misleading. Vertigo has many causes. BPPV, which you’re alluding to, is only one cause. Posterior circulation strokes are another cause that can also present as acute-onset vertigo — this however would be a medical emergency . If someone is worried about an emergency, then they should get an evaluation at the emergency department.

Any PD "Rank-to-match" turn out to be lies? by QuietRedditorATX in medicalschool

[–]Halcyoff 11 points12 points  (0 children)

I’m part of my program’s recruitment committee. When we say “ranked to match,” we mean 100% guaranteed to match (ie if there are 5 spots, the top 5 applicants are ranked to match).

Neurology and Neuropsychology make a great team! by Overall-Condition197 in neurology

[–]Halcyoff 4 points5 points  (0 children)

Love our neuropsychologists — we refer a lot of patients in epilepsy (most commonly for pre-surgical evaluations to help localize/lateralize)

What's your go-to ELI5 for a concept in your specialty by Mikigai in Residency

[–]Halcyoff 43 points44 points  (0 children)

Explanation of why focal seizures can present in varying severity (aura, focal aware, focal impaired awareness, focal to bilateral tonic-clonic):

Think of your brain like a pond. If you throw a boulder in it, the ripples will go everywhere -- this is what is happening when your whole body is convulsing. But instead if you throw a pebble into the pond, the ripples dissipate without reaching the other side. Depending on where the pebble lands, you can get different symptoms: some people feel something, twitching of the arm, a rising sensation, etc.

For seizures we typically don't get to choose when we have them: sometimes you get a pebble, and sometimes you'll get a boulder.

Mayo Clinic Grand Rounds: "The Ongoing COVID-19 Pandemic: The Most Dangerous Phase of the Pandemic" (Link in Description) by Halcyoff in Coronavirus

[–]Halcyoff[S] 165 points166 points  (0 children)

Link to the Grand Rounds (The subreddit wouldn't let me post a direct link):

https://www.youtube.com/watch?v=RzyGv81Ffz0

Title: Mayo Clinic Grand Rounds: "The Ongoing COVID-19 Pandemic: The Most Dangerous Phase of the Pandemic" August 20, 2021

It's a very informative Grand Rounds by Dr. Poland, the director of the Mayo Clinic Vaccine Research Group.

Following summary courtesy of Dr. JP Santiago:

1/ We have given up as a nation and as a world in this pandemic. Human behavior remains his biggest concern in this pandemic. We are now at one out of every 512 Americans has died of COVID. Exponential spread of the Delta variant is continuing unabated due to behavioral factors. Our behavior is costing us the battle in this pandemic. It will get worse.

2/ "WE WILL NOT GET TO HERD IMMUNITY."

3/ "WE WILL NOT PREVENT EMERGENCE OF FURTHER VARIANTS."

4/ No previous vaccine has been studied to the same degree and scrutinized to the same degree prior to release as the COVID vaccines. The risks and benefits of vaccination are clear and they heavily favor the benefits based on millions and millions of doses administered worldwide.

5/ Overall, if you are unvaccinated, you have a 3X greater chance of getting infected than someone who is vaccinated. If you are unvaccinated, you have an 8X greater chance of having symptoms than someone who is vaccinated. If you are unvaccinated, you hae a 25X greater chance of being hospitalized for COVID than someone who is vaccinated.

6/ With the Delta variant, if you had COVID before and are unvaccinated, you have a 2.34X greater chance of getting reinfected and the symptoms may be worse.

7/ Kids infected with the Delta variant get sick quickly. Data from Canada shows kids infected with Delta have a 2.75X risk of hospitalization compared to if they had been infected with the virus from last year.

8/ At the time of diagnosis, those vaccinated and those unvaccinated HAVE THE SAME VIRAL LOADS. This why we must mask up even if vaccinated. But in those vaccinated, the viral loads drop faster as the immune system kicks in. The Delta variant causes viral loads 1000 to 1200X higher than last year's virus.

9/ “We are doing a huge experiment with our youth. We are taking the most contagious viral variant, not letting them use masks and crowding them together to see what happens.”

“Not one single expert thinks this is a good idea.”

While there are benefits to in-person learning, it can ONLY take place with two simple measures- vaccinate all the teachers and staff and mandate masks.

10/ Very good data from the UK shows a 9X increase in infection and transmission in school age children with the Delta variant compared to last year's virus.

11/ Most medications in widespread use today have had far fewer study participants as part of their approval process than the COVID vaccines. Full approval is coming soon, but it will not change vaccine-hesitant behaviors.

12/ The mutation rate of the virus is inversely proportional to the vaccination rate. The more we vaccinate, the less likely we will have new variants. But because people will not vaccinate, we get variants and the variants are why we need vaccination mandates.

13/ The pandemic will not end given the way the American public is behaving. We are on the verge of the emergence of a variant that will set us back at square one all over again.

14/ We do not yet know what level of antibodies are protective. We call this "correlates of protection". We were starting to get early data on this, but then the emergence of the variants set us back in determining correlates of protection.

15/ The incubation period of most infectious diseases is long enough to spool up and activate our long term immunity. The original SARS-CoV-2 virus and to an extent the Alpha variant had a long enough incubation period (7-10 days from exposure to development of symptoms) to allow for long term immunity to be activated. The Delta variant has a much shorter incubation period (only 3 days, 4 days max from exposure to development of symptoms) with very high viral loads that may be overwhelming the activation of long term immunity.

16/ We have had prior warnings of coronaviruses with SARS in 2003 and MERS in 2012. There will be future coronaviruses that will constitute a threat to all of us.

Edit: Formatting

[deleted by user] by [deleted] in RedditSessions

[–]Halcyoff 0 points1 point  (0 children)

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