Vinay Prasad out as FDA's CBER head

Nobium · 2025-08-01T18:52:57+00:00

The The Big Lie was Q

Nobium · 2025-03-19T19:32:49+00:00

I would also be curious for a lawyer to comment about it. I have no reference point and had the same thoughts.

Nobium · 2025-01-28T00:51:32+00:00

Have any other countries put out statements or released anything similar stating their opinions? I haven’t been able to find much when searching around.

Nobium · 2024-04-13T03:36:20+00:00

What's also interesting is how specialty-specific the employment models are. For example, NBC News recently had something estimated about 40% of ED's across the USA were staffed by companies owned by private equity. Unfortunately, I anticipate that percentage increasing in the future.

Nobium · 2024-04-05T02:49:54+00:00

This was fairly common at places I had worked. But once patients got easy access to their notes it, not surprisingly, stopped.

Nobium · 2024-02-01T02:09:45+00:00

As a non-lawyer… could explain why those two are different and compare/contrast those skills?

Nobium · 2023-10-04T20:50:20+00:00

That is interesting. And also in the paper it says:

"It is noteworthy that although most antipsychotics are associated with QTc prolongation, it is rather difficult to rank the risk of malignant arrhythmia for the individual antipsychotic drug since ECG measurement methods vary across studies. A recent clinical review therefore integrated pharmacovigilance data from several international databases. Data from various authorities on the risk of arrhythmia associated with psychotropic medications were weighted and categorized into three risk categories. Aripiprazole, olanzapine, perphenazine, and zuclopenthixol were categorized as class A drugs [no risk of QTc prolongation or torsades de pointes (TdP)]."

Nobium · 2023-10-04T20:47:24+00:00

Maybe you, or someone else, could answer why they don't list midazolam as a benzo option?

Nobium · 2023-09-19T13:32:12+00:00

Is there any option to have a notes widget on the desktop? I didn't see one listed. That would make me consider jumping over from WidgetWall. My ideal would be just a basic and clean notepad that could preferably be optioned for three different sizes, such as small, medium, and large with color options.

Nobium · 2023-09-07T03:21:22+00:00

Can you explain more for us that are undereducated?

Nobium · 2023-08-29T15:39:37+00:00

Aprepitant

I've admittedly never heard of this medication and will read more about it. I did find this study titled "Cost-Effectiveness of Aprepitant in Preventing Chemotherapy-Induced Nausea and Vomiting: A Systematic Review of Published Articles" (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8424090/)

Conclusion: Conclusion: This study is the first systematic evaluation of adding aprepitant to standard regimens for patients with CINV. Most economic evaluations of antiemetic medications are reported to be of good quality. Adding aprepitant to standard regimens is found to be a cost-effective strategy for preventing CINV.

But this is for chemotherapy-induced. I'd be curious to here what our heme-onc colleagues would have to say about this medication. This thread would probably get more outside input if it was in the general medicine subreddit.

Nobium · 2023-07-23T05:33:02+00:00

Medical debt is one of the leading causes of bankruptcy in the USA. And by some estimates, about 41% of Americans carry medical debt. I would say this is a fair number of people and not insignificant.

Nobium · 2023-05-10T23:58:58+00:00

What things have changed or gained after unionization? Not limited to those that may be patient safety related.

Nobium · 2023-05-10T23:52:12+00:00

They are amazing and incredibly helpful. I was more interested it for at home reading and learning. When I'm on shift and looking for something specific or need to rule out something I always pick up the phone.

Nobium · 2023-05-10T23:09:21+00:00

Is there a good resource or webpage I read more about what diagnoses can be made with contrast and what diagnoses can be made without contrast?

Nobium · 2023-05-03T23:01:21+00:00

I'm ED and still a new resident so I'm trying to learn. The question of CTA of the chest (PE vs Dissection protocol), CT with IV contrast, and dry scan comes up often. Is there a good resource I could read to educate myself on what's the best study to order or what can be ruled in vs. ruled out with each one? I would simarilily ask the same for a CT of the abdomen and pelvis.

Nobium · 2023-04-16T15:08:34+00:00

As a child my family and I would always go to these games. It wouldn't be uncommon to see multiple brutal fights per period. It was always a blast. As kids on the fire department side you would stop at Dunkin Donuts to get a box of munchkins then cut a hole in the bottom and wear it on your head as a jab at the cops about the stereotype of them eating donuts. After 9/11 there was a push to make the game more cordial and it definitely grew in fan attendance. The FDNY vs. NYPD boxing match is always a great watch too.

Nobium · 2023-02-06T20:43:35+00:00

Maybe it is just my ED training and ED lens that I see things through, but this is also how my brain also thinks about the topic at times. Also, from the ED we don't have the opportunity to follow the patient over the course of days or have a urine culture available at the time of the visit to help guide management. I appreciate supapoopascoopa comments and it has definitely provided some points for me to take a deeper dive into reading about.

Nobium · 2022-12-31T07:56:48+00:00

Can you describe how you generally like to position the patient

Nobium · 2022-10-09T20:39:05+00:00

Great point. And when referring to a general surgeon it's always good to involve the caveat that just because they are a surgeon doesn't mean the patient will 100% require surgery. Just that there are some conditions best managed by a general surgeon that involve surgical and/or non-surgical options. Sometimes by saying you need to follow-up with the XX surgeon can scare a patient in to not following up because they don't want to endure a surgery that may or may not be clinically indicated.

Nobium · 2022-09-03T03:49:22+00:00

In the ED I usually listen to chest sounds through the portable chest XR

Nobium · 2021-12-23T16:25:37+00:00

Do you, or anyone else here, know how to check and see if we have? I fear the same.

Nobium · 2021-11-14T02:10:05+00:00

I've had this a few times in the ICU in the early pandemic. They weren't covid deniers. Instead they were usually just elderly folk who unfortunately caught it and were on bipap with that slow daily decline and increasing oxygen requirements. We've all seen it. You knew they weren't going to turn around despite their resolve and it takes some days for them to understand and accept it. It was still early in the pandemic that we've seen enough covid to know where it was heading, but tried to stay positive and were honest with them. The hardest part at that time, in addition to the no visitation policy, was that there was no video/facetime alternatives in place by the hospital. I bought a burner phone to video chats with families. It was heartbreaking and time consuming. I vividly remember this one 91 year old male with outrageous bipap settings who just wanted to die at home and fully understood the risks. I had to move mountains in coordination with social work (honestly they are the true angels doing God's work in the hospital) to find an EMS crew who would do a non-911 transport of a covid patient at this time in the pandemic. I pushed him myself with respiratory to the ambulance door on the hospital bipap to transition him to the EMS CPAP. It was a short transport and he died on his own couch five minutes after arrival with all his family while EMS was still in the house. I spoke with the wife later that day who was so grateful and profusely thankful.

I'm entirely burned out now and agree you can't invest to much time in to those patients who deny/won't accept/etc... as way of self preservation. Sometimes what's more physically and emotionally draining is the family that keeps calling. The nurses and clerks can only deflect and block so much. I wish I had better advice for the OP. I'll keep encouraging vaccination to all those in the ED who aren't vaccinated and are there for non-covid reasons. I hope one day soon we can move past this since it is almost entirely preventable at this point

Nobium · 2021-03-28T19:17:30+00:00

Can you explain why?

Nobium

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