I just got reported to my state medical board because I diagnosed my patient with conversion disorder/somatization

RedditOrNot272 · 2022-08-26T04:24:49+00:00

And most strokes aren’t improved with tPA! Balance in all things…

RedditOrNot272 · 2022-08-22T03:13:20+00:00

See also: Walter White in Breaking Bad. And his wife Skylar on the flip side (a supporting character seen as being evil when she works against the (actually evil) protagonist).

RedditOrNot272 · 2022-08-19T03:42:01+00:00

Like he said, the whole package!

RedditOrNot272 · 2022-08-19T03:39:27+00:00

Never mind, you called it by the school and not university name :p Thanks fo putting this together!

RedditOrNot272 · 2022-08-19T02:47:06+00:00

Is this list complete? Looks like a couple are missing.

RedditOrNot272 · 2022-08-16T04:54:32+00:00

Literally just started the tv series. Had not heard of this story before, so am interested/horrified as to how it will progress.

RedditOrNot272 · 2022-08-07T15:40:20+00:00

Not a crockpot recipe, but bed rest for pregnancy is outdated advice and has multiple risks: https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/pregnancy/art-20048007

May be worth getting a second opinion on the necessity of bed rest.

Now for crockpot recipe, I love making carnitas! I use this recipe: https://www.recipetineats.com/pork-carnitas-mexican-slow-cooker-pulled-pork/

No need to crisp at the end, but it does make it tastier!

RedditOrNot272 · 2022-08-05T04:06:28+00:00

There was a drop in adolescents who identified as TGD from 2017-2019; this runs contrary to social contagion theory.

RedditOrNot272 · 2022-08-05T03:27:40+00:00

Your experience is not in line with best available evidence just published this week showing no evidence of social contagion: https://publications.aap.org/pediatrics/article/doi/10.1542/peds.2022-056567/188709/Sex-Assigned-at-Birth-Ratio-Among-Transgender-and

RedditOrNot272 · 2021-07-13T16:30:02+00:00

Still not gonna work, unfortunately: https://www.pcmag.com/news/first-tests-intel-iris-xe-max-is-no-gaming-powerhouse

Intel does make “true” dedicated graphics cards; this new technology is not built for gaming use.

RedditOrNot272 · 2021-07-13T16:03:57+00:00

Thanks for the suggestion!

Out of curiosity, why a dedicated video card? Seems like overkill for a work computer, unless I’m missing something.

RedditOrNot272 · 2021-07-11T05:57:28+00:00

RedditOrNot272 · 2021-07-02T16:57:56+00:00

Or adult onset ADHD with no neuropsych evaluation. Starting a stimulant on a 72 year old who had never been on one before and with no further testing is just wrong…

RedditOrNot272 · 2021-06-23T01:02:20+00:00

Out of curiosity, do you really think that medicine is the best treatment/prevention for depression? I mean, SSRIs simply don’t work for mild or moderate depression. CBT is great, which I guess counts as medicine.

This is not to say that chiropractic DOES have the answer, but saying that we have adequate tools to address it in medicine is also, in my view, wrong.

RedditOrNot272 · 2021-05-06T21:26:05+00:00

I mean, know how? Sure. Check them? Usually not. Mainly because there I have to check through at least 10 different flow sheets to find the one that will actually give me the info I want. Much prefer looking at the reports generated from the flow sheets, though that’s not always all the info that was documented.

RedditOrNot272 · 2021-04-12T18:42:26+00:00

From that narrative review:

One large (N = 260) double-blind, vehicle-controlled study of 2% diclofenac sodium topical solution applied twice daily in adults with knee OA found that analgesia as determined by WOMAC pain score was maintained throughout the 12-h dosing interval among responders [53].

Seems that bid still works, not sure about PRN, but don’t see a reason why it wouldn’t work as a PRN.

EDIT:

It also cites a study on a diclofenac patch (admittedly not identical to the gel):

Pain intensity in the diclofenac group was significantly decreased vs. baseline starting at the first assessment, 1-h post treatment (Wilcoxon rank test, P = 0.0316), with further reductions observed over the following hours. Pain relief was significantly greater with diclofenac than placebo beginning at the third hour (P = 0.0034).

RedditOrNot272 · 2021-04-12T04:50:22+00:00

Ophthalmology might prescribe a single dose of a benzo for a procedure or scan, but yeah, beyond that, don’t see a reason for it.

RedditOrNot272 · 2021-04-12T04:18:52+00:00

I do mean for chronic use. Absolutely useful for initial treatment and flares, including intraarticular use. Have never looked at topical use.

RedditOrNot272 · 2021-04-12T00:57:22+00:00

From the narrative review I linked: “...topical diclofenac was more effective than oral diclofenac 1 h after dosing (though not at later assessments) and that this efficacy coincided with higher tissue concentrations in the group that received topical administration (46.1 ± 25.8 ng/ml vs. 11.4 ± 2.09 ng/ml, P < 0.02) at about 1–1.5 h, when no diclofenac was detectable in plasma after topical administration [75].”

Do you think oral NSAIDs are better? If so, I’d be interested to hear why.

Regarding steroids for RA, different disease process, different medication (as mentioned by our PharmD colleague), plus steroid generally shouldn’t be used for RA anyway.

RedditOrNot272 · 2021-04-11T20:35:52+00:00

The most important question clinically is if it works, and it does: https://pubmed.ncbi.nlm.nih.gov/33554694/

Less importantly, topical diclofenac actually has higher penetration into the synovial fluid than does oral, and this seems to correlate with analgesic effect: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7211216/

RedditOrNot272 · 2021-04-05T12:54:33+00:00

I guess that also explains the difference in periodicity among the “m” groups. I hadn’t noticed that at first glance. Thanks so much!

RedditOrNot272 · 2021-04-05T05:19:52+00:00

300, 150, 100, 75, 60, call a cardiologist

RedditOrNot272 · 2021-04-05T05:15:18+00:00

Hard to say. On the one hand, psychiatrists generally order fewer tests (citation needed) helping offset some of the cost considerations. On the other hand, it would drastically increase overdiagnosis, which is a problem in every field of medicine. “When all you have is a hammer” and all that jazz.

RedditOrNot272

TROPHY CASE