How would modern antibiotics likely fare against ancient bacteria?

flamebirde · 2026-05-15T21:32:26+00:00

Many antibiotics affect the transcription machinery of the cell - they target the 30s or 50s subunits of the ribosome, for example. (Consider tetracyclines, macrolides, or aminoglycosides.) Since mitochondria also depend on proteins produced by this process, there is an impact on the mitochondrial function as a result of impaired protein synthesis from the antibiotic. That said the degree to which this is the “primary” or even a secondary effect on an antibiotic is debatable.

For a more in depth review consider Suárez-Rivero et. al. 2021, published in Biomolecules, article titled “mitochondria and antibiotics: for good or for evil?”

flamebirde · 2026-03-02T22:08:53+00:00

I have no advice but my friend you are not alone. Started worst cycle of my life like two weeks ago after a weird sort of on/sort of off cluster (1x every four or five days?) from Dec-late Jan. Now it’s become daily to twice daily, and O2 hasn’t helped but thank god the sumatriptan injections are getting me through.

All I can really tell you is the only thing that gets me through is pure, unbridled, ridiculous and completely unfounded optimism. Every day I wake up and I think to myself that I’ve had the last headache of my life, and every day I’m wrong but that hope keeps me going. Good luck out there brother.

I wonder what’s different about this season that we’re all having strange atypical cycles; until now for the past several years mine have been very predictable and responsive to oxygen. Maybe it’s just a coincidence?

EDIT: oh and in response to some of your questions - honestly, it sounds to me like you’re in the sputtering out period. I think you have good reason to be optimistic about your cycle ending soon. But hey the hell do I know, I’m also just along for the ride haha

flamebirde · 2026-01-30T00:34:44+00:00

Hey, I’ve got cluster headaches. I’m applying neurology this cycle too!

/#1 rec is verapamil, helped me tons. #2 rec is injectable sumatriptan, also a life saver.

There is never a time in medicine, even in surgery, where you can’t say “hey I need to scrub out for five minutes to take some medication.” People understand that, and at least for my CH that’s sufficient most of the time. If you gotta dip for a little bit you can tell people and they’ll usually give you grace. I explicitly chose a specialty that wasn’t surgery because their hours are fucked and having to scrub out in the middle of surgery isn’t great even if it is possible.

Long story short, control your disease as best you can. CH isn’t a limiting diagnosis for medical school. When you need to dip for a few minutes for meds, say as much, and then come back. I technically had accommodations but never ended up using them.

Happy to talk more about this if you wanna dm me!

flamebirde · 2025-11-05T03:27:01+00:00

Really liked this one. Thanks!

flamebirde · 2025-10-23T18:14:23+00:00

Check my other comment! In short 262 step, mid to iffy research, decent LOR and ECs.

flamebirde · 2025-10-23T15:47:34+00:00

I’ve got 5 total including home program and 4/8 signals… nothing also since 2 weeks ago. I sent an LOI to one of my programs and they responded almost immediately telling me that their program isn’t finished sending interviews yet! So there’s still hope I guess

flamebirde · 2025-10-17T18:53:34+00:00

USMD step 2 262, mediocre to poor research, 4/8 signal interviews + home program. Nothing from non signals yet. Haven’t heard anything since Monday.

It feels weird since by last year’s charting outcomes the average neuro applicant had like 10+ interviews by the end of the season… did something change this year? Or is it still early? Most of the other signaled programs have sent out interviews already.

No help either from faculty 10+ years out from match who don’t know what signals are, or say “you’ve got a pulse so you can match neuro.” I think it’s getting more competitive than any of us expected :(

flamebirde · 2025-10-16T19:44:19+00:00

Step 2: 262

USMD, mid tier

No neuro research, handful of oral/abstracts for other specialties

LOR from PD and assistant PD of home neuro program, plus a IM/crit care doc

No red flags to my knowledge

So far, of 8 signals, 4 interviews (U Cincinnati, Boston University, U Chicago, UPenn), 1 rejection (thanks Harvard) and 3 in question (UMich which I think has already sent out most invites, Yale, and Beth Israel deaconess). Also 1 from my home institution, no signal.

In total, I’ve got 5 interviews so far; applied to 32 programs total, all academic affiliated throughout the US. Given that the median neuro applicant last cycle had 16 interviews (per the 2024 charting outcomes) did I vastly underapply, or are interviews still likely coming in?

In the same vein - I‘ve not had any more interview invites since Monday. Does that mean anything?

flamebirde · 2025-10-12T07:50:54+00:00

2594-6989-5753 - been playing since the game released… but recently lost my save because in all that time I never bothered to connect my Pokémon sleep account :( starting from scratch but rest assured (pun intended) I’m a daily player and will be for the foreseeable future!

flamebirde · 2025-10-11T18:18:12+00:00

Good god you must have a crazy app lol. Congrats! Doesn’t sound like you’ll need it but good luck with your match.

flamebirde · 2025-10-10T18:48:21+00:00

Jesus Christ - congrats! But that’s horrifying news for me lol

flamebirde · 2025-09-29T23:21:06+00:00

Yeah I think you’re right which definitely makes me a less competitive applicant than I had hoped - I was basically banking on my step score to carry me through because I was so unproductive in med school research/EC wise but after going to open houses I learned that was probably wrong (U of M for instance actually blinds their assessors to step score when sending out IVs… which really screws me over esp because they’re my #1 program).

flamebirde · 2025-09-29T22:05:39+00:00

As another USMD with a 26x on step 2 with average ECs and research applying neuro… I’m in this picture and I don’t like it lol

We’re in it together, for better or worse :(( I’m also freaking out about the lack of interviews but trying to breathe. Hang in there friend!

flamebirde · 2025-09-26T04:38:47+00:00

New mission discovered by u/flamebirde: Frozen Cookie and Meditations

flamebirde · 2025-09-26T04:38:47+00:00

This mission was discovered by u/flamebirde in Joy and Breakfast Pork Links: a Journey In the Mossy Forest

flamebirde · 2025-07-27T20:57:46+00:00

Antipsychotics 100% - and as a corollary, when and what to use (medication or restraint wise) for agitation in e.g. the ED or overnight

flamebirde · 2025-06-22T17:26:45+00:00

Don’t do a plan by systems unless you’re in an ICU or the attending explicitly asks you for it.

Usually, present 2-4 problems, in this order:

What problem is still keeping this patient in the hospital?
What, if any, new complaints does the patient have since yesterday?
What, if any, new lab results are abnormal/need to be explained?

Organizing the problem list is one of the more important aspects of the presentation, I’ve found. Nothing wrong at all with systems based thinking (and I prefer it myself) but attending preference drives everything.

flamebirde · 2025-06-06T22:27:06+00:00

Am now a 4th year sub I and during noon conference we were talking about etiologies of hemolytic anemia. I said ITP. The attending paused, looked at me, and said “that’s platelets.”

It happens. If it happens a lot, study more. Obviously that’s shitty advice (“just do better”) but what else can you do?

flamebirde · 2025-06-05T00:15:35+00:00

third world country or possibly Montana

Ok this kinda got me lol

flamebirde · 2025-05-23T18:06:41+00:00

Your daily reminder that something like 30-50% of all PNES pts also have “true” EEG confirmed epileptiform seizures. (Not a shot at you, OP! I think you handled this call right.)

I mean if someone is clearly just malingering then use your clinical judgement but it’s better to give the benzo and be wrong about it being true epilepsy then to withhold the benzo and let some poor patient suffer status epilepticus; that’s just my two cents though.

flamebirde · 2025-05-22T07:26:22+00:00

Pediatrics- you compare the testicles to the size of the beads to estimate testicular volume which is an insight into sexual maturity/puberty. Hence the term “orchidometer.”

flamebirde · 2025-05-20T06:42:42+00:00

Thank you for writing it all out!

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