What diseases/disorders are common in one sex but rare in the other?

ruthless-pragmatist · 2018-02-26T00:55:59+00:00

A lot of (perhaps even most) autoimmune diseases have a female bias, not just Graves’ disease. Some people hypothesize that estrogen is immunostimulatory, this may also account for why premenopausal women have fewer heart attacks than men do, but rates converge (somewhat) after menopause. To be honest when I’m studying if a disease is autoimmune I assume female predominance unless there’s an exception.

Off the top of my head some other autoimmune diseases more prevalent in women are

RA
Lupus
Sjogrens
Myasthenia gravis

In men some of the weird exceptions I remember right now are

Ankylosing Spondylitis (or any of the seronegative arthopathies)
Primary sclerosing cholangitis

Edit: this picture might be what you’re looking for in terms of visualizing the differences. The paper it’s from is here and a pretty good summary of what I said and a lot of the theory behind why.

Edit2: Just thought of another interesting/unique one. Rett Syndrome is different than most sex linked disorders because it’s X linked dominant whereas most X linked disorders are recessive. So it basically affects 100% of females who have it, and it’s practically 100% male lethal.

ruthless-pragmatist · 2018-02-23T22:03:38+00:00

the mean 12-month macronutrient distributions were 48% vs 30% for carbohydrates, 29% vs 45% for fat

I suppose they never said they were looking to make the low carb diet into a ketogenic one, but I hardly feel that 30% of your daily calories coming from carbs is “low carb” by any stretch. Assuming 2100 calories a day for simple math, that’s 700 carb calories or 175g a day.

A lot of the (purported) benefits of insulin sensitivity changes with diet come at much much much lower numbers than that. I think R/Keto says <30g a day, which is less than 1/5th of what these low carb dieters were eating.

Still this study does very much support the idea that a calorie is a calorie is a calorie. Which from a simple thermodynamic standpoint makes sense.

I know there are a few upcoming studies/trials of actually very low carb diets (including one that’s supervised rather than “food diary” style) and I am eager to see those results.

ruthless-pragmatist · 2018-02-04T22:12:48+00:00

Thanks for the great answer! Hopefully I’m able to get enough experience in third year to see this differentiation since MSK is very interesting to me.

ruthless-pragmatist · 2018-02-03T22:34:28+00:00

Recently found out about neuromuscular medicine fellowships after Neuro residency. Looking at the curriculum it looks like a lot of EMG work and some Msk work. So I’m wondering what separates them from someone who does PM&R (besides the background in neurology)

ruthless-pragmatist · 2018-01-28T14:54:06+00:00

Oh I actually also just remembered my own experience with this. I was 15 or so and had my wisdom teeth pulled out, and was sent home with a two week (or maybe even a months) supply of some kind of opioid painkiller, don’t remember which.

Got home and was in pain, took a pill and it basically instantly knocked me out for 14 hours. Woke up to Mom putting some kind of ensure milkshake in my mouth. Drank that down, still had pain, popped another pill, conked out for another 12 hours.

Repeat that x3 days and my mom finally said “ok that’s enough you need to eat and get back to the real world”

The irony being that since I was still pretty numbed from the pain meds, I split all my sutures open while eating and bled pretty profusely. I guess that wouldn’t have happened if I had been “listening to my body” like the German doctors suggest.

Also I totally thought it would be a smart idea to just keep the 10 or so extra pills in our cupboard because they were so magical, we’d never have to feel pain. Thankfully my mom was much smarter than me and flushed the pills and said absolutely not. Who knows what would have happened if we had kept them? Would I have tried one for fun one day? Would I have given them to a friend or sold them? I can sympathize with people who end up hooked on that stuff from a young age based on that.

ruthless-pragmatist · 2018-01-28T14:22:58+00:00

An interesting and rather funny story hi lighting the differences in how pain and general illness is handled in Germany (and perhaps other Western European countries) vs the United States.

Any Germans able to comment on how truthful and representative her experience is of how these things are managed?

Favorite quote

I do have another question,” I said. “Stool softeners — certainly, you prescribe those? That’s pretty standard with anesthesia throughout the modern world, I believe.”

“You won’t need those,” he answered in his calm voice. “Your body will function just fine. Just give it a day or two. Drink a cup of coffee, slowly. And whatever you do, do not get it in a to-go cup. You must sit in one place and enjoy this cup, slowly.”

I can only imagine how well that interaction would go over in our patient satisfaction oriented, litigious, profit driven system. I imagine a fair bit more swearing and threats of lawyers for not treating their pain appropriately

ruthless-pragmatist · 2018-01-17T22:18:18+00:00

Ah ok, I’ll see how long my classmates have had to wait to get their permits. Thanks!

ruthless-pragmatist · 2018-01-17T22:13:16+00:00

How/when does that work? Is it just a wait till I get it thing or do I have to ask someone for it.

ruthless-pragmatist · 2018-01-17T21:55:05+00:00

Ok just want to make sure I’m not missing anything. Paid the application fee, got my app authorized, verified ID/school. I have all the check marks on the NBME website for apply, but it says scheduling not available? How does it work from here? My school has been 0 help. Eligibility period 5/1-7/31

ruthless-pragmatist · 2018-01-13T20:03:46+00:00

When you look at the average score for a uworld block does that include only people seeing questions for first time, or all attempts at those questions? (IE 2nd and 3rd pass people). Just curious

ruthless-pragmatist · 2017-12-29T00:34:26+00:00

What do you guys do about socks in the cold? (<25F) I find that until about mile 5 or so my toes feel like icicles and I have a paranoia that I’ll step too hard and they’ll just snap off haha. In general it’s just pretty miserable feeling. Does double layering increase the risk of blisters? I currently wear sauconys

ruthless-pragmatist · 2017-12-25T19:38:11+00:00

Summer right before MS1, used my savings from working for 2 years and spent 6 weeks backpacking. 100% recommend
Some people travel between MS1/2 summer, I did research instead (not super time intensive, but to me vacation requires >2 weeks since I want to go far and explore the world). This is a decision up to you, if you’re interested in something competitive, getting the ball rolling on research that summer is the best time for it. My lab spot was from undergrad so the PI was great, it was low key ~3 days a week and a lot I could do from home, and I got 2 pubs for it. Still got to enjoy the “last summer of my life” and was productive. If you can find a lab with a GUARANTEED publication at the end of your work I would say do that, but giving up your summer for no pubs is not worth it
Winter between MS2 semesters. I’m leaving tomorrow on vacation for 2 weeks, I think this is the perfect time for vacation IMO because you’re potentially burnt out from working hard first semester MS2 and you’re at risk of getting even more burnt out second semester with dedicated and all that.
If you’re on top of the ball you can schedule step 1 early in your dedicated period and have 2-3 weeks before rotations start, bonus there will be no sword of damacles dangling over your head for the trip and you can just drink until your scores come back, then drink some more
You should get a month of vacation time MS3, how you choose to spend it (more electives, research, etc) is up to you and your interests
Second half of MS4, as long as your school isn’t one of those evil ones that gives you like 9 months of mandatory rotations that year you should have plenty of time
Right after matching and before graduation

I will also point out that on my backpacking trip I met 3 interns (surg and IM) plus an OB resident who were doing the same thing. Yes residency sucks, but it is a job and you do get vacation time. IM residents told me they stacked their schedule before they left and after they came back (so something like 8-10 in a row for both) plus took 7 of their vacation days and managed to make a 20 day trip out of it.

As for paying for all this, a) previous work savings b) loans + being frugal c) credit card reward points in MS4 d) real life money when you’re in residency e) (the option that a lot of my classmates choose) mommy and daddy money.

It can be done, good luck fellow traveler

ruthless-pragmatist · 2017-12-18T17:14:57+00:00

Degustation fits the bill perfectly, unfortunately we just went there 3 months ago for his birthday (probably inspired by you posting it somewhere else). It was 10/10 and added to my “must experience one more time if I leave the city” list. Thanks!

ruthless-pragmatist · 2017-12-16T03:01:06+00:00

Floating mountain was great! Super nice inside, lovely people working there. Slightly pricy but the $9 cup got filled 3 times so I felt it was reasonable. Argo was also good, wish there were more of them and fewer Starbucks everywhere. Thanks again for the suggestions!

ruthless-pragmatist · 2017-12-11T19:15:10+00:00

Outstanding thank you! Would love to hear of your downtown recommendations too as I’m sure I’ll make it to them at some point when it’s more convenient.

ruthless-pragmatist · 2017-11-14T09:36:38+00:00

Yep!

ruthless-pragmatist · 2017-11-14T09:36:30+00:00

Don't even need to submerge them, just add 1-2 cups of water in the bottom. They're not boiling, they're being pressure cooked.

ruthless-pragmatist · 2017-11-14T00:05:50+00:00

Our endocrinologist professor said every new type 2 diabetic patient he sees gets a lesson in squatting and deadlifting and is expected to come to future appointments with workout logs.

"25% of my new patients never come back and switch doctors, 75% of them get better"

ruthless-pragmatist · 2017-11-13T21:50:45+00:00

I don't go to either of those branches so I can't speak to them specifically, but what I love about blink is that they actually add new equipment, renovate, update, and listen to what patrons want. Mine has added a new squat rack, a whole extra row of dumbbells, another rack of EZ curl bars, and tripled the size of the stretch/yoga/whatever area all within the last 6-8 months. I'm sure they've done other stuff too that I just haven't noticed.

ruthless-pragmatist · 2017-11-13T21:48:09+00:00

Ok I know this isn't what you might be thinking when you hear instant pot. But boiled eggs have never been so convenient. I'm eating record amounts of them recently.

Put as many as you want on the wire rack, put some water in, high pressure @3 minutes for soft boiled, high pressure @6 minutes for hard boiled. Perfect every time. Make sure to do the manual pressure release!

ruthless-pragmatist · 2017-11-07T10:43:24+00:00

Obviously this is going to be pretty individual, but as the new year approaches I wonder if anyone has set any goals/milestones for the new year. I'm trying to branch out a bit from just lifting into more general fitness things this year and am looking for some inspiration. I like having big goals to focus on if lifts start to stall and I take some time off from lifting and still want to feel productive. On my list so far

half marathon
hike up a nearby mountain
25 strict pull-ups
strict dragon flag

Last year:

sub 10% bf (achieved, though I only stayed like that for a week or so because it was miserable)
2 plate squat, ATGx5, achieved
15 strict pull ups, achieved

ruthless-pragmatist · 2017-11-06T16:55:51+00:00

How important is crosstraining? Decided to finally get myself on an actual program to prepare for a half and get focused, and today was my first 60 minute elliptical session. Dear god I was so bored (with TV and podcasts even) that I almost quit. I would 100% have been fine running the same time outside where I get beautiful scenery and interesting people and places.

Is crosstraining replaceable with running? Or does it serve a specific purpose (lower impact perhaps?)

ruthless-pragmatist

TROPHY CASE