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cbrsmurf last won the day on March 11 2020

cbrsmurf had the most liked content!


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    Physician Assistant

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  1. Please excuse my ignorance. Can someone explain how this advances our profession?
  2. Yea it looks like they increased it from $130 to $150 to $180 now in a timeframe of 3-4 years. That’s quite a jump.
  3. Here's a trial where they use it humans, although it is being used on patients with an uncommon type of corneal ulcer: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6031214/ Abstract Purpose Platelet-rich plasma (PRP) is an autologous blood product without preservatives and rich in proteins and growth factors which make it possible for cells to differentiate, proliferate, and migrate, thus stimulating healing and regeneration of tissues. The aim of this study was to evaluate the efficiency of autologous platelet-rich plasma in the treatment of neurotrophic keratopathy. Methods The study group consists of 25 patients with nonhealing corneal ulcers due to herpes simplex or herpes zoster infection and facial nerve or trigeminal nerve paralysis as a result of a neurosurgical operation caused by a tumour or stroke. The patients were given autologous platelet-rich plasma drops five times a day and additionally preservative-free artificial tears and a vitamin A ointment at night for maximum 3 months. The following were evaluated: best corrected visual acuity (BCVA), healing of corneal surface, subjective symptoms, and changes in corneal thickness with the use of anterior segment optical coherent tomography (AS-OCT). Results BCVA before the treatment was 0.10 ± 0.14, and after the treatment it was –0.3 ± 0.27 (p=0.001). Improved visual acuity and less subjective symptoms were observed in all patients. Complete healing of the ulceration was observed in 20 patients (80%). Four patients (16%) experienced considerable improvement of their clinical condition (reduced size and depth of the ulceration and inflammatory state: smaller conjunctival injection and swelling, improved visual acuity, and less subjective symptoms). In one of the patients, an amniotic membrane was transplanted due to the lack of improvement of his local condition. In all patients, the progression of corneal thinning was stopped. An average corneal thickness in its thinnest point was 322.3 ± 125.8 µm before the treatment, and 404.5 ± 118.7 µm (p < 0.05) after the treatment. None of the patients reported general or local side effects of the treatment. Conclusions Autologous platelet-rich plasma is a blood-based product which seems efficient in the treatment of neurotrophic keratopathy.
  4. Disagree partially. Yes, we signed up to take care of sick patients. We did not sign up to take care of contagious patients with garbage bags and bandanas for PPE. Where is it stated in the Hippocratic oath or any contract that you have to put you or the people you live with at risk? The general medical field is not the military, you are not obligated to take the field especially without proper equipment. We have the ability to complain about the government or administrators for not adequately preparing for this disaster and putting us at risk, all the while cutting our pay and/or hours. I think it's an individual decision and I do not think people should be shamed for that.
  5. I think you are trying to imply that we should not have a lockdown for Covid19. If we didn't have a complete lockdown, models predict at least 1-2 million people dying in the US alone. On top of that, some patients are left with permanently reduced pulmonary function (unknown percentage at this time).
  6. Read an article about the scientist who did the HCQ/Zpack study. Apparently he has a history of fabricating data/studies. This is highly concerning given that the study design was already very poor. https://forbetterscience.com/2020/03/26/chloroquine-genius-didier-raoult-to-save-the-world-from-covid-19/
  7. ^ I thought I read somewhere that Cuomo signed some legislation that significant limited malpractice in NYC recently to help deal with the pandemic.
  8. No. I would not be a hero by continuing to work. I'll get sick and take possibly take up limited resources. Before I go home to quarantine, I'll be potentially spreading the virus to uninfected patients. Also, CDC does not say bandanas/home made masks/scarves are "OK." They recommend it as a last resort, better than nothing, if no PPE is available. From CDC: "In settings where facemasks are not available, HCP might use homemade masks (e.g., bandana, scarf) for care of patients with COVID-19 as a last resort. However, homemade masks are not considered PPE, since their capability to protect HCP is unknown. Caution should be exercised when considering this option. Homemade masks should ideally be used in combination with a face shield that covers the entire front (that extends to the chin or below) and sides of the face."
  9. If patients survive, 10d according to his Chinese study: https://jamanetwork.com/journals/jama/fullarticle/2761044 There is no evidence past exposure confers future immunity.
  10. It should not be a surprise that if you do not make money, your employer probably cannot afford to keep you on. I would not be surprised if admin and other support staff get laid off or furloughed as well. This applies to every industry, including health care unfortunately. I hope it does not happen to me, but I would not be surprised as I am only seeing 1/3 of the patients I usually see now (and mostly telephone consults).
  11. I don’t envy the mods’ job with regulating political posts since it is practically impossible to separate politics from public health policy, especially during a pandemic. The frustration is understandable as the lack of preparation (or proper response, depending on your perspective) has and will result in healthcare professionals and patients being hurt or killed. I’m afraid bitching about it here won’t get anything done, unfortunately.
  12. I think I saw this first on reddit. People there was saying there are a few errors, particularly the recommendation for corticosteroids. It is NOT recommended unless pt has something comorbid such as COPD. I forget what else.
  13. In vitro, seems to work in vivo good results (actually perfect results) but very poor study
  14. Testing is still incredibly limited where I am. If you are outpatient, got almost no chance of getting tested. What’s it like in your guys’ neighborhoods.
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