The reason people get endophthalmitis is rarely due to a contaminated batch, but it certainly happens. But frankly it’s unsustainable to have all patients on branded drug, it would be too costly for patients and payers. Not to mention it is slightly unethical in the US due to drug rebates incentivizing branded drug use.
Endophthalmitis is bad, but we can treat it if caught promptly. Patient education, informed consent, good hygiene practices, and easy access to their ophthalmologist can make a tremendous difference.
I’m in ophthalmology where AI diagnostics have been promised for almost a decade. We have FDA approved diagnostics for diabetic retinopathy screening that has been commercially available since 2018, and papers claiming board certified ophthalmologist level classification accuracy as far back as inceptionv3. Maybe it’s just an economic barrier but these tools still haven’t made any meaningful impact in the US. Other countries without healthcare access? It’s helpful for culling the herd, but it doesn’t fix the last mile problem of what you do when you find referable disease that needs treatment.
My philosophical take: if AI can outperform the average, it’s probably a net benefit for society that I won’t have a job. Until then, I’m going to take my income and save up for an early retirement.
It’s not often that an ophthalmology study makes it into the New England journal of medicine. This is pretty neat technology, but subretinal surgery is a skill mostly forgotten by retina surgeons. It will be interesting to see who will end up offering this kind of surgery.
They didn’t really demonstrate that patients without the implant had worse vision. You could argue that with the magnifying glasses themselves that patients could improve their vision without surgery. So it will be up to a future study to determine this.
As someone at an academic institution, this drives me insane. I mean, have some sort of pride in your work. Copy forward but make the necessary changes!!
Most people don't get blocks nowadays for cataract surgery. I will do so for patients with wandering eye movements or for more difficult cases, or for more invasive surgery besides cataract surgery. I just did a cataract surgery on a young patient today using topical numbing drops. But I have them monitored by an anesthetist with mild sedation during the entire case.
Eye surgeon here:
FLACS isn't really that amazing. I would actually argue that a man made incision using steel or diamond (yes, diamond) is better than the incision made using the femto laser for long term safety/sealing. Number of studies have borne this out.
95% success rate seems low. you need to define success in this scenario. Are we aiming for 20/20 vision outcomes? Just getting the cataract out in full?
Eye doctor here:
some hot takes in this thread about the diagnostic abilities of the specialists involved in this patient's care. It's easy to be an armchair clinician.
The timeline for delayed immune reaction to a leptospirosis infection makes diagnosis incredibly difficult. There was no mention of an acute febrile illness preceding this during the patient's trip to the tropics, which I assume a uveitis specialist would ask.
While empiric treatment with doxycycline wouldn't be a bad idea, you have to decide what to empirically treat with, and for how long, and what the ramifications of increasing resistance to antibiotics are for society. Do I commit a patient to the hospital for two weeks of IV penicillin because I "suspect" syphilis? of course not.
Better diagnostics for these occult diseases should be applauded. But we shouldn't be vilifying the clinicians that are by all accounts doing their best.
This is something that really bothered me - I had an app that was small and worked fine on the latest Android OS, yet they took the app and account down because we hadn’t uploaded a new version in a year. Appeals didn’t help
Advantage is relevant. Medicare advantage is a specific type of plan that isn’t quite Medicare that insurance companies offer. And it’s at the center of that case.
holy crap, that’s insane. You don’t just accidentally add sildenafil or tadalafil to your supplements. Unless the FDA is misidentifying compounds present in the herbs in these supplements, which seems unlikely but I’m no pharmacology expert.
Note this strategy is mainly only being executed by Nintendo, who insists on selling their hardware at a profit. I still suspect they are making more money on their software though.
I believe Microsoft And Sony lose money per console sold
This is correct. Do you know what percent of lung cancer is attributable to smoking? 90%! 9/10 lung cancer deaths are attributable to smoking.
Compare this to ~5% of cancer related death attributable to alcohol use.
It's just not even an accurate comparison.
To be honest though? I am willing to bet that cost to healthcare system for alcohol related illness is outpacing that of smoking related illness. Cirrhosis of the liver is a very costly disease when it gets close to end stage.
Armchair thought that the author never brought up - food with high protein “tasted gross” per author, until starting what they thought provided anti histamine activity. I know that if I have a stuffed nose from cold or allergy, I also find that food tastes miserable, because sense of smell is so important in human perception of taste.
Endophthalmitis is bad, but we can treat it if caught promptly. Patient education, informed consent, good hygiene practices, and easy access to their ophthalmologist can make a tremendous difference.
Source: I do these injections for a living.