What did you learn today?

[Russell L]

ALL the best beams headed your way from North Georgia.

Don’t worry about the
Drop D...I love my 5 string!

Your heart is a five-stringer?

 

[the harp unstrung]

Five strings...
Five chambers...

Whatever it takes!

 

[Tom Bomb]

Critical cows can be confusingly cosmic. … Mysterious cosmic 'Cow' may have produced a black hole or fast-spinning neutron star.

The sudden appearance of a powerful blast from a nearby galaxy last year sent astronomers around the world into a spin. …

Key points:

"The Cow" was detected in a galaxy 200 million light-years from Earth.

The event was tracked for months by more than 100 astronomers using telescopes around the world and in the sky.

The jury is still out about what caused it — astronomers say it could be a new type of cosmic blast or black hole shredding a star.

… It soon became clear the explosion, called AT2018cow — or simply "the Cow" — was like nothing the astronomers had seen before.


… After chasing down the Cow for more than six months, they are still baffled. …

 

[paste]

TIL argyria is a condition where too much silver in the diet will turn you into a smurf.

 

[paste]

TIL this is the president of Mongolia, Battulga.

 

[blastoff99]

I learned that in spite of a hospital computer system that flagged Medication K as a severe intolerance (historically not once but twice), an RN and an MD that both heard the patient say 'I can't have that or anything like that,' the conscious, lucid, insistent, clean/sober patient was nonetheless given a medication that is in the same class as Medication K.

What I'd like to know next is if this computer system somehow thought that a next-gen version of Medication K didn't come from the same class as Medication K (it does!) or if, over the objections of the computer and the patient, the MD and RN decided to give the drug anyway.

 

[S-Bigbottom]

or if, over the objections of the computer and the patient, the MD and RN decided to give the drug anyway.

That it it.

 

[PillO]

I learned that in spite of a hospital computer system that flagged Medication K as a severe intolerance (historically not once but twice), an RN and an MD that both heard the patient say 'I can't have that or anything like that,' the conscious, lucid, insistent, clean/sober patient was nonetheless given a medication that is in the same class as Medication K.

What I'd like to know next is if this computer system somehow thought that a next-gen version of Medication K didn't come from the same class as Medication K (it does!) or if, over the objections of the computer and the patient, the MD and RN decided to give the drug anyway.

Sorry to hear about this.

I will point out that the least reliable source of information about patient allergies and intolerances is the patient. As an example, self-reported penicillin allergy ranges (depending on the study) from 1% to 10%. However, penicillin allergy (evidenced by antibodies to penicillin) is less than 0.1%. The patient that self-reports an allergy, who does not have a true allergy, can lead to choices of antibiotic that are simultaneously more expensive and less effective and may also contribute to the development of drug resistant bacteria.

Drug allergy and intolerance is a very complicated area and adding poor information to the mix can make treatment choices exceedingly difficult.

 

[blastoff99]

Sorry to hear about this.

I will point out that the least reliable source of information about patient allergies and intolerances is the patient. As an example, self-reported penicillin allergy ranges (depending on the study) from 1% to 10%. However, penicillin allergy (evidenced by antibodies to penicillin) is less than 0.1%. The patient that self-reports an allergy, who does not have a true allergy, can lead to choices of antibiotic that are simultaneously more expensive and less effective and may also contribute to the development of drug resistant bacteria.

Drug allergy and intolerance is a very complicated area and adding poor information to the mix can make treatment choices exceedingly difficult.

Fair enough. But when the patient's most recent previous visit to that very ER was due to being given a cephalosporin antibiotic and having a severe reaction to it, AND the computer says 'Nope,' AND the patient (the conscious, lucid, sober, insistent patient) says 'No Keflex or anything remotely like it, ever,' AND the nurse says 'ceftriaxone for you' and the patient says 'sounds like related to Keflex' and the nurse says 'Nope it isn't,' then the problem is most emphatically NOT the reliability of the patient self-reporting an intolerance.

Further, neither the drug given intravenously nor the drug prescribed for the ten-day course are listed to be effective against the GI infection the patient was known to have (but hey, they're good for gonorrhea and otitis media and skin infections!) OR the infection the MD told the patient he had (which he does not in fact have).

While I appreciate the validity of your comment in general, please do not attempt to defend these clowns.


Edited to get rid of a sort-of double negative.

 

[PillO]

Fair enough. But when the patient's most recent previous visit to that very ER was due to being given a cephalosporin antibiotic and having a severe reaction to it, AND the computer says 'Nope,' AND the patient (the conscious, lucid, sober, insistent patient) says 'No Keflex or anything remotely like it, ever,' AND the nurse says 'ceftriaxone for you' and the patient says 'sounds like related to Keflex' and the nurse says 'Nope it isn't,' then the problem is most emphatically NOT the reliability of the patient self-reporting an intolerance.

Further, neither the drug given intravenously nor the drug prescribed for the ten-day course are listed to be effective against the GI infection the patient was known to have (but hey, they're good for gonorrhea and otitis media and skin infections!) OR the infection the MD told the patient he had (which he does not in fact have).

While I appreciate the validity of your comment in general, please do not attempt to defend these clowns.


Edited to get rid of a sort-of double negative.

Not trying to excuse those (or any other) clowns, just thought it was worthwhile pointing out why self-report is generally ignored.

Another fascinating study done in UK about 20 years ago. Patients that were having a lower limb amputation were given a black permanent marker and told to write "do not cut" on their good limb. Half got it wrong.

 

[PillO]

Fair enough. But when the patient's most recent previous visit to that very ER was due to being given a cephalosporin antibiotic and having a severe reaction to it, AND the computer says 'Nope,' AND the patient (the conscious, lucid, sober, insistent patient) says 'No Keflex or anything remotely like it, ever,' AND the nurse says 'ceftriaxone for you' and the patient says 'sounds like related to Keflex' and the nurse says 'Nope it isn't,' then the problem is most emphatically NOT the reliability of the patient self-reporting an intolerance.

Further, neither the drug given intravenously nor the drug prescribed for the ten-day course are listed to be effective against the GI infection the patient was known to have (but hey, they're good for gonorrhea and otitis media and skin infections!) OR the infection the MD told the patient he had (which he does not in fact have).

While I appreciate the validity of your comment in general, please do not attempt to defend these clowns.


Edited to get rid of a sort-of double negative.

I'll add one more point (again, not excusing the clowns, I have no data beyond what you presented and details are important in here), Keflex is a 1st generation cephalosporin, whereas ceftriaxone is third generation. For the small number of patients that may experience a problem (and again, for clarity, I am not excusing any clowns and I have no idea what the problem(s) are/were) with a 1st generation may not experience the problem with a 3rd generation; it depends upon what the reaction was.

I don't have any detail, nor do I want any. I am not excusing the clowns, just presenting some information.

 

[Tom Bomb]

Just a wee bit did I learn about the Snark phenomenon — "The only significant piece of information we have about the Snark’s identity is that it might be a Boojum."
Slaying the Snark: what nonsense verse tells us about reality | Aeon Ideas

 

[PWRL]

I learned this:

https://gizmodo.com/mother-of-all-breaches-exposes-773-million-emails-21-m-1831833456

 

[Groove Doctor]

Fair enough. But when the patient's most recent previous visit to that very ER was due to being given a cephalosporin antibiotic and having a severe reaction to it, AND the computer says 'Nope,' AND the patient (the conscious, lucid, sober, insistent patient) says 'No Keflex or anything remotely like it, ever,' AND the nurse says 'ceftriaxone for you' and the patient says 'sounds like related to Keflex' and the nurse says 'Nope it isn't,' then the problem is most emphatically NOT the reliability of the patient self-reporting an intolerance.

Further, neither the drug given intravenously nor the drug prescribed for the ten-day course are listed to be effective against the GI infection the patient was known to have (but hey, they're good for gonorrhea and otitis media and skin infections!) OR the infection the MD told the patient he had (which he does not in fact have).

While I appreciate the validity of your comment in general, please do not attempt to defend these clowns.

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• A recent Johns Hopkins study claims more than 250,000 people in the U.S. die every year from medical errors. Other reports claim the numbers to be as high as 440,000.
• Medical errors are the third-leading cause of death after heart disease and cancer.

Here are some other ways patients can be vigilant right now:

Ask questions.
Gain as much insight as you can from your health-care provider. Ask about the benefits, side effects and disadvantages of a recommended medication or procedure. Use social media to learn more about the patient's own condition, as well as those medications and procedures for which they were prescribed.

Seek a second opinion.
If the situation warrants or if uncertainties exist, get a second opinion from another doctor: A good doctor will welcome confirmation of his diagnosis and resist any efforts to discourage the patient from learning more — or what Makary calls, "attempts to gag the patient."

"Too often," he said, "the health-care system silences people around a problem." Why? Many doctors are reluctant to speculate, but some admit the answers range from simple ego to losing a patient to another doctor they trust more.

Bring along an advocate.
Sometimes it's hard to process all the information by yourself. Bring a family member or a friend to your appointment — someone who can understand the information and suggestions given and ask questions.

Ilene Corina, president and founder of the Pulse Center for Patient Safety Education & Advocacy, based in Wantagh, New York, urges both the patient and their advocate to be "respectful but assertive" in seeking answers to the questions they may have. In some cases, she recommends a "designated medication manager" to be a safety check on the advice the care provider gives.

Download an app.
By having your medical information literally in the palm of your hand, you can work as a team with your doctor to cut your risk for medical errors. Health-care apps can be simple or complex, and depending on your age and condition, you can manage your well-being, medications and more.

 

[Tom Bomb]

​

Not so Quixotic, tilting at windmills. Renewables overtake coal as Germany's main energy source | Reuters.​

 

[paste]

TIL bears sometimes shed a type of tapeworm commonly called the broad fish tapeworm. This will slightly stress the bear but insignificant to the bear’s health.

 

[paste]

TIL that Sodium Citrate is the secret ingredient to make any cheese into smooth, creamy nacho cheese sauce. Coincidentally, Sodium Citrate's chemical formula is Na3C6H5O7 (NaCHO).

[Invalid or Expired Link Removed]

 

[MJ5150]

What I'd like to know next is if this computer system somehow thought that a next-gen version of Medication K didn't come from the same class as Medication K (it does!) or if, over the objections of the computer and the patient, the MD and RN decided to give the drug anyway.

I work in this industry, healthcare IT and specifically EMR/EHR software. Drug interaction databases are managed and updated on a regular basis by the software vendor or a third party vendor they in turn contract to.
It is typically reliable for detection of potential allergy issues or when conflicting meds are prescribed.
However, the 'garbage in, garbage out' rule applies here as well. The computer system is only as good as the data entered into it.
A typo by a clinician, a misunderstanding, a mistake in the drug name/family, failure to update the drug interaction database files, or ignoring the patients request/info/suggestion/comment are all possible reasons this happened.
Many clinics and providers now thoroughly review a patients medication list and known allergies at each visit. My doctor has me do it online before each visit. They use the Epic EHR software like many enterprise healthcare organizations do. I can see what I have been prescribed, what I am known allergic to, and any medications I am currently taking if there are any. I have room to add my comments and remove anything I am no longer taking.
If your (not you specifically buddy, just speaking to 'your' generally) provider is not doing this, insist they do.

-Mike

 

[spiritbass]

I didn't know until today that since around the year 2000, most automatic transmissions learn and adapt to your driving style by adjusting shift points. I had no idea...

 

[PWRL]

I didn't know until today that since around the year 2000, most automatic transmissions learn and adapt to your driving style by adjusting shift points. I had no idea...

That's entirely new to me, too.