We’ve found that just over 60% survive to discharge if cannulated for VV ECMO within 7 days of intubation. This is consistent with prior experience with non-COVID ARDS. Outcomes are less favorable at our institution when cannulated after 7 days.Originally Posted by Caballoflaco
https://www.thelancet.com/journals/l...008-0/fulltext
I like my rifles like my women - short, light, fast, brown, and suppressed.
Not sure if you saw the Lilly press release that came out today, but I thought it would elicit a healthy eye roll from you.
Patients treated with baricitinib in combination with remdesivir had a significant reduction in median time to recovery from 8 to 7 days (12.5% improvement) compared to remdesivir [hazard ratio: 1.15; 95% CI 1.00, 1.31; p=0.047].
Patients treated with baricitinib in combination with remdesivir were more likely to have a better clinical status at Day 15 compared to patients treated with remdesivir [odds ratio: 1.26; 95% CI 1.01, 1.57; p=0.044].
The proportion of patients who progressed to ventilation (non-invasive or invasive) or died by Day 29 was lower in baricitinib in combination with remdesivir (23%) compared to remdesivir (28%) [odds ratio: 0.74; 95% CI 0.56, 0.99; p=0.039].
The proportion of patients who died by Day 29 was 4.7% for baricitinib in combination with remdesivir vs. 7.1% for remdesivir, a relative reduction of 35% [Kaplan Meier estimated difference in Day 29 probability of mortality: -2.6% (95% CI -5.8%, 0.5%)].
Remember this spring when rural folks were pointing out how all the trouble seemed to be in cities?
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Many rural communities across the U.S. have resisted masks and calls for social distancing during the coronavirus pandemic, but now rural counties are experiencing record-high infection and death rates
Critically ill rural patients are often sent to city hospitals for high-level treatment, and as their numbers grow, some urban hospitals are buckling under the added strain.
Kansas City has a mask mandate, but in many smaller communities nearby, masks aren't required — or masking orders are routinely ignored. In the last few months, rural counties in both Kansas and Missouri have seen some of the highest rates of COVID-19 in the country.
At the same time, about three out of four counties in Kansas and Missouri don't have a single intensive care unit bed, so when people from these places get critically ill, they're sent to city hospitals.
A recent patient count at St. Luke's Health System in Kansas City showed a quarter of COVID-19 patients had come from outside of the metro.
https://www.npr.org/sections/health-...spital-capacit
Yeah.
In College, one of my biochemistry professors had a Nobel prize for the discovery of Cysteine sulfur bonds in DNA.
In Residency, the group of old guys who showed up to the Coagulation conference had discovered about half of the intrinsic clotting cascade factors.
On one hand, it's kinda hard not to be awed by them. On the other hand, after listening to them kvetch about this or that, or talk about their grandkids, etc, they're just people.
The difference is, they are people who were actually paying attention when something didn't work like it was supposed to. Remember, Fleming wasn't the first person to have mold ruin his bacteria plate, he was the first one who didn't throw it out and start over. And that, is the moment of genius.
Those old guys (and ladies) are awesome. I've had a few, no Nobel Laureates, but one who was close. They're the tentpoles that hold up the whole field. Lots of people do useful work, but there's a select few who are the icebreakers that make the big discoveries that give the regular scientists something to grind on. Sorry for mixing metaphors there.
Any opinions on Merck's CEO Kenneth Frazier "You can’t rush science" commentos on COVID vaccines?
Although logical, it seems there is a component of "Dang, we missed the boat!"...
https://www.cnbc.com/2020/09/09/merc...s-vaccine.html
https://www.cnbc.com/2020/10/29/covi...le-future.html
Too bad you can’t make a vaccine out of sour grapes.
Ignore Alien Orders
Critique of the recent vaccine studies.
What COVID Vaccine Hype Fails to Mention.
There was no information about the cycle number for the PCR tests. There was no information about whether the “cases” had symptoms or not. There was no information about hospitalizations or deaths. The Pfizer study had 43,538 participants and was analyzed after 164 cases. So, roughly 150 out 21,750 participants (less than 0.7 percent) became PCR positive in the control group and about one-tenth that number in the vaccine group became PCR positive. The Moderna trial had 30,000 participants. There were 95 “cases” in the 15,000 control participants (about 0.6 percent) and 5 “cases” in the 15,000 vaccine participants (about one-twentieth of 0.6 percent). The “efficacy” figures quoted in these announcements are odds ratios.
There is no evidence, yet, that the vaccine prevented any hospitalizations or any deaths. The Moderna announcement claimed that eleven cases in the control group were “severe” disease, but “severe” was not defined. If there were any hospitalizations or deaths in either group, the public has not been told. When the risks of an event are small, odds ratios can be misleading about absolute risk. A more meaningful measure of efficacy would be the number to vaccinate to prevent one hospitalization or one death. Those numbers are not available. An estimate of the number to treat from the Moderna trial to prevent a single “case” would be fifteen thousand vaccinations to prevent ninety “cases” or 167 vaccinations per “case” prevented which does not sound nearly as good as 94.5 percent effective. The publicists working for pharmaceutical companies are very smart people. If there were a reduction in mortality from these vaccines, that information would be in the first paragraph of the announcement.
David S.
In college I had a physics professor who was Korean. He went to boarding high school in Japan and was there when the bombs dropped. He talked of what he witnessed at his local train station, people with radiation burns who were fleeing the blast areas. Fellow students who went home looking for family in and near Hiroshima & Nagasaki never to return to school.
Later he came to the U.S. to study at Princeton. He spoke of an old physics professor puttering around the labs he would occasionally run into, his name Albert Einstein.
I've been wondering since spring why HVAC wasn't getting more attention.
Blog post from a UW prof on the efficacy of filters:
https://cliffmass.blogspot.com/2020/...purifiers.html
He links to a more in depth discussion from the EPA.
We did the high-MERV filter+box fan thing when the smoke was bad this summer, and it seemed to work pretty well.
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