Stoked!
Memes like that should inspire schoolteachers everywhere to cough shamelessly on boomers whenever the opportunity presents itself.
Public golf in California next Monday.
IMO, you can move that notion from preconceived to validated. For every loon on tv there are 500 programmed to cheer him. Another 500 quietly nod and silently agree.
I get both US and Canada on the telly. Seem your news is informative while here it is designed to incite and generate $$$.
A few people feel the rain. Most people just get wet.
This paper https://www.medrxiv.org/content/10.1...856v1.full.pdf
compares 11 tests head to head, several with low <90% specificity but 2-3 come in >99% specific with >90% sensitivity. More studies like this will be helpful for validating AB responses.
Move upside and let the man go through...
This is the mechanism by which a lot of younger people are getting into trouble (as well as the expected issues with older patients). I'd kinda alluded to it earlier:
Apologies for the vague musings on my part, that post was kinda oblique.
So I'll explain further: a lot of the microembolic (small clots) phenomena seen in severe cases of SARS CoV 2 reminds me of a condition often seen in the ICU in really sick patients called disseminated intravascular coagulopathy (DIC) but has some key differences that make me think it's not quite that, although there is likely a fair amount of clinical overlap.
In reading the reports, the SARS CoV 2 behaviour brought to my mind a much less common condition called catastrophic antiphospholipid syndrome (CAPS). CAPS is pretty darn rare, I've only been called to consult on it a few times over the years, but the upshot is it manifests as widespread microemboli that can affect a wide variety of organs with severe results - strokes, cardiac arrest, pulmonary failure from clots or bleeding, kidney failure among others, also with skin manifestations from hemorrhage/clotting, usually in the distal extremities like the toes. It's very often fatal. These CAPS symptoms mirror what we're seeing in endstage SARS CoV 2. What causes CAPS is the patient has/develops antibodies to surface antigens on their own cells, primarily proteins involved in plasma phospholipid binding. This is felt to trigger inappropriate clotting in a cascading/snowballing manner, leading to the end result.
It's known that viremias can trigger antiphospholipid antibody formation, well established in earlier studies with several different viruses, including prior coronaviruses. And in fact, a recent paper in New England Journal article from 4/23 describes a case series of SARS CoV 2 patients with coagulopathy (inappropriate clotting) and antiphospholipid antibodies. There's almost certainly other biological factors at work, more than likely having to do with individual patient characteristics such as intrinsic immunity from genetic and environmental exposures, but I think there's a signal here.
As far as treatment for CAPS, that's been a tough nut to crack over the years. A new manufactured monoclonal antibody called eculizumab targets part of the runaway coagulation cascade, and we use it a lot on our service. There's a clinical trial up and running using eculizumab (Solaris) on endstage SARS CoV 2 patients. We'll see how it goes.
Counterpoint to that:
https://slate.com/news-and-politics/...istancing.html
You can feel the nation's bones creak under the weight of these dense MFers. On one had, it's all a bit sad because clearly a few of these people are mentally ill - others, just poorly equipped for a normal life. But the 'both sides' and equal reporting / representation is stifling our progress. In the old days, you said some BS like this and your neighbor would turn to you and go " you know what? you sound like nut"... these days they get media time and forums that appear semi-legitimate and become part of the public debate. Madness. It degrades the entire conversation. One girl in the video did have massive cans tho.
The Cell paper linked below proposes direct viral infection of blood vessels and capillary beds via ACE2 receptors on vascular smooth muscle endothelial cells and in kidney tubules.
https://www.sciencedirect.com/scienc...92867420303998
Move upside and let the man go through...
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