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Showing content with the highest reputation on 24/01/21 in all areas

  1. 14 points
    Mechanical ventilation means using a machine to breathe for the patient. This can be done in a number of ways. What most people would call ventilation is what we would call invasive ventilation: a tube in someone's windpipe either through the mouth/nose or a hole in the neck. Invasive ventilation can be used to fully take over someone's breathing (mandatory ventilation) or to help/support their own attempts at breathing (assisted ventilation) Other types of ventilation would be classed as non-invasive. This would include face masks and hoods, often called NIV. These methods cannot (or perhaps should not in normal circumstances) be used to fully take over someone's breathing, but are used to assist breathing. Options like CPAP and high-flow oxygen are not types of ventilation as they don't assist with breathing, they are just a way of providing more oxygen. Invasive ventilation is only done (in ideal circumstances) in the intensive care unit. Non-invasive ventilation, CPAP and high-flow oxygen can and is often done in medical wards. This is one of the changes we've seen in the first wave - where the evidence from Italy was that we should rapidly intubate and invasively ventilate patients, whereas we now see that many can be managed with non-invasive techniques. There will be some patients who are invasively ventilated that are rapidly weaned and come off ventilation. However, for the majority, this is a very slow process. This is the backlog we see in ICU that patients take a long time to get better. ICU care is also not just about ventilation. Very sick patients develop muliple-organ dysfunction and often need advanced support for blood pressure, kidneys and other organs, even if their lungs are better. Since we're managing more patients on the wards, the patients that get admitted to ICU are by definition sicker, as they're often the ones that fail ward management and are a self-selected group.
  2. 13 points
    Telling a medical professional how to treat patients is a punchy call - even for this thread.
  3. 10 points
    You are arguing with a Medical Professional, stop pretending you know everything there is to know about everything that has ever been because you spent a few years at Uni studying fucking History.
  4. 9 points
  5. 8 points
    This is from our GP...
  6. 8 points
    Because before we start firing random drugs into critically unwell patients, we need to know if they're effective or not. Not all morbidity and mortality in Covid is caused by inflammation and not all "anti-inflammatories" work in the same way and some could potentially cause worse outcomes. There's no point in a drug reducing your risk of dying from Covid if it increases your risk of dying from something else. For example, we used to give anti-arrhythmic drugs to everyone who had a heart attack, because we knew that many people who died later died because they had an arrhythmia. This was common practice, but we stopped when someone actually did a randomised trial and we found that you actually had a higher chance of dying if you were given the anti-arrhythmic than not. Just because there's plausible reasons why something might work, doesn't mean it will in practice. It's the same issue in Covid. Lot's of drugs have potential benefits, but they need to be actually studied properly. There are massive trials going on at the moment, like the RECOVERY trial (https://www.recoverytrial.net/) which has recruited and randomised tens of thousands of patients (an amazing achievement in the current circumstances) and has given us great data on what is and isn't effective. Things like dexamethasone (effective), convalescent plasma (waste of time), azithromycin (no benefit), hydroxychloroquine (more likely to kill you than save you).
  7. 7 points
    As I said, just because drugs may work in theory does not mean they will work as expected in practice. Aspirin, dexamethasone, colchicine, infliximab, hydroxycloroquine, paracetamol: all anti-inflammatories, all with different mechanisms of action and effects. Inflammation isn't just one entity either, it's a combination of thousands of different physiological pathways, only a small number of which we fully understand. It's usually a protective and beneficial response to illness, it's uncontrolled, pathological inflammation that is the problem*. Anti-inflammatories aren't a homogenous class of drug, they have a myriad of effects caused by a myriad of different (and often not understood) pathways. In your example above, there really isn't a difference between using hydroxycholoroquine (an "already medically tested anti-inflammatory drug") and bleach in Covid. They are both more likely to kill you than benefit you. *gross oversimplification here, but point still stands
  8. 7 points
    It's amazing the number of people who scoff at 'that Devi Sridhar woman's Covid zero nonsense' also want what a covid zero policy has achieved
  9. 7 points
    A few from a visit to Skye late last year
  10. 7 points
    Btw, hats off (both of them) to John Mcglynn. I always thought he was a great servant at Hearts who suffered from getting the job when he shouldn't have. Because of that it tarnished his image with Hearts fans, but glad to see him doing well, he deserves it.
  11. 6 points
    Makes you think, mind: things would be very different if Aberdeen had beaten us in the last 16. For one thing, Livingston would be lining up to play Rangers today.
  12. 6 points
    Ach well it looks like you lads are gonna win the league, thank goodness for that. I say that out of no affection for RFC, I'm just delighted I won't have to listen to this 10 in a row pish for at least 10 years. As someone who will very shortly enter his 7th decade Im hoping it's the last I'll ever hear of it with any luck.
  13. 6 points
    The job JMcG is doing for us is beyond incredible when you think where we were under Locke, Hughes and Smith. If he was younger, full of his own self importance and wore brown shoes, clubs would be lining up to steal him. Thank f**k he’s as humble as they come and prefers the double hat look. He’s an absolute legend.
  14. 5 points
    Institut de cardiologie de Montréal (ICM – Montreal Institute of Cardiology) Thank the Lord they translated that, I was struggling a bit.
  15. 5 points
    They'll be waiting for a newer more expensive drug that some Tory has a stake in before approving new treatments.
  16. 5 points
    It's time for the penultimate round, still all to play for, i'm not going to type it all out you can read it a few posts up. @WhiteRoseKillie @Geaky @Arabdownunder @MixuFruit @The Captain @Cardinal Richelieu @gkneil @Aidan @kingjoey @Arch Stanton @The Hologram @Leeds Saint @Bully Wee Villa @NJ2 @Snobot @BigBo10 @mathematics @Jacksgranda @Eednud @MSU @Silky Si McFly @peasy23 @SlipperyP @NotThePars @Blootoon87 @Gaz @jagfox BLM @Rugster @Helpma @alang1993 @German Jag @pleslie99 @LincolnHearts @ArmadaleKillie @Spring Onion @Robin.Hood @CaspianChris @Perkin Flump @Salvo Montalbano @The DA @101 @Ross. @JamesP_81 @The_Kincardine @Genuine Hibs Fan And its the semi of both cup comps Firstly the Beach boys club White Rose Killie v Eednud The DA V Silky Si And in the S Club shield Bully Wee Villa v Jagfoxblm BigBo10 v The Kincardine Can we have all the scores on the door in by 7PM on Tuesday, been a great turnout so far. Thank you for partaking https://www.quizyourfriends.com/take-quiz.php?id=2101240356365888&stp&
  17. 5 points
    Which also makes a mockery of his having been given a "bonus" of 96k for a job well done??? How do these charlatans keep getting away with it. Time for a government led review? Not saying they should but some body of legislative powers should be called in to review spfl process and impose regulations, esp if public money is being given to shore up their finances. This was what some clubs wanted end of last season but spfl adopted a Trump type pose of nothing to see here and denial. Perhaps if it had been a club out with the OF that had proposed a review it would have had the backing of clubs. Only in the financially corrupt world of football.......oh, and politics could you get away with it.
  18. 5 points
    After the last year I'd take any news coming out of China with a shovel full of salt.
  19. 5 points
    I should really get shot of the plant. It has had it’s day.
  20. 5 points
    Here are this week's RaithTV highlights
  21. 5 points
    I’m not sure Jason Kerr is an international quality defender. But then I hear Ryan Porteous being included in Scotland squads, and I think Kerr compares favourably. I’ve put together a simple infographic which rates their respective qualities for anyone interested. It’s fairly basic, but I think it’s quite clear who comes out on top.
  22. 5 points
    I'd rather you didn't call anyone anything and just judged their argument purely on its merits or otherwise. If we are considering what to call people though what would you call someone who has been completely wrong about two absolutely fundamental issues surrounding the pandemic, who refuses to consider any argument other than their own and can't see that there are shades of grey? Simps?
  23. 4 points
    There will never be widespread civil unrest in the UK. We are a tubby compliant mass of blobs for the most part. If you can still get a Chinese delivered on a Saturday night to have while you watch Strictly Celebrity on Ice then that will do for most people.
  24. 4 points
    Just to illustrate this point, with the first penalty... It's the Rovers' right-back, Reghan Tumilty, who starts on the ball. Mackay-Steven appears about half-way through to come and cover the winger, Dan Armstrong, who's hanging in support, which gives a good idea of just how uninterested (by instruction, I'm sure, as above) the Hearts' wingers were in tracking back. GMS must start about 40 yards away from "his man". And then once he gets there, and Kingsley hands Tumilty off to cover Armstrong with the ball, Mackay-Steven half-heartedly steps out to cover the ball back up the line, then switches off as Tumilty goes into the box. If Armstrong isn't fouled and finds the cutback, Tumilty has acres of space for a shot at goal. It feels like a real abdication of sensible management by Neilson. He seems (from the limited exposure I've had to Hearts this season) to be keen on letting his attacking players off the leash, without defensive responsibilities, in order to maximise their impact. But that seems totally backwards to me. If Hearts spent just a little more effort keeping it tight at the back, the attacking quality they've got would absolutely shine through more often than not when they do have the ball. Particularly at Tynecastle, Hearts are always going to have a lot of the ball, and they'll create a lot of chances. They don't need to get into these situations like this, and the Ayr Utd game, where they're trying to outgun teams. Especially with the Rovers well-publicised lack of training, they were never going to have the legs to keep it tight defensively all afternoon. If Hearts were just a wee bit more conservative, they'd have had a much, much better chance of keeping a clean sheet in the first half and then turning the screw in the second. You can see the same thing with the third. When the ball is turned over in midfield, Tumilty and Ginnelly are side-by-side in the top right hand corner here, albeit Tumilty is on his toes because he's going to close down Kingsley. By the time the ball goes into the goal, Tumilty is on the goal-line and Ginnelly isn't in shot, eventually appearing at the edge of the D complaining to the linesman about the alleged handball. When you look at this Rovers team and where they're going to damage you, it's going to come down the wings. Kennedy adds an extra dimension because he's happy to go outside or inside, but broadly speaking we've got inverted wingers and full-backs who are keen to push on. You can't expect your full-backs to defend that on their own, they need support. Neilson totally failing to give his own full-backs any extra protection is naivety in the extreme. If he asks Mackay-Steven and Frear (and later, Ginnelly) to play ten yards deeper and keep an eye on the overlap, Hearts probably still score at least twice - but there's no way the Rovers score three.
  25. 4 points
    Tried some arty-farty shots last week after the first snowfall. The guy just happened to appear.
  26. 4 points
    I believe it’s spelt “Frank conner”
  27. 4 points
    News recently from China is all about locking places down and building quarantined camps to house cases in. It can’t be all perfect over there.
  28. 4 points
    How is the wee man? Is he still with us? Kevin McClellan the physio commented on a FB query about Moore saying that he's doing rehab with him, didn't think i'd need to say this but we could do with him back ASAP
  29. 4 points
    I've said this before but it is not, and should not, be a case of making comparisons with England as if it is simply a case of being better than them. That's lazy, simplistic and represents everything that is wrong with the Nationalist cause - and I say that as a Nationalist. I don't care what is happening in England, I'm not English and I don't live there. They are doing things in a different way, have different demographics, infrastructure etc. I want to know that the SG are doing all that they can to get as many people vaccinated as quickly as possible. I get why we are doing care homes first, and I get that this can take more time. But if there is enough of the vaccine to simultaneously vaccinate other groups while the care home are worked through then that should happen - dragging our feet while the rest of the population suffer is not acceptable. This is the acid test for the Scottish Government now. Lockdown can be painted as a tough decision made by strong leadership, but that's far easier when it's the only option open to you. Now we have a vaccine that - to whatever extent - can limit the loss of life and accelerate an end to this never-ending nightmare, it is the responsibility of government to do deliver that vaccine as quickly and as efficiently as possible and we should be demanding this of our government.
  30. 4 points
    This has f**k all to do with adversarial politics. This is a group of people who have, quite literally, the key to mitigating an infectious disease to an appropriately low level, such that they can withdraw the emergency powers they have implemented, rendering daily life, livelihoods, health and education et cetera utterly fucking wrecked. As much as they needed to be implemented quickly, so they need to be removed, and the idea that folk can't rise above politics to question the people responsible about whether they could be doing more is laughably, and also embarrassingly, insulting.
  31. 4 points
    Watch box sets of The Saint, Randall & Hopkirk (Diseased), The Persuaders, The Champions and The Avengers. No hoofball in sight. Still hope for Hopkirk in that one. He was dead in the one I watched.
  32. 4 points
    I’m made up for my pal Shaun Rooney who had the game of his life tonight, he doubted himself at one point when he had trials at St Mirren and Hearts before Dunfermline signed him. He’s a great lad and deserves every bit of success that comes his way, especially after coming through some very tough and tragic personal tragedy within his family.
  33. 4 points
    Great Chieftain O' the puddin'-race
  34. 4 points
    That's Andrew Neil, hand picked by Murdoch to The Sunday Times, founding chairman of Sky News, chairman of fascist rag, The Spectator and ex-editor-in-chief of *checks notes* The fucking Hootsmon and current owner of a brass neck a mile wide.
  35. 3 points
    And this was Nick Robinson's report. A bare faced lie.
  36. 3 points
    Week 4 update Two deaths this week. Up first is talented but flawed music producer, Phil Spector: Phil Spector obituary | Phil Spector | The Guardian I also enjoyed this passage from later in the article: Oh and he killed someone too. Spector died at 81 so he's worth 44 Base Points. He was a Deadly Duo pick for @gkneil and @Mark Connolly, so it's 69 points total for both of them. ========================= Up next this week was American television man Larry King: Larry King, talk-show titan who lit up worlds of politics and showbiz | Larry King | The Guardian The thought of being as influential and successful as he was after starting his television career at 52 is quite something. Maybe it's a product of watching a lot of American film and television but I agree with the general sentiment of that article - that he was an interviewer with gravitas and distinction, and that appearing on his show was something to be taken Seriously. Despite this the only thing I really know him for is his two Simpsons appearances. He read the Bible in one of them: King died at 87, so he's worth 38 Base Points for @Bert Raccoon, @doulikefish, @Fuctifano, @Lex and @psv_killie, with a Vice-Captain bonus bumping @amnarab up to 57 points. As a result, the standings look like this: 1. choirbairn 180 2. Ned Nederlander 122 3. Bishop Briggs 105 4. dee_62 101 5. Savage Henry 82 6. gkneil, Mark Connolly 69 8. amnarab 57 9. Bert Raccoon, doulkefish, Fuctifano, Lex, psv_killie 38 14. Everyone else 0 The spreadsheet has also been updated with these scores: https://docs.google.com/spreadsheets/d/1-OTo44wF_W7A4Q0NFnd1sX3qEDdxTLDobvjhhSgnzkg/edit?usp=sharing
  37. 3 points
    Anything that annoys the Taxpayers Alliance is good with me.
  38. 3 points
    Pentland Hills panorama yesterday.
  39. 3 points
    You could, Jesus wouldn’t approve though.
  40. 3 points
    Delta Goodrem - The River
  41. 3 points
    I'll blame the schools...
  42. 3 points
    You are forgetting two very important things - vaccine supply, where we weren’t projected to receive 400k a week, even before Pfizer and AZ started backing out of their schedules. But even more importantly, you’ve forgotten the pesky matter of second doses. Everyone who’s received dose 1 by the start of March will need another one by the start of June. That’s why it’ll be into autumn before we get into the rest of the population, assuming nobody else starts supplying beforehand (I have high hopes for J&J’s single doser).
  43. 3 points
    Patti Smith & Michael Marra - Sweet Afton
  44. 3 points
    You have no idea how fine......... Considering they have a League Cup semi final to prepare for, great help and assistance from David Martindale and Livingston too. The requirement for players to have been Covid tested within past 7 days is completely understandable but it doesnt half limit your options for a last minute emergency. Half the keepers in the country unable to play or even train right now but they werent an option as getting them tested on time couldnt be guaranteed.
  45. 3 points
    Certainly lower the catering budget. Thank you.
  46. 3 points
    Good luck to the saintees, thoroughly deserved and I hope you all enjoy the final.
  47. 3 points
    RG in 3 games time "Rooney is shite. I've found a player in the Vauxhall conference who wins more tackles than him per90 since 2016."
  48. 3 points
    Catching what little snow there is left earlier.
  49. 3 points
    Hearts had a good amount of chances and MacDonald kept us in the game. However, when you consider the circumstances surrounding the game, before you look at the gap in budget etc, to be 3-0 up at Tynecastle was very good going. I've always liked Mcglynn and been a but if a fan boy, but that was a Mcglynn masterclass today. He really manages to get the most out of players in a way very few Rovers managers have.
  50. 3 points
    Fergus McCann is the only reason Celtic still exist as a football club. He far from made a hash of things. Fergus McCann was clear from the onset as to what he would do at Celtic and in what sort of timeline and he delivered it to the letter and he was far from revered at the time because of his refusal to put stopping Rangers at the top of his priority list or would he cave into the wage demands of the likes of PvH and Di Canio. Yet he got us debt free, built an amazing stadium and set us on a path that would see us become successful again and without it being his goal stopped Rangers winning the 10. There is a much greater appreciation of him now because of Rangers collapse, it now all made sense. He stuck to his plan and got out exactly when he said he would
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