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Comment Options (Score 2) 183

Let me preface by saying I am a Gastroenterologist; you obviously have discussed the options here, and it sounds like you've developed a fibrostenotic stricture. While retrieving the capsule may give you some peace of mind for a while, it will not address the underlying issue, namely the fibrosis that has developed in this segment of bowel. First, you need to be on biologic therapy, either an anti-TNF like remicade, humira or cimzia, or one of the newer drugs such as entyvio, or things will, eventually get worse. Assuming this is already the case, I would proceed with a small bowel resection, performed by an experienced colo-rectal surgeon, preferably one with extensive experience inflammatory bowel disease. If you have not had a recent MR enterography, they can run the small bowel during surgery to evaluate for any other likely strictured or heavily diseased areas. I would not be in favor of stricturoplasty as recommended above, as recurrence rate is higher with stricturoplasty.

Comment I doubt a class would help (Score 2) 499

These people have generally made up their minds despite all the evidence to the contrary, often down the "I don't trust this vaccine" or the "the vaccine will be worse than the disease" or even the whole disproven autism connection. Despite my attempting to explain the benefits and science behind it, these patients rarely change their minds - and I treat adults. The most commonly given vaccines we give to adults are all either protein, polysaccharide or heat killed and have near zero ability to infect or cause anything beyond local irritation or at worst an allergic reaction in egg- allergic patients for the flu shot. I can explain all that and the immunology and science behind it (if I care to run way over the 20 minutes allotted for a patient visit) and hardly anyone changes their minds. (Clearly, I am a physician)

Comment Re: You know? Something here is disturbing... (Score 3, Informative) 508

That's actually entirely wrong. I am a physician who gives gardasil to young adults routinely - it is approved through age 26 in men and women. The vaccine is a combination of 4 recombinant capsid proteins, one from each of 4 strains of hpv. The only genetic manipulation was inserting the genes for these proteins into yeast for mass production. Injected into the body it works like any other vaccine that doesn't consist of live virus. And finally, the reason it is indicated for young people is to give them protection before encountering the virus. You could give it to a 40 year old virgin with the same effect. The problem is it is so prevalent that most people are exposed by the time they are 30. Let's not forget that hpv is the cause of most anal cancers in men, including straight men, as the virus has been shown to migrate from the scrotal skin up the perineum to the anus where it basically replicates in much the same way as the cervix.

Comment Re:Mental Illness Reporting (Score 1) 935

Surprise! Healthcare professionals have ALWAYS been able to (and in fact, are required) to report mentally ill people who express a plan to hurt themselves or others, even if they are not known to have access to firearms. Source: I am a physician, and have taken multiple, mandatory, work related "mandatory reporter" courses

Comment What tfa fails to mention (Score 1) 174

And helps make sense of the situation is that when a galaxy becomes causally disconnected from us, it's not that the distance between us has expanded so far that light no longer has "time" to reach us, it's that the photons carrying that information have become so redshifted that they have a wavelength equal to or larger than the observable universe and are thus undetectable, although in practice this happens well before reaching a wavelength that large

Comment Re:One step forward, two steps back (Score 4, Insightful) 62

Actually, given that there's 100-400 billion stars in the galaxy, and 0.001^4 works out to one in a trillion, that gives you about a 10 to 40% chance of there being one intelligent species in the milky way. /semantic But I agree, in general. The odds of earth being the only planet with life at all in the whole galaxy...are pretty astronomical, in my opinion.

Comment Re: Former C. Diff Patient here ... (Score 2) 135

C. diff infections are NOT always caused by antibiotic "overdose," which isn't really a thing - there's dose related toxicity for some classes of antibiotics, but not overdose. In the healthcare setting, infections are usually caused by overgrowth in the setting of depleted colonic flora, but symptomatic infections can also happen with contact with a patient already experiencing a C. diff infection - two years ago, a resident at my hospital ended up with such a severe infection she picked up from a patient that she nearly ended up with a total colectomy. In the community setting, about 50% of cases occurred without any prior antibiotic exposure in the past 30-90 days, at least according to a recent meta-analysis [http://www.ncbi.nlm.nih.gov/pubmed/25058469].

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I tell them to turn to the study of mathematics, for it is only there that they might escape the lusts of the flesh. -- Thomas Mann, "The Magic Mountain"

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