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Comment Caldera (Score 1) 739

Caldera (before the turn to the dark side) in a 1 G partition on the family desktop.
I kept practically everything on the much bigger Win 98 partition and mounted it at boot.

Second install was an ancient incarnation of RedHat (6 I think) on an old Toshiba laptop.
Had to use framebuffer for the graphics for months before I got X to run properly.
It was great.

I've never used Windows since.
Installing modern distros is just too easy ...

Comment Re:Still a long way to go... (Score 1) 126

You remember right about the retina being "inside out". However ...

There's actually a potential space between the photoreceptors (rods and cones)and the outermost layer of the retina, the pigment epithelium. This is the level at which the retina comes loose in retinal detachment.

The way you do this is not to get between the photoreceptors and the nerve fibre layer (which would cause total loss of vision in that part of the retina) but between the photoreceptors and the pigment epithelium, essentially by making a limited retinal detachment on purpose.

This is major league eye surgery (very much more so than a cataract operation, for example) which could only be carried out by a highly trained subspecialist in retinal surgery (this is one of the ways in which the publicity handout from Moorfields is pretty misleading).

If this technique proves valuable when it finally gets trialled (and that's by no means inevitable - there have been a great many false hopes over the years in treating this miserable disease) actually getting the treatment for everbody who needs it will be a huge logistical problem. This is a disease which eventually affects every third person in Western countries.

Comment Re:Still a long way to go... (Score 4, Informative) 126

No, that's incorrect.

"Blindness" is being used in this context in a technical but generally accepted sense to mean vision so poor that you can't see the top letter on the eye chart with either eye. That's a grim state to be in, but most people who are "legally blind" like this are far from having no vision at all.

In particular, Macular Degeneration hardly ever leads to the total blindness you are referring to.

That doesn't mean it isn't a horrible crippling condition of course.

Comment Re:Still a long way to go... (Score 4, Informative) 126

IAAO too ...

This is, I think, stem cell implantation subretinally for Geographic Atrophy, a.k.a "dry" macular degeneration. Potentially a big deal inasmuch as currently we have no treatment for this at all and it accounts for 90% of all macular degeneration.

It involves major invasive surgery: "outpatient procedure" gives a highly misleading idea of what's involved. It doesn't mean any more than that you could get away with not admitting the patient to hospital, not that you could ever do it anywhere except in an operating theatre.

Moorfields have lately developed a very bad habit of prematurely and misleadingly announcing "breakthroughs" in eye treatment, which I suspect is related to their own funding issues (they did this not long ago with some extremely misleading publicity about three patients with Leber's Amaurorosis they'd treated with gene therapy, not one of whom in fact showed measurable objective improvement in vision - not the impression the news reports tried to give.)

Peng Khaw BTW is not a retinal expert (though Lyndon da Cruz certainly is; he was also involved in the publicity about the gene therapy, interestingly.)

I'm sorry to say that I think this is the Moorfields spin machine in action.

Comment This is how it is in the UK now (Score 4, Informative) 203

The UK has a huge DNA database including large numbers of minors and people subsequently found innocent.
The much maligned European Court is protecting our liberties by declaring this illegal:
http://www.guardian.co.uk/uk/2008/dec/04/law-genetic
Such a shame that the mother of democracies should come to this.
Be warned by our bad example

Comment Re:And next up (Score 5, Insightful) 467

This is in fact the way things work now in the UK.

There is a pretend-independent government committee called NICE (yup) which decides which treatments are to be made available through the free-at-the-point-of-delivery government health service, the NHS.

They do indeed make heavy use of QALYs, "Quality-Adjusted LifeYears" in much this way.

Although the way NICE works in specific instances has led to a lot of very justified criticism, there seems to be no realistic alternative to something like this if you have a tax-financed system that the sick don't pay for directly. There just isn't enough money to do everything possible for every patient.

I don't know the right answer. I work for the NHS (as a retinal specialist too!) and have had endless grief getting funding for some treatments for my patients; on the other hand, I've worked in systems where the first question you have to ask is not "what does this patient need?" but "what can this patient afford?" and I prefer the former despite all its problems and stupidities.

Comment Re:Doesn't everyone have macular degeneration? (Score 1) 55

That's very true.

Normal people don't go round always comparing the vision in their two eyes, and unless it happens very quickly, many people don't notice loss of central vision (only) in one eye.

They often come my way (I'm an eye surgeon) because they've just been on a routine visit to their optometrist, or just accidentally happened one day to cover the good eye and noticed a problem with the other one.

I see about twice as many people with the second eye affected by the first time they see a doctor as I do people who've notice a problem with just one eye.

BTW this technique won't enable a person to drive again; as someone rightly has pointed out already, you pay for the benefit to central vision by losing peripheral field, which would almost always be enough to stop you driving legally. But that doesn't mean it can't help a lot in other ways.

Comment Re:Doesn't everyone have macular degeneration? (Score 5, Informative) 55

Grandparent was apparently just being sarcastic, but the idea is actually not stupid; you can indeed get telescopic "low visual aids", though there's no way physically of making them flat (hey, telecope!) and they tend to be impractical especially for the older age group who are much the most commonly affected. They tend to be more useful for younger people with retinal diseases not related to age.

The device described in the article is not in fact a new breakthrough concept; there are a number of similar devices out there already. Some just go for magnification; some try to divert light away from damaged central retina (macula) to normal peripheral retina. The trouble is that peripheral retina just isn't as sensitive even if it's healthy.

The actual surgery is not actually very difficult for a competent eye surgeon; it's just a variation, really, on the standard modern cataract operation involving an intraocular lens implant.

The clever part (as with a lot of surgery) is trying to decide who would benefit from the operation beforehand. If there's too much damage to the retina this won't help; if there isn't all that much, then the risks of the surgery may outweigh the benefit.
The major reason why this sort of technique has not already become standard practice is because there aren't yet reliable ways of assessing beforehand which patients will benefit.

BTW the cost is steep but a lot less than a course of Lucentis treatment (the best current option for actual treatment, as opposed to rehabilitation). If it helps the patient retain their independence it would probably pay for itself.

There are a lot of unanswered questions about this sort of technology still, and the way reporters just regurgitate the manufacturers publicity handouts and proclaim a new "cure for blindness" causes a lot of grief to vulnerable people by cruelly raising false hopes.
(I'm an ophthalmic surgeon specialising in retinal diseases)

Comment Re:Doesn't everyone have macular degeneration? (Score 5, Informative) 55

No.

It's a specific disease, or rather family of diseases.

It's very common (by their eighties about 1 in 3 people has it) but it's *not* normal ageing.

Unfortunately many people, especially older people, do indeed think that losing vision as they grow older is just natural, and don't seek help; even a few years ago they weren't in fact missing out on much as treatment was pretty useless, but there's now a much more effective treatment (Lucentis) for the 10% of people with the most aggressive and damaging variant of the disease (so-called "wet" macular degeneration) and it's heartbreaking when people miss out on it because they don't realise that there's *always* a specific reason if your vision goes bad on you.

(I'm an eye surgeon specialising in this very area, and I spend almost half my work time on this disease every week)

Comment Despair vs hope (Score 1) 921

Believers (Christians, Jews, Muslims) think their lives are a gift of God, and that it's not just up to them to decide that their life isn't worth living any more. Sure, there are believers who fear death when you come right down to facing the real thing; but the flip idea that this study "proves" that believers are all really hypocrites doesn't actually explain why they would fight against death harder than unbelievers. If you really do think that the explanation is that believers are afraid to die and face judgement, then you just haven't met many. I don't think many of the comments are intended to be taken as more than on opportunity for abuse.

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