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Administering immunotherapy in the morning seems to matter. Why?

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Re: Administering immunotherapy in the morning seems to matter. Why?

#161

Post by unshavedyak »

kmarc wrote: post #160
stronglikedan wrote: post #154

Earlier quoted context omitted.

Don't be a germaphobe. Don't wash your hands a lot. Give your immune system a little work out each day by not babying it. Try not to take any medicines unless you absolutely need them, and stay away from hand sanitizers. If you do need to clean anything, soap is more than enough and water is usually enough. I thought it was normal to be over 50 and not take any medicines, but all the doctors and staff were surprised…

Above 50? My 30+ year old American friends are all running on pills, daily, many different of them. I was shocked. So I am rather with you. It should be normal not to take medicines.

What sort of pills? Vitamins or ?

Re: Administering immunotherapy in the morning seems to matter. Why?

#162

Post by ch4s3 »

raverbashing wrote: post #99
AbrahamParangi wrote: post #68

Earlier quoted context omitted.

The razor to use to determine whether something is actually evidenced based under uncertainty is whether you would follow the same policy if it was your own child. There are many things that are simply uncertain and “untrue until proven otherwise” isn’t an exclusively optimal policy.

It's ok, the strongest defenders of EBM are never going to discover anything worthwhile as they get caught in a loop of "no evidence enough to test" and "no evidence for this because nobody tests it"

The opposite approach exposes people to a lot of unnecessary and dangerous medical treatment. The evidence based approach has uncovered that stenting doesn't work[1], yet a lot of do something proponents are still installing them at great risk to patients and at great cost to medical systems.

[1] https://lowninstitute.org/stents-dont-work-a-look-back-at-th...

Re: Administering immunotherapy in the morning seems to matter. Why?

#163

Post by ch4s3 »

jcims wrote: post #149
ch4s3 wrote: post #54

Earlier quoted context omitted.

It’s not shameful, it’s how evidence based medicine works. One case is interesting but not a basis for changing a protocol by itself. Tons of things could have influenced the outcome and you need a proper study to know that.

Well the concept is now being studied quite closely. Had someone taken it seriously thirty years ago it's quite possible that the net amount of suffering that millions of patients have endured since then could have been reduced. https://pmc.ncbi.nlm.nih.gov/articles/PMC9599830/ I'm comfortable calling that shameful. Not on any one in particular, it's a systemic problem that could be reduced with sufficient tenacity a…

There's limited time and a finite supply of doctors and researchers. They can't study everything that's promising all at once, and good ideas fall through the cracks all of the time.

Re: Administering immunotherapy in the morning seems to matter. Why?

#164

Post by kmarc »

unshavedyak wrote: post #161
kmarc wrote: post #160

Earlier quoted context omitted.

Above 50? My 30+ year old American friends are all running on pills, daily, many different of them. I was shocked. So I am rather with you. It should be normal not to take medicines.

What sort of pills? Vitamins or ?

Some yes, and then all sorts of mood boosters, painkillers, etc. Basically all the stuff I later saw during a commercial break at a bar during some sports game. (this should be banned, TBH)

Re: Administering immunotherapy in the morning seems to matter. Why?

#165

Post by bregma »

bloqs wrote: post #122
raylad wrote: post #48

My father was on chemotherapy with fludarabine, a dna base analog. The way it functions is that it is used in DNA replication, but then doesn’t work, and the daughter cells die. Typically, patients who get this drug experience a lot of adverse effects, including a highly suppressed immune system and risk of serious infections. I researched whether there was a circadian rhythm in replication of either the cancer cells…

As a younger person what are the best habits to get into to maintain optimal long term immune health?

You want to live a long time? Avoid any of the things that make it worthwhile.

Re: Administering immunotherapy in the morning seems to matter. Why?

#166

Post by JamesSwift »

ch4s3 wrote: post #163
jcims wrote: post #149

Earlier quoted context omitted.

Well the concept is now being studied quite closely. Had someone taken it seriously thirty years ago it's quite possible that the net amount of suffering that millions of patients have endured since then could have been reduced. https://pmc.ncbi.nlm.nih.gov/articles/PMC9599830/ I'm comfortable calling that shameful. Not on any one in particular, it's a systemic problem that could be reduced with sufficient tenacity a…

There's limited time and a finite supply of doctors and researchers. They can't study everything that's promising all at once, and good ideas fall through the cracks all of the time.

I think this clears a bar of things that are useful and simple to study. Theres basically no effort involved. If it ends up beneficial we just update job postings from 'daytime infusion tech' to 'nighttime infusion tech'. Instant improvement in outcomes. I doubt you even need to clear this in any way to get the study greenlit.

Re: Administering immunotherapy in the morning seems to matter. Why?

#167

Post by Aerroon »

NiloCK wrote: post #146
vkou wrote: post #55

Earlier quoted context omitted.

> And shameful (for them.) 1. A single positive outcome with N=1 should generally not be the basis for making a medical recommendation. 2. It takes a mountain of research work to go from that to a study that you can draw meaningful conclusions from. 3. The hospital is not in the business of doing research, it's in the business of treating patients.

1. The N=1 positive result isn't the sole basis for expanded effort. The basis the is the compelling, research backed, causal mechanism that predicted the scheduling adjustment's success. 2. Does it? Speaking directly out of my butt here (not in healthcare, not an academic), but the OP spoke of pretty acute symptoms specific to a treatment plan. If the treatment program is at all common, then a very straightforward A…

And if the A/B test says that your intervention made the situation worse? Now the doctor is held liable for that.

Re: Administering immunotherapy in the morning seems to matter. Why?

#168

Post by [deleted] »

xvector wrote: post #87
_qua wrote: post #77

Earlier quoted context omitted.

Move fast and break things in human medicine means unethical researchers maim and kill people, often marginalized people. Nazis, Japanese experimenting on prisoners, Tuskegee airmen syphilis experiments, Cincinnati radiation experiments and many others stand as testament to what ambitious unethical scientists will do to further their knowledge and career. Thus we have strict guardrails that slow down how we do things…

I am close with a few folks in medical research and the broken nature of the system and sheer amount of red tape has broken their dreams. It is impossible to get anything done. There is a difference between "reasonable guardrails" and suffocating progress until it's nearly impossible barring Herculean efforts by multibillion dollar entities. It cannot be understated how badly the current bureaucracy has destroyed med…

[deleted]

Re: Administering immunotherapy in the morning seems to matter. Why?

#169

Post by refurb »

jcims wrote: post #149
ch4s3 wrote: post #54

Earlier quoted context omitted.

It’s not shameful, it’s how evidence based medicine works. One case is interesting but not a basis for changing a protocol by itself. Tons of things could have influenced the outcome and you need a proper study to know that.

Well the concept is now being studied quite closely. Had someone taken it seriously thirty years ago it's quite possible that the net amount of suffering that millions of patients have endured since then could have been reduced. https://pmc.ncbi.nlm.nih.gov/articles/PMC9599830/ I'm comfortable calling that shameful. Not on any one in particular, it's a systemic problem that could be reduced with sufficient tenacity a…

> Had someone taken it seriously thirty years ago it's quite possible that the net amount of suffering that millions of patients have endured since then could have been reduced.

You can only say that with hindsight because of the data over the past 30 years.

What if the data showed the opposite? Then the doctor would have given his patients a worse outcome all on a "hunch".

Re: Administering immunotherapy in the morning seems to matter. Why?

#170

Post by refurb »

renewiltord wrote: post #98
_qua wrote: post #65

Earlier quoted context omitted.

Even simple studies are expensive and difficult. You need IRB approval, data collection and organization, staff to do those things. It seems simple from the outside but making it happen takes time, effort, and money which then means also applying for grants which is a process in and of itself.

Indeed, as any ethicist worth his salt would argue: we don’t want anyone saving lives without proper approval.

What a intellectually lazy response.

No, it would be more accurate to say "any ethicist worth his salt would argue: don't make changes that could be harmful based on a hunch"

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