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To be precise, rituximab depletes all CD20+ B cells from pre-B cells onwards to early plasmablasts. At least in some cases it depletes in tissue as well as blood although tissue depletion is variable. Virtually all antibody is made by plasma cells, which are in both spleen and marrow, with the...

Of all of the millions of PWME over the last five decades a few would have shown up virus used pathology if it was there. We have a few post mortem cases diagnosed in life as ME, with some odd neuropathological changes but nothing that really looked viral or really explained the illness. It...

That's deadly nightshade that is. Or nearly deadly.

Never heard of him but I suspect this says it all: (The conflict of interest being income for rehab.)

I think Michiel has the right analysis here. If even a significant subset of ME/CFS was due to persistent viral infection somewhere sometime someone would have found some barn door pathology in a case that got so bad the pathology showed up. All the chronic viral illnesses end up with barn door...

It looks like a sensible technique. It would make sense to screen an ME/CFS cohort like the ME Biobank. The abstract does not say anything about rates of autoantibodies in normal healthy people - which of course is not zero. Quite a lot of healthy people have autoantibodies.

What might behavioural health be, I wonder? Nul points, I am afraid.

Well, that might be a bit political and a bit transatlantic for me to say more. Although, I may have been exaggerating, judging by the filibuster this week.

It is interesting to see Simon Wessely publicly putting his name to such ignorant remarks. Effectively, they are saying 'yes, just to be explicit, we really have no clue about how to gather reliable evidence'.

Responding to a deleted post about a German doctor prescribing larger doses of Abilify. I would just ignore it. I wouldn't go near an Abilify Facebook page. I don't think I would go near an 'ME/CFS doc' in Germany to be honest. Surely this is all just gossip. We live in a world where important...

Thinking about it I think there is a further division of meanings. The BPS people consider biomedical to be a way of thinking. On here we use biomedical to refer to items of research that tackle biomedical rather than psychosocial questions. The BPS people would of course say that focus on these...

That is a point. It has another meaning in that context - science teaching relevant to medicine rather than nuclear physics or botany. It might be that the author is referring to Biomedical Science PhDs but I think not because Biomedical Science in the curriculum sense is only an undergraduate...

What the 'patient-centre' educationalists of today may forget is that in theban old days of the 1970s patient's stories were the centrepiece of an educational session - in those days the Grand Round. The first half of a presentation was the patient's account. This was normally formalised by the...

If you look at his publication list you can see it is the latter dressed up as the former. It is also the new received wisdom for the multidisciplinary team brigade all the way from Guyatt, Glasziou and Garner to Turner-Stokes and the Bristol psychology team. It is a very specific form of...

To be clear, there are two people involved. One is Casper Shoemaker, who is a reasonably ancient paediatric rheumatologist. His gossip is being given blog space by a young NIHR research fellow interested in ethics.

Yes, but I think to be realistic we have to assume that if a PhD student really said this about n=1 rather than doctor Schoemaker dreaming it up they would have assumed that it was in the context of experiments about causation and specifically trials where in general single exceptions - i.e...

We use the term biomedical in the way that people are forced to use the artificial term 'allopathic', invented by the homeopaths, to describe real medicine. I don't know who coined 'biomedical' but I suspect the touchy-feely BPS people - as in 'over-medicalisation'. I have never much liked the...

Ah but is it? If a Dr Who is always some time else then there is no particular Dr Who now.

My experience is that his is not realistic assessment of the scenario. Well designed trials tend not to need very large numbers. In general you only need very large numbers of subjects if the drug hardly works. For drugs that really have a significant useful effect five in each group is enough...

The guy who is quoted on the blog (Casper Schoemaker) is paediatric rheumatologist like Esther Crawley. He is heavily in to patient choice and apparently critical of evidence evaluation by things like GRADE - reminiscent of Turner Stokes I guess. Clearly very much up in the Gordon Guyaltt...