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  1. Jonathan Edwards

    Doctors order needless scans on the elderly because they fear talking about death, study suggests

    Of course a study of this sort will never identify the 679 procedures that weren't done in other people and might have been of use. This sort of moralising overgeneralising approach to medicine has always been around and should be ignored. All a doctor can do is make the best decision they can...
  2. Jonathan Edwards

    Persistent Autonomic and Immunologic Abnormalities in Neurologic Post-Acute Sequelae of SARS-CoV2 Infection, 2024, Goldstein, Walitt, Nath+

    Seems like a rag-bag of tests on a small number of people with presumably no information on what those tests showed before Covid or whether their occurrence was due to Covid or coincidence. Since we do not have any clear evidence of relation of Covid to any specific neurological abnormality...
  3. Jonathan Edwards

    Positive signs for FND: Looking for Criticism

    Hi @AR561. I am a professor of medicine trained in neuroscience and clinical neurology but not a neurologist. I accept that, like all neurological signs, these signs are useful in coming to a diagnosis. No single sign is 'rigorous' in neurology. The diagnosis always depends on the entire...
  4. Jonathan Edwards

    Care and Support Plan template free to download, Action for ME

    I would be very pleased to add my name to your letter @Trish.
  5. Jonathan Edwards

    The Long Read: Excellent BPS papers

    I have been getting suspicious about the poor quality of BPS papers posted on the forum. I can no longer believe that these can be the best BPS papers on ME/CFS or Long Covid or anything else. Illustrious posters like Andy and SNT Gatchaman who have been bombarding us with very bad papers must...
  6. Jonathan Edwards

    CAR-T therapy

    More than 50 years ago, the immunologist Avrion Mitchison defined T cell help as a function that “lies at the heart of inflammation and other aspects of immunological and infectious disease” Yes, well, dear old Av did as much as anyone to slow down the pace of autoimmune research. Fortunately...
  7. Jonathan Edwards

    Salt

    PoTS is supposedly OI without low blood pressure. Other electrolytes like calcium, magnesium and potassium (sodium is salt) are not going to have any relevance to the effect of salt. Potassium is mostly inside cells, not in blood plasma. I rather doubt sea veggies are different from bananas in...
  8. Jonathan Edwards

    Salt

    The standard of evidence and practice varies greatly according to how common a problem is and how easy the problem is to understand. Giving insulin for diabetes is based on a lot of good evidence, although it has taken decades for doctors to work out the best way to use it and when I was a...
  9. Jonathan Edwards

    Salt

    That's fairly easy. Doctors bullshit all the time. They are trained to bullshit - to sound knowledgeable. It is supposed to inspire confidence. 'Prominent figures in the field' often turn out to be people pushing a line. They are not necessarily prominent in the medical community as a whole. I...
  10. Jonathan Edwards

    Thesis Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): Clinical trials, medical treatment and pathomechanisms, 2024, Rekeland

    Possibly, but that doesn't in any way require that antibodies are pathogenic and it is still upside down of Sjogren's. I think we can be reasonably sure that whatever it indicates it suggests that ME/CFS has nothing to do with autoimmunity as we are familiar with it in other diseases.
  11. Jonathan Edwards

    Salt

    It may seem odd but it is worth remembering that although there have been physicians and hospitals for centuries almost all medical advice was baseless until around 1970 - apart from Caesarian section after sepsis was understood and penicillin around 1945. When I first started medicine all...
  12. Jonathan Edwards

    Thesis Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): Clinical trials, medical treatment and pathomechanisms, 2024, Rekeland

    There is a vast amount f disinformation around 'dysautonomia', to the extent that I suspect 95% of material put out is pure fantasy. I spent my career studying and treating autoimmune diseases including Sjogren's. Most of it is secondary to lupus or rheumatoid. 'Primary Sjogren's' worth calling...
  13. Jonathan Edwards

    Salt

    That sounds like straight nonsense. It looks as if you are quoting from some Harvard health advice page. Presumably it has been dumbed down out of all physiological recognition. I am not sure how solid the evidence is for a causal effect of high salt intake on blood pressure. High salt intake...
  14. Jonathan Edwards

    Opinion Post-exertional malaise – A functional brain aberration?, 2024, Wyller

    And it has been tested - in the PACE trial. Treatments aimed at changing perceptions did change (reported) perceptions, but made no difference to objective measures of disability. The weird thing is that if the predictive coding model is right then the CBT therapist should be telling patients...
  15. Jonathan Edwards

    Thesis Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): Clinical trials, medical treatment and pathomechanisms, 2024, Rekeland

    Sjogren's and lupus are exceptions. A small proportion of Sjogren's patients also have hypergammaglobulinaemia, which can be substantial. Nobody has much idea why. It probably has little to do with the other features of Sjogren's, which occur in people with normal IgG levels. Sjogren's is a...
  16. Jonathan Edwards

    Opinion Post-exertional malaise – A functional brain aberration?, 2024, Wyller

    Poor old Wyller has not noticed that the predictive coding model of Mark Edwards is back to front.
  17. Jonathan Edwards

    Salt

    I can see a problem there that if patients were more active as a result of expectation of improvement, their blood volume might changer as a result of that. It looks as if high salt has no effect on blood volume in healthy people, which is what I would expect. The question is whether people...
  18. Jonathan Edwards

    Thesis Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): Clinical trials, medical treatment and pathomechanisms, 2024, Rekeland

    I am implying that there may be no cause and effect relation between IgG and illness. The report of improvement and the lower IgG levels may both in some indirect way be effects of something very general - like being overweight for instance (a key factor in Covid-19 illness). In autoimmunity...
  19. Jonathan Edwards

    Salt

    I have no idea why it should and I know of no evidence. If you eat salt your kidneys reduce their reabsorption of salt in the tubules and within a short while you have peed it out. There may be a period of feeling thirsty because of a slight increase in body salt concentration. Total body water...
  20. Jonathan Edwards

    An investigation into General Practitioners’ experience with Long Covid, 2024, Farrell et al.

    Sounds as if they were very well educated - all the right answers! Maybe the 19% who thought they knew of treatments need a quiet word...
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