26 Comments

Regarding the Oxygen Trial:

Now it is time to replicate the 2 trials from the 90s that we use to support doing oxygen therapy in COPD. They weren't very robust and they have more than 30 years now.

Would it be a medical reversal? It would be a good thing for patients not have to have a big and heavy bag or cyllinder around

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It seems that there is some question about Jean Clement ? The French lady that was supposed to be well over 100 may have been her daughter collecting her benefits

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Maybe too simplistic but it seems most often analysis of studies simply proves 'less is better'.

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1. Not surprised that there is no difference between 15 and 24 hour per day oxygen since oxygen therapy is just a supportive modality and has no therapeutic effect on the underlying disorders. It might be more useful to compare as needed usage (when symptomatic) vs. continuous or one or the other vs. no oxygen at all. An ancillary observation is that the degree of separation between the two curves on the graph is remarkedly similar to that seen in the statin studies that were said to justify using statins as "preventive" therapy for virtually everyone. Though neither of the differences are of any practical significance, the statin enthusiasts are sure to repeat the mantra of "statistical significance".

2. Equally unsurprised that community-based interventions have not reduced the number of fatal opiate overdoses. I claim no expertise or even familiarity with the topic but have to wonder whether the true causes are being overlooked. My understanding is that many of the deaths result from taking drugs of completely unknown potency from street dealers. Back in the days of alcohol prohibition there were lots of deaths from people taking methyl alcohol and other unknown substances from dealers in the illegal substance. When prohibition was repealed, the incidence of these deaths fell to negligible levels. Those who oppose any form of drug legalization will argue that drug use would then increase dramatically. My response would be that they should then stop using the accidental death rate as an emotional plea to continue the present system.

3. The supercentenarian article is the most useful. These fraudulent statistics have long been beloved by those who claim that our toxic environment is the chief cause of disease and death. It reminds me of the old story about a few villages in the Caucuses which were said to contain populations that lived to unbelievably old ages. It turned out that during WWI or WWII (I can't remember which) the Russian army wanted to draft everyone they could but quite a number of people in these remote villages used forged birth certificates or other documents in order to prove that they were too old for the army. This resulted in a number of them being reported as 110 to 120 years old when they died. This led to all kinds of declarations about the purity of their air or water or various other factors being responsible for their longevity.

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One other thing you hear ad nauseam is how our ancestors all checked out by age 35. I've been doing genealogy on my ancestors, all mainly English and German. I have birth and death records going back through Salem to England, and from Iowa to Germany. At least my ancestors typically seemed to live well past 50, in most cases well past 70. Families of 8 or more children not uncommon.

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Yes, in the days before clean water systems, efficient waste management, and antibiotics, the frequency of death in young children coupled with the incidence of maternal death in childhood really drove the life expectancy averages down. For comparative purposes we shouldn't consider any of the figures prior to the early 1900s or so. My wife and I did our genealogy a number of years back and I have recently done some for friends as I enjoy it as a hobby---kind of like working out a puzzle. So I have spent a ton of time going through US records going back to the founding in New England and before that in England and Scotland. I can confirm that plenty of people lived into their 80s and 90s during that time. As I am sure you probably noticed, childhood death was so common that many families had more than one child with the same first name. One of my mother's ancestors who came here from Northern Ireland just after the Revolutionary War lived to be 92 and had 20 children by four different wives because the first three died in childbirth.

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It IS a nice hobby. People may not realize how much data is now freely accessible online. I use census records both state and national, even some English census records from the 19th century. One bit of family lore was that my grandfather was a contortionist because he was gifted with very flexible joints. An Iowa census revealed it was actually his grand uncle, who had a stage name and career that lasted over 30 years, while he lived with his parents all those years.

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It is incredible how much easier it is now to do the research. My wife and I became interested in genealogy back in the 1980s---well before the internet. Basically one had to find a Mormon church that had a genealogical library where they had lots of books and information was all on microfilm and microfiche. Some people with hyperextensible joints may have a variant of Marfan's syndrome. They are usually tall and thin. So you may have that gene somewhere in your family line.

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Doing genealogical research before the Internet took real devotion and energy! Now we have the Ancestry website which is expensive but the same people, Mormons, also maintain a free site "FamilySearch" and most of what's on Ancestry can be found there.

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Thanks for the tip. I'll give it a try. I think the Mormons may have more European data since they send their young people for two year missions where they spend a lot of time copying records and sending them to the data centers in Salt Lake City and elsewhere.

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The rapidity with which opioids kill can explain the decline in deaths which occur over a specified period of time. More valuable will be a longer study to confirm a trending decline. If those more likely to die from opioids are dead, they can't survive or die again next year. As newer live people enter the statistical pool, short term declines in death may begin to be balanced by a return to the mean. Still worth a try but let's keep a broad perspective.

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The way to reduce opioid overdose death is to move the pharmaceutical dominant paradigm back to the 70s and 80s. Use opiates only for in hospital applications such as immediately after surgery and switch to benzodiazepines for all else. Unbelievable we have consented to the pharmaceutical industry creating such a morally bankrupt model. Nobody wakes up and says "I think I'm gonna try fentanyl today".

The entire Sackler family should be staked to a fire ant hill, after a public flogging. It's the fucking pills....

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Benzos are at least as problematic as opiates.

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Not even close. Be quiet, sit down.

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Yes, Your Majesty.

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Loved the review of the blue zone paper. Agree the whole concept is not evidence based. Cultish adherence to it is likely silly if not stupid. Otoh, they’re also mostly motherhood concepts: eat “better” and in moderation; do more physical activity; develop some hobbies and interests to keep your brain engaged; foster social connections. Those seem like pretty basic things for a decent QOL.

But yeah, the people who feel the need to sell books about it are most likely scheisters. And the people who buy those books are suckers. Sadly, in our marketplace, there are plenty of both.

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Newman, not Neman.

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Fixed.

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Oooooh I just love #3! I actually laughed in delight just at the title of that paper. So much has been made of the blue zones. It really is never simple, is it?

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I thought this one was worthwhile last week too: https://www.sciencedirect.com/science/article/pii/S0264410X24009873

Conclusions: The combination of vaccination and natural SARS-CoV2 infection was associated with the development of severe heart failure and cardiogenic shock in patients with STEMI, possibly related to an increased serological response.

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Single center. Potential for confounding huge. Kid of gets a shrug.

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This article has been heavily promoted by anti-vaxxers. Was it also forwarded to you by a patient? Hypothesis generating at best.

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The Blue Zone paper provides a lesson far beyond its subject. The so-called Blue Zone studies have generated an industry worth what I guess has made billions for those who have jumped on the fad to sell their Blue Zone related products. I, for one, have always been skeptical of the Blue Zones; it didn't pass my smell test. The research by Dr. Neman cracks open a window on how popular science misleads the public but enriches those who would take advantage of it. I am not so much criticizing those who profit from fads as I am criticizing a gullible public.

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Blatant lies and lame azz projection all you've got, besides the two followers that is?

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"Science misleads the public"? What a crock of shit. Is the agitprop bullshit cyber accounts like you that mislead the public.

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I recall years ago reading the first words to the section on oldest humans in the Guinness Book - "No area is more rife with fraud and deception than age" or words to that effect. Wouldn't that be something if the whole Blue Zone fad turned out to be BS?

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