patrick.net

tatupu70 says

How did Obamneycare make Drs. prescribing the wrong medication worse?

It increased the cost and perverse incentives, expanding the pre-existing problem.

tatupu70 says

Are you arguing that allowing more people to see Doctors is a bad thing?

If you spent more time reading, you might learn something. As for whether Obamacare allows people to see doctors, and if so which ones, and which medicines, you might want to read this.

tatupu70 says

It was clear that the Congressmen at the time were only going to allow small step change.

Both houses of Congress were controlled by Democrats, and the White House signed onto their plans rather than trying to change them. It was actually a huge step for the existing "stakeholders," i.e. the biggest players in the existing industry, arrogating unprecedented federal power as their tool to maximize revenues.

In that Oregon Medicaid study, depression rates dropped 30%.

That must be the statistically unsound component of the study.

Given this horrible news, that one of the most prescribed drug categories in America is so dangerous to unborn babies, maybe it is a perverse benefit that it also causes sexual dysfunction.
Well over 1/2 of those taking this medication report loss of libido or inability to achieve orgasm. (This is greater than the number reporting positive effect on their depression.)

Autistic kids aren't so bad. They are like human rolodexes that remember all your crap for you when you grow too old and senile to remember it yourself.

Iosef V HydroCabron says

In that Oregon Medicaid study, depression rates dropped....

by less than a third of what you claim, and it was a placebo effect:

"Those who are in denial about Medicaid’s poor physical outcomes point to the Oregon results on depression. 30 percent of uninsured patients at baseline screened positive for depression; relative to being uninsured, the authors estimate that Medicaid reduced depression diagnosis by 9 percent, with a p value of 0.02 (i.e., a 2 percent chance of statistical noise). “This is an astounding finding,” exclaimed Jonathan Gruber, the Oregon study co-author who is best known as the architect of Obamacare. “That is a huge improvement in mental health.”

There are a number of flaws in the way that the Oregon investigators measured depression; for a detailed look, go back to my comprehensive review of the results from last week. But here’s the kicker. In 2011, the authors noted that two-thirds of the improvement in patients’ “self-reported health” took place “about 1 month after [Medicaid] coverage was approved,” but before “any increase in health care utilization.” In other words, patients felt better once they knew they were on Medicaid, but before they had seen a doctor, or undergone a test, or filled out a prescription.

That is the classic definition of a placebo effect. And it’s hardly “astounding” to anyone with experience in clinical trial design."

The Oregon finding corroborates the many previous reports that the entire "benefit" of SSRIs can be attributed to a placebo effect, and even the placebo effect of being newly insured might wear off when people realize their Obamneycare insurance doesn't give them access to their doctors or their drugs. If the sanctimonious boosters of Obamneycare really cared about the poor even half as much as they claim, they'd give actual money instead, at lower cost and with greater benefit. But, in truth, they don't really care about the poor, or facts in general, they care only about being in the partisan chorus, chanting the cult mantra, which has been drilled into them by the bishops of PhRMA.

All that ad hominem, demonization of your opponents, and "wake up, MSM/pharma zombies" talk hardly resembles the learning through discussion you claim to be interested in.

I'm not convinced SSRIs are worth much, but, just to be clear: any statistically significant correlation which violates your preconceptions is due to a placebo effect.

Do I have that right?

If so, why do you even bother arguing about anything with anyone? Why not just publish?

There are a number of flaws in the way the Oregon investigators measured depression.

Oh, Jesus Christ. As predicted, the depression results are cast into the part of the study deemed "flawed".

Cherry pick much?

Why, then are the parts of the study which support your conclusions not also suspect?

Ceffer says

Autistic kids aren't so bad. They are like human rolodexes that remember all your crap for you when you grow too old and senile to remember it yourself.

It could be that some parents find autism desirable (secretly), and that the generation of autistic kids was therefore a placebo effect!

Iosef V HydroCabron says

Do I have that right?

No, but you don't care anyway so it's a waste of time.

Update with further corroboration:

"Antidepressants in Pregnancy Tied to Autism

***

The overall risk is low - less than 1 percent of the nearly 150,000 babies in the study were diagnosed with autism by age six or seven.

But children of women who took antidepressants during the second and third trimesters of pregnancy were 87 percent more likely to develop autism than kids born to women who didn't take the drugs, researchers report in JAMA Pediatrics."

"Selective Uptake and Bioaccumulation of Antidepressants in Fish from Effluent-Impacted Niagara River

The major pollutants observed were the antidepressants (citalopram, paroxetine, sertraline, venlafaxine, and bupropion, and their metabolites norfluoxetine and norsertraline) and the antihistamine diphenhydramine."

Not getting pregnant solves the problem.
The unborn won't be missed.
http://www.worldometers.info/world-population/
.......
https://patrick.net/post/1309603/this-could-only-happen-in-the-waters-of-the-great-lakes

Suicide rates rose steadily in nearly every state from 1999 to 2016, increasing 25 percent nationally, the Centers for Disease Control and Prevention reported on Thursday. In 2016, there were more than twice as many suicides as homicides in the United States.

Gosh, I wonder why subsidizing toxic placebos known to cause suicidality would be accompanied by an increase in suicides.

curious2 says

Suicide rates rose steadily in nearly every state from 1999 to 2016, increasing 25 percent nationally, the Centers for Disease Control and Prevention reported on Thursday. In 2016, there were more than twice as many suicides as homicides in the United States.

Gosh, I wonder why subsidizing toxic placebos known to cause suicidality would be accompanied by an increase in suicides.

Yeah this has nothing to do with electing idiots in the white house in 2000 and 2016...

JH says

2016...

The data end in 2016. Maybe you are suggesting a huge number of people with TDS jumped off bridges in November and December, due to the election results? How would that explain the increase in 2014-2015?

curious2 says

JH says

2016...

The data end in 2016. Maybe you are suggesting a huge number of people with TDS jumped off bridges in November and December, due to the election results? How would that explain the increase in 2014-2015?

he was 'elected' long before nov 2016 in 'murica.

curious2 says

SSRIs can also drive hospitalizations, the biggest revenue model of all.

BTW, as for what is driving the increase in "anti-depressant" use: "1 In 3 Adults In The U.S. Takes Medications Linked To Depression"

This is called synergy: the more pills the patient is prescribed, the more pills the patient needs.

The American medical system itself, specifically medical error, is the third leading cause of death in the USA, behind only heart disease and cancer. Let me put that another way: if you are at all concerned by what might actually kill you and the people you care about, the three most likely culprits are (1) heart disease, (2) cancer, (3) medical error. As long as you can be distracted by global warming or "assault weapons," or whatever appears in the daily headlines, you can't address what is actually most likely to kill you, and the $3T/year can keep rolling in.

Nearly hot off the press:

http://science.sciencemag.org/content/360/6386/327

William is a friend of mine. We're having kids at an older age on average. This paper is one of the benefits of whole genome sequencing of significant segments of the population. Actually it's only 2600 families but it's a sign of what's to come.

These are not single letter mutations but large structural changes to the genome being passed down by fathers.

Study Ties Paternally Inherited Structural Variants to Autism Risk
Apr 19, 2018
| staff reporter

NEW YORK (GenomeWeb) – Researchers have linked paternally inherited cis-regulatory structural variants to autism spectrum disorder.

While de novo protein-altering variants contribute to about a quarter of autism spectrum disorder (ASD) cases, researchers from University of California, San Diego, suspected that variants affecting regulatory elements could also contribute to risk of the condition.

UCSD's Jonathan Sebat and his colleagues searched for structural variants in cis-regulatory elements (CRE-SVs) within the whole genomes of more than 9,000 people from 2,600 families affected by ASD. As they reported today in Science, the researchers found that paternal-origin CRE-SVs were more likely to be inherited by their children with ASD rather than by their unaffected children.

"Our results suggest that rare inherited noncoding variants predispose children to ASD, with differing contributions from each parent," the researchers wrote in their paper.

The researchers' discovery set included 829 families, spanning 880 affected and 630 unaffected individuals, who had undergone whole-genome sequencing. These families had previously been screened for de novo loss-of-function mutations and large copy number variants using exome and microarray approaches, but those analyses came up empty. This, the researchers said, meant their cohort was more likely to contain novel and non-coding variants.

Using a pipeline they developed that included a support-vector machine-based software tool, the researchers uncovered an average 3,746 structural variants per person. For three individuals, the researchers, who included employees of Oxford Nanopore Technologies, performed nanopore sequencing to validate the structural variants.

Sebat and his colleagues also identified genomic regions that are generally intolerant to structural variations, reasoning that when they do occur in those spots, they would be more likely to be pathogenic. Within the discovery cohort, as compared to simulations, they found that structural variants were depleted within promoters and untranslated regions.

They then conducted family-based association testing to find that paternal-origin SVs affecting intolerant genes were more likely to be inherited by their children with autism than by those without it. Maternal CRE-SVs, meanwhile, were not associated with ASD.

Similar results were found, the researchers reported, in a cohort of 1,771 families from the 1000 Genomes Project. Further, a combined analysis of the 2,600 families also noted the association between ASD and paternal CRE-SVs.

Sebat and his colleagues found that some CRE-SVs recurrently affected intolerant genes like CNTN4, LEOP1, RAF1, and MEST. For instance, they uncovered two de novo loss-of-function variants that disrupted LEO1 — a gene previously implicated in autism and developmental delay — and both those LEO1 deletions led to the elimination of an upstream regulatory element.

They also found de novo mutations within their discovery sample, including 104 deletions, 19 duplications, eight complex structural variants, and 23 mobile element insertions.

The researchers said that the paternal origin effect they uncovered was surprising, especially as previous autism studies have noted a maternal bias in the transmission of truncating variants.

According to Sebat and his colleagues, there are three possible scenarios that could explain the effect they observed. First, they said it could be due to a "bilineal two-hit model" in which the proband inherits a variant of large effect from the mother and a CRE of moderate effect from the father to contribute to disease. Or, the paternal origin effect could be due to epigenetic mechanisms, though the researchers said that was unlikely. Lastly, they said it could be due to a meiotic drive, in which allele-specific selection occurs differently in paternal and maternal germ cells, a scenario they also deemed unlikely.

Aphroman says

Trumpublicans are in charge of the government so the liberals can’t ruin everything anymore. Remember how every Republican including Trump swore every day how they were going to repeal and replace Heritage Foundations’ signature piece of legislation, PPACA aka Obamacare? Whatever happened with that?

The left can't meme, those cartoons are comically bad.

It's like when the leftist at Time thought this cover would actually "hurt" Trump.

It's clear that the older the parents the more likelihood of a irregularity/mutation. Previously the focus was mainly on the age of the woman which still is the biggest factor, but now older men are also implicated, in this case with an increased risk oaf autism. Still compared to the health and age of the woman I'd say the paternal influence is very muted..

Goran_K says

The left can't meme, those cartoons are comically bad.

Perhaps, but they are also very true. I heard about repeal for the longest time and nothing happened, probably due to insurance companies strategically buying off few key Republicans.

drB6 says

Perhaps, but they are also very true. I heard about repeal for the longest time and nothing happened, probably due to insurance companies strategically buying off few key Republicans.

It's a long game. Politically just doing a straight repeal isn't politically feasible, I don't care how popular you are as POTUS, and how much congressional support. But Trump did stab ACA in the heart by killing the individual mandate.

Now we'll see ACA actually stand up to market demand. Want to guess how it's going to go?

#4DChess

Goran_K says

Want to guess how it's going to go?

That is 100% clear and I suspect we both agree on it.

Goran_K says

drB6 says

Perhaps, but they are also very true. I heard about repeal for the longest time and nothing happened, probably due to insurance companies strategically buying off few key Republicans.

It's a long game. Politically just doing a straight repeal isn't politically feasible, I don't care how popular you are as POTUS, and how much congressional support. But Trump did stab ACA in the heart by killing the individual mandate.

Now we'll see ACA actually stand up to market demand. Want to guess how it's going to go?

#4DChess

Yep when you're in charge it's a "long game". When you are not, claiming the need for immediate repeal/replace/deny/obstruct is the only way.

JH says

You need to have your paranoia treated.

Thanks for the tip, but if your toxic SSRI placebos are not helping, then you may be prescribed an anti-psychotic, "as seen on TV." Specifically, viewers are told to continue the toxic SSRI placebo and add an anti-psychotic called "Abilify". According to the advertisers, if the previously advertised "anti-depressant" doesn't help, then the patient must be both depressed and psychotic.

If you ever watch commercial "news", count the ads to see which payers are calling the pipers' tune. The relentless narrative of worry and woe, from TDS to the latest misfortune anywhere on earth, gives the audience headaches and indigestion, and drives the audience to anxiety and depression, and the advertisers to cash in. "World to end at 10, details at 11."