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Ph.D. in social psychology. Former researcher in pandemic behavioral risk reduction (non-pharma intervention). Only here to keep up. @joffir@med-mastodon.com
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Bonus post: "'I’ve been right about everything,' the president said, making and repeating a slew of misleading and false claims." www.nytimes.com/2025/09/23/u...
3/ this. Actually grown-ups had to sit and listen to this. At the UN. Let the "relentless human suffering" begin. bsky.app/profile/atru...
2/ this, and also... bsky.app/profile/atru...
Oh, swell. And to kick things off, we have... 1/3 apnews.com/article/un-g...
That would be bad.
Those are all fetal risks, not maternal SCAD risks.
Much, much too far to drive at this point, but if it's arriving there, it will likely be elsewhere, too! Thanks for the heads up!
Possibly, yes.
Anyone heard anything yet, re: the failure to launch (into heaven)?
Dunno.
3/ if you do not have subject knowledge is not a good idea.
2/ to the Trump administration, people should most definitely have listened to government scientists at the CDC, FDA, NIH, etc. The political messaging was bad during the early years of the pandemic, but the scientific messaging was good. Please listen to field experts; relying on your "own brain"
1. People can be infected w/ both covid & flu at the same time ("coinfection") but do not worry about a coronovirus combining w/ an influenza strain. They are very different sorts of virus, and reassortment is far more complicated than two viruses being in the same place at the same time. 2. Prior
9/ or carrying your baby, toddler or preschooler around after they hit 20-40 lbs. They are to be avoided whenever possible, which means *no NSAIDS* during pregnancy. Finally: your post was extremely rude and trollish, as well as wrong. So kindly f** off.
8/ events in pregnant (and other young) women are nothing to joke about. They can kill you. They can put you into heart failure (a lot of fun with a newborn). They can result in major cardiac surgery. They always result in activity restrictions - including weight restrictions, so good luck lifting
7/ woman has a stroke or heart attack) are advised, like pregnant women, not to take NDAIDs. But with the new messaging to discourage Tylenol use, more pregnant women *will* be compelled to take NSAIDs (despite the earlier cautions not to do so), increasing their risk of a major CV event. These...
6/ The average age of a 1st time SCAD patient is 42, although it can occur in a woman's teens &20s; among pregnant women who have SCAD, it obviously occurs most often among younger women. Women who have had a SCAD (or who have FMD, a precipitating cause that's gen. not discovered until *after* a
5/ & NSAID use *increases that risk more*; that's why pregnant women are advised not to take them, despite the fact that, by def., pregnant women are NOT elderly. A lg. majority of women who have SCADs are non-elderly; all those who have them during pregnancy/post partum are, by def., nonelderly.
4/ journals.plos.org/plosone/arti... Likewise, in this study (of people age 10 & older), increased risk was associated w/ higher NSAID dose. blogs.the-hospitalist.org/content/nsai.... So no, I'm not conflating jack. *Pregnancy increases the risk of major CV events (both heart attack & stroke),*
3/ here are a few studies suggesting increased stroke risks from NDAID use even among younger patients: Premenopausal women, aged 15-49: journals.plos.org/plosone/arti... Both sexes: Found "higher IS risks observed in younger people and in males except for diclofenac." (Citation next post)
2/ that doesn't mean that CV events (& you brought up strokes, specifically) aren't *made more likely w/ the use of NSAIDS even at younger ages.* That's why long-standing cautions by the FDA www.fda.gov/drugs/drug-s... & places like Mayo aren't age specific. www.mayoclinic.org/diseases-con... Next,
Ffs. 1st, yes, stroke risk is higher among elderly folks - in part because of how elderly vs nonelderly people absorb meds, but also b/c older folks are more likely to have preexisting CV disease than younger, & are more likely to take NSAIDS at higher doses & for longer periods of time. But...
3/ contamination risks. When I share a gift link, please read the article before asking for clarifications on the article. I share gift links so that I won't have to be a free Cliff's Notes service on those pieces.
2/ dosing). There are also other concerns. One is that people are turning to (illegal) compounded products, which may not be safe. Another is that vials for Zepbound or Mounjaro "don’t contain preservatives and are only for single use." That means repeated draws from a vial could increase...
Not at all. I shared a gift link; did you read the article? All medications carry benefits & risks. Meds are prescribed when the benefits outweigh the risks. But with no solid evidence yet on any benefits of micro-dosing, there is no way to do that analysis (which has been done for regular...
UK broadcasters should avoid coverage lapsing into while there is little/no evidence at all for Trump's statement, might he have a point anyway? Should report on how much US attitudes are polarising (or not) & risks that has for health bsky.app/profile/joff...
Well stated.
They're having the FDA send a letter out to all physicians. As DHHS Sec., Kennedy uses the CDC & FDA to inform & persuade the public. As to "nobody" trusting Trump & RFK; unfortunately, millions of folks do. Trump won the election, & part of the way he did that is by incorporating Kennedy's voters.
Reiki for hemorrhagic fever? Colonic irrigation for plague buboes? No, thank you; I'll pass.
Gupta: It is safe. That’s what the best-quality research shows. And how irresponsible, using the podium of the WH to put this out there when you’re not even offering an alternative. That is dangerous. An untreated fever is dangerous. Untreated pain in pregnancy is dangerous.
2/ But it was not safe after all, & was taken off the market. Rheum asked me if I wanted to go back to Celebrex, which was getting a black box warning for cardiovascular side effects. I said I'd pass. I can't do NSAIDs anyway, anymore, b/c I had a SCAD heart attack. It's Tylenol or nothing, now.
These have been off the market for years, now. First I was put on Celebrex; it didn't work for me. Then my rheumatologist tried Vioxx; didn't work & then was taken off the market. At that point, my rheum. recommended Bextra. "Are you sure this is safe?" I asked. She said yes. I actually loved it.
Ah.
Too tired to listen - is this the part where he says people see what they wanna see and hear what they want to hear? He was right. (And great album.)
They aren't MAGA, they're just egotistical, self-righteous idiots.
Statement by the American Psychiatric Association: (Note that, when they refer to "future treatments" at the end of this statement, they are presumably referring to treatment of specific & significant disability, not some sort of treatment to eradicate autism.)
Did you think I was?
2/ say tomorrow when the Rapture ghosts them. Will they buy their cars back? Will tariffs make that difficult? Or will they just start taking the bus, because it Could Still Happen? Lots of suspense, tonight. essaysyoudidntwanttoread.home.blog/2022/06/11/o...
Cognitive dissonance theory began with research on a 1950s millennial cult whose members thought they were about to be saved from a global flood by ETs. They gave away their stuff, but no ETs (or flood) arrived. Then they dug in. It will be interesting to see what the Christian millennialists 1/2
Public health messengers rightly stressed for decades that the public should listen to the CDC & FDA. Do folks realize the profound damage likely to result from the fact that, of necessity, they now must tell the public not to? Imagine what will happen when the next pandemic starts, for example.
2/ Now, it can't be trusted.
Acetaminophen (Tylenol) is safer than NSAIDs during pregnancy; pregnant people should avoid NSAIDs like ibuprofen whenever possible, per the ACOG. Also, please remember that about 16% of pregnant women in the US do not get adequate prenatal care. That's one reason why FDA guidance was so important.
Lots of people trust the FDA, so that's not what will happen, and people are going to get hurt.
Whoops; just saw your profile. You know.
NSAIDs can cause a variety of sorts of damage. But pregnant women get pains, as well as fevers from various infections. It's very worrisome that many may think NSAIDs are a safer option than Tylenol.
I'm *appalled.* So women who believe the FDA, or their doctors who believe the FDA (as we've always told people to), not understanding that all HHS agencies are now profoundly compromised, are...what? At fault? Collateral damage? People can be real pigs. With apologies to actual pigs, of course.
Funny, because I was seeing this:
NSAIDs (which many pregnant women will now take instead of Tylenol) are associated with an increased risk of cardiovascular events like heart attack & stroke. Pregnancy-associated SCAD is also a leading cause of heart attacks during pregnancy & postpartum. NSAIDs increase SCAD risk. I am concerned.
Please do not come here to tell me that a pregnant woman who follows the new FDA guidance & her fetus, who could both suffer injury if the mom doesn't take Tylenol when she needs it, deserve what they get, & that any potential deaths are just "thinning the herd." What the hell is wrong w/ you?
*contradicts, in post 1
You expect an lot of folks who are used to heeding the FDA about what is/isn't safe to consume. If they heed the FDA & so don't take Tylenol for fever b/c they think it will hurt their babies, & then give birth to babies w/ brain injuries or other harms, you think those babies & moms deserve that?
5/ both...often invoking debunked claims that the condition is linked to vaccines."
4/ careful work that research demands. They warn that drawing broad conclusions from incomplete evidence isn’t just premature but reckless. And it risks undermining the public trust that is the foundation of public health." "The autism initiative is a shared brainchild of Trump and [RFK Jr], with
3/ leucovorin without proper medical oversight and limited understanding of its effectiveness or long-term risks. But the fears run deeper than medical misuse." "What alarms many in the scientific community is [also] the politicized rush to present these drugs as solutions, bypassing the slow, ...
2/ medical societies." The admin said the FDA will "be updating the drug’s labeling and that a letter would be sent to all physicians in the country." Experts "expressed concerns that the warnings could prompt pregnant individuals to avoid Tylenol even when sick, or could push parents to try...
Even if this admin ended tomorrow, the damage they've done to trust in public health is a gift that will keep on giving for decades. US "officials will issue a warning label for pregnant individuals - a move that cobtadicts the guidance from the major 🧵1/5 www.washingtonpost.com/health/2025/...
Extortion, much?
A hard time for academia: "Conservative efforts to...punish educators over liberal ideas have grown..., led in part by [Kirk]....The campaigns to silence educators who speak critically of figures on the political right have been effective [& are] likely to expand." www.nytimes.com/2025/09/22/u...
Be very careful what vampires you welcome across your threshold. Trump's ComSec Howard Lutnick bought the penthouse, holds more shares now than anyone else, & is poised to sell it out from under the residents (including Shari Redstone, so I'm not crying too hard). www.nytimes.com/2025/09/16/b...
Hmm. Mind the drop.
Holy shit RFK Jr just used the idea that we should "believe all women" to defend the idea that vaccines might have caused their kids' autism, I am INCANDESCENT with rage
If you, like me, are the parent of a neuro-atypical child dreading this autism press conference, please remember: These are the people hurting our kids. Not us. They are the ones stigmatizing and pathologizing them. They are the ones peddling untested science. And we should be very, very angry.
3/ environment. Otherwise, I'd likely just feel guilty.
2/ vacation (or a luxury trip to WDW; even. I speak from personal experience on all three counts.) But that degree of accessibility was already straining the ecosystem; wholesale mass tourism will destroy it. I'm grateful we went, b/c it formed the basis of someone's career that protects the...
I agree; although I think folks who aren't wealthy deserve to be able to appreciate world heritage sites as the wealthy do, the sad fact is that there aren't a lot of checks on that industry except cost. 20 years ago, at least, a trip to the Galapagos was no more expensive than, say, a European...
More reporting: www.washingtonpost.com/business/202...
Whew! www.nytimes.com/2025/09/22/c...
2/ residents to offer DIY options. It feels rn like "the cat is out of the bag," but this threat was always hanging over tourism in the Galapagos; I don't know whether the current moment represents a real Pandora's box opening, or just a misstep we can still walk backwards out of. Time will tell.
Or perhaps people for whom it's a true bucket list item will go but be extra careful to go under the eye of the NPS & obey all rules to the letter. To the extent that folks with cash go & leave some of that cash there (there are various charitable initiatives), there will be less pressure on...
Coming back tomorrow. "It is still unclear whether Nexstar and Sinclair...will air future episodes of the show. Representatives for Nexstar and Sinclair did not immediately respond to a request for comment." www.nytimes.com/2025/09/22/b...
11/ that employs NPS staff to make sure things are done correctly. If, OTOH, you're just looking for a beautiful beach for your vacation, there are many other places to choose from, instead. Choose wisely; an entire, unique ecosystem depends on it.
10/ are a pristine place of nature like no other; the origin of Darwin's Origin of Species Until now, they've managed to survive alongside humans. But that survival depends on our continued respect & goodwill. If you have a sincere calling to go, please book with a legitimate, established company
9/ expects Galapagueños to keep bickering over Airbnbs, and officials to keep largely ignoring the issue....'the government has sent a clear message of what they care about, and it’s not conservation,' he said. 'That’s not good for Galápagos."" What a profound loss this would be. The Galapagos...
8/ happening...225 tons of the drug were seized there in 2023." A NYU law prof. "who studies legal protections for Galápagos ecosystems, believes the government...is sending the message that 'minerals, fossil fuels, and resource extraction' are more valuable than tourism and conservation....He
7/ "placed the islands on the World Heritage in Danger list for a few years." "Growth was so unrestrained that in 2015, the government issued a moratorium curbing all development." But the moratorium on all Galápagos hotel development doesn't apply to Airbnb. And now, cocaine "trafficking is
6/ "With visitors regularly chasing animals, drinking, and trashing beaches, many residents fear these islands are becoming the overrun Venice of the natural world." With private residents leading trips instead of park guides, rules aren't always followed, to the extent that UNESCO "placed the...
5/ discovering their latent wanderlust. Is this a democratizing of tourism? I guess. Is it a good idea? Not in my opinion. Now, it's not made clear to tourists that 97% of this archipelago is a protected national park, & they "fail to respect wildlife in this UNESCO World Heritage site."
4/ created income for residents (generally living in poverty) who otherwise might have resorted to less eco-conscious ways to male a living. It was a delicate balance. But as they say, too much of a good thing can be really bad. Now Air B&Bs have hit the Galapagos, just as throngs of tourists are
3/ for backup whenever they saw something on the islands that ought not be there, so it could be removed (well, killed) - sadly, once a kitten on a bluff, & another time, a goat who did not want to be found. Yes, nature would have been better off w/o our presence, but the money our tourism provided
2/ were members of the National Parl Service in the islands. As scientists themselves, they did due diligence: we used safe products they provided; they always got us off the islands by the time set by the NPS; they made sure we took nothing (not even the sand on our feet) back with us; they called
🧵 This is an environmental tragedy in the making. Two decades ago, I was fortunate to visit the Galapagos though a NatGeo program; one family member w/ me was a budding ecologist, so it was a dream come true. But we went with a reputable company, whose staff... www.nytimes.com/2025/09/21/b...
2/ is another ex. of this type of situation. I've known many kids w/ that, who are diagnosed w/ dyslexia much later than we'd expect them to be. Generally, among kids I've known, although they may know something seems different, they don't know what it is until they finally get the dx & go "ah ha!"
Right - esp. when a person is bright, they may develop "compensatory streategies" that "mask" areas of learning or other disability - that happens with neurotypical people, too. So folks can go a long time w/out a caretaker, educator or hc provider noticing what the situation is. "Stealth dyslexia"
Yes, I posted this study myself yesterday. It's a well-known one. But the point I was making is that most of the public has no ability to assess the quality of such research. We present good studies, they present terrible ones, & to the public, it's all a wash. In the... bsky.app/profile/joff...
5/ makes little sense given that it was on the market many decades ago, & pregnant women have always taken it, since; if Tylenol were going to cause an explosion of autism cases, it would have done so back when their grandmothers were pregnant in the 60s. That's the sort of thing that might help.
4/ now able to access professional evaluations (we're "looking for it more" so are finding it more), & that the meaning of autism has expanded to inc. lots of people who wouldn't have been seen as autistic previously. They can also understand that Tylenol causing an increase in autism rates only now
3/ my point is that, instead of just saying "the science shows" (which RFK does too, b/c he's a liar selling a lifestyle), we need to communicate particular arguments that an average person with no science ed. can grasp. These might include (as I said) that rates look higher b/c more people are...
2/ past, the problems this issue creates were often minimized by the fact that large swaths of the public understood who was a credible science communicator; they didn't need to read & interpret a study themselves, b/c they would trust credible sci com figures to do it for them. Now, they don't. So
Yes, I posted this study myself yesterday. It's a well-known one. But the point I was making is that most of the public has no ability to assess the quality of such research. We present good studies, they present terrible ones, & to the public, it's all a wash. In the... bsky.app/profile/joff...
5/ diff. But it is simply fact that some autistic people do *not* have enhanced cognitive abilities; I've known several autistic people who, in their teens, had the mental age of an 18-24 month old. That doesn't mean that other folks who identify as autistic aren't very, very bright & accomplished.
4/ issues that put them at risk of harm. "Autism" is now an enormous category, & we don't know whether, w/ highly functional people with autism vs severely disabled people, it's just a (huge) matter of degree, or whether the different outcomes fundamentally represent different categories of brain
3/ was language disorders. My SIL & her husband also worked at a res. facility that served these clients. I also have friends with severely disabled kids (adult kids, now, in some cases) who need caretakers & will eventually need to move to res. settings, b/c there are very significant safety...
2/ ASD, there are sig. impairments w/o an enhanced cognitive or other set of abilities. For those folks, who are generally nonverbal, there is generally marked cognitive disability. I did an internship with profoundly disabled autistic people as an undergrad, b/c at the time, my area of focus
There is nothing "wrong" with any neurocognitive difference. And for some folks, autism is simply a difference that confers some functional advantages, relative to neurotypical people, and some disadvantages; they have a mix of skills & talents just like anyone else. But for other people with...
He certainly isn't as insulated by being on HBO as we might have hoped.
Agree - but this is crossing my mind a lot. Plenty of old family stories in my head.
Obie power!
You can't say it's not in the back of our minds.
*path, not past.