Desflurane is a common anesthetic used in hospital operating rooms worldwide. It’s also a climate super pollutant. Now, several decades after the drug was first introduced, a growing number of US hospitals have stopped using the anesthetic because of its outsized environmental impact. On January 1, the European Union went a step further, prohibiting its use in all but medically necessary cases.

Desflurane is more than 7,000 times more effective at warming the planet over a 20-year period than carbon dioxide on a pound-for-pound basis. However, curbing its use alone won’t solve climate change. The anesthetic contributes only a small fraction of total global warming, which is driven by far larger volumes of carbon dioxide and methane emissions.

Still, emissions from the drug add up. Approximately 1,000 tons of the gas are vented from hospitals and other health care facilities worldwide each year. The emissions have a near-term climate impact equivalent to the annual greenhouse gas emissions from approximately 1.6 million automobiles. //

Instead of desflurane, the Yale New Haven Health System now relies primarily on sevoflurane, an anesthetic that is 10 times less potent as a greenhouse gas and approximately half as expensive. The health care system saved $1.2 million annually on anesthesia medications after making the switch, Sherman said. //

USAP physicians and others are also using less nitrous oxide or “laughing gas,” a mild anesthetic and potent greenhouse gas. Nitrous oxide is commonly distributed throughout hospitals via a centralized, leak-prone pipe network. Pipe networks in US hospitals can leak up to 99.8 percent of the gas before it reaches patients, according to a study published in 2024 in the British Journal of Anaesthesia. Using small, portable tanks can reduce losses by 98 percent. //

A paper published in the academic journal Anesthesia & Analgesia in July argued that the climate impact of desflurane emissions was not significant and suggested that more harm may come from withholding the drug from patients. //

j5i7 Seniorius Lurkius
5y
2
As a anesthesiologist, a few points:

• Desflurane does have distinct advantages compared to sevoflurane or isoflurane. It's is faster acting, and faster to wear off. However, clinically, this doesn't matter too much if you adapt to the anesthetic you are using. But it could get a patient out of an operating room a minute or two faster. The more obese a patient, the larger a difference it could make.
• Due to its vapor pressure, Desflurane requires a powered vaporizer that uses electricity on top of its significantly higher CO2 equivilent.
• Anesthesia machines use a circle breathing system. There is no way to strictly deliver anesthetic gases only when a patient is breathing in, but you can get very close.
  Anesthetic waste gases are generally vented through a roof vent in the hospital. There are technologies out there to recapture the anesthetics, but I don't believe any are commercially common.
• A lot of nitrous is lost due to leaks in the pipes. Generally nitrous isn't that useful in anesthesia for adults, but it does have its place in pediatrics.
• You can do anesthesia without any gases and just using medications that go through an IV. These are slightly more expensive, but better from a climate perspective. However, there are medical reasons to choose inhaled gases verses IV anesthetics.
• Finally, commonly used anesthetic gases are NOT flammable. However, oxygen is a great oxidizing agent...

To go along with that recent CETP trial news, here's another one for the "We don't know much about human lipid handing" file. A dietary study originally done back in the 1960s and 1970s has been (almost literally) resurrected, with data pulled out of yellowing stacks of paper, old cardboard boxes, and ancient-format computer tapes.
What it shows is that, under about the most controlled conditions possible in a large human trial (institutionalized patients being served standard meals), that replacing saturated/animal fat in the diet with vegetable-derived fats and oils provided. . .no cardiovascular benefit whatsoever. In fact, the lower the cholesterol levels of the patients, the higher their death rates. This was in over 9,000 subjects over five years, probably the largest study of its kind ever conducted, and it had only produced one (not very thorough) paper in 1989 that didn't make much of an impression. ///

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In the past 20 years, there have been only nine anthrax cases in the US.

However, B. anthracis is part of the larger Bacillus cereus group, which also includes B. cereus and B. tropicus, a newly recognized species. And these species can also carry and produce anthrax toxins. Both can be found in soils, and B. cereus is considered ubiquitous in the environment.

In 2022, CDC researchers found an unexpected pattern. Since 1997, there had been seven cases of infections from Bacillus group bacteria producing the anthrax toxin—all in metalworkers. Six of the seven were welders, hence the term “welder’s anthrax,” with the remaining case in a person working in a foundry grinding metal. Of the six cases where a specific Bacillus species was identified, B. tropicus was the culprit, including in the newly reported case.

Speculating risks
It’s unclear why metalworkers, and welders specifically, are uniquely vulnerable to this infection. In their 2022 report making the connection, CDC experts speculated that it may be a combination of having weakened immune responses in the lungs after inhaling toxic metal fumes and gases created during metalwork, and having increased exposure to the deadly germs in their workplaces. //

Environmental sampling of his workplace found anthrax-toxin-producing Bacillus in 28 of 254 spot samples. //

The experts also speculated that iron exposure could play a role. Bacillus bacteria need iron to live and thrive, and metalworkers can build up excess iron levels in their respiratory system during their work. Iron overload could create the perfect environment for bacterial infection. In the teen’s case, he was working with carbon steel and low-hydrogen carbon steel electrodes.

For now, the precise risk factors and why the healthy teen—and not anyone else in his workplace—fell ill remain unknown. CDC and state officials recommended changes to the workplace to protect metalworkers’ health, including better use of respirators, ventilation, and dust control.

agt499 Ars Tribunus Militum
13y
2,148
So, about the way Cholesterol guy ...improved his “mental clarity.”

I had a cardiac event in 2010, recovered fine with a bunch of meds, but found that I felt substantially diminished mental reasoning.
I went through a pile of tests, MRI, expert neurologists and cognitive testing, which all amounted to "you're pretty smart", but I just couldn't think like I used to.

In 2018 I got a new general practitioner and mentioned this, and she instantly suggested my cholesterol was too low, that the brain needs a level of cholesterol to function well and she'd seen it repeatedly before that cardiologists "overcook" cholesterol management.

Over a few months she reduced my lipid dosage to a quarter of what it had been, with fairly immediate mental improvements and cholesterol readings still in safe bounds.

I'm pleased to have my brain back despite the experts missing it all, and now I know I can go on the "nine pounds of cheese" diet for a brain boost...

Rhabdomyolysis, often shortened to rhabdo, is a condition in which your muscles get damaged and break down, which can lead to muscle death.

That muscle death releases toxins into the body, which can cause kidney damage.

There are lots of potential causes, including medications like statins, antidepressants and antivirals. It can also happen as a result to dehydration and overheating, drug abuse, certain underlying medical conditions, injury or trauma. //

But becoming more common is exertional rhabdo, which is caused by high-intensity exercise like marathons, CrossFit and yes, spinning. It’s especially a threat for people attempting these tough workouts with inadequate training, or those who push themselves too hard.

And spinning might just be the worst culprit. One 2021 study found that people who suffered exertional rhabdo caused by spinning actually had more severe cases than those who had exertional rhabdo from other causes.

The study authors also noted that the condition predominantly strikes young, healthy women — and wanting to keep up with your fellow SoulCyclers could be increasing your risk. //

Top symptoms to look out for are the “classic triad” of muscle pain, muscle weakness and dark urine the color of tea or cola.

But not everyone gets all three symptoms — in fact, only about 10% of people with rhabdo only experience one or two, according to the American Academy of Physical Medicine and Rehabilitation.

Other potential symptoms include fever, nausea, vomiting, malaise, dehydration, infrequent urination, confusion and loss of consciousness. //

if you do spin class, make sure to properly hydrate, avoid any medications or supplements that can increase your risk, and gradually build up exercise volume and intensity.

Disorders and Diseases of Hamsters

Electroconvulsive therapy, or electroshock, has a bad reputation, but medically its efficacy is well documented, even if nobody knows how it works. //

In electroconvulsive therapy (ECT), an electrical current is used to induce grand mal seizures as a treatment for psychiatric patients. Some hundred thousand Americans receive the therapy every year, a statistic comparable to the number of appendectomies or hernia surgeries performed. When drug alternatives prove ineffective, it’s considered safe and effective for people suffering from schizophrenia, depression, mania, catatonia, and other psychiatric diseases. As these BMJ authors note, its value is undoubted even if we don’t know how it actually works

A Community for Invisible and Chronic illnesses
Do you want friends with your same disease?

Click below to join our community ///

POTS

The man’s family told doctors that, up until a few months prior, he had been taking three different types of herbal supplements that claim to treat joint pain. The man had taken the supplements for four years, and sometimes as often as four times a day, but he had stopped using them in the lead-up to his illness.

Deadly doses
The supplements were: Artri King, Nhan Sam Tuyet Lien, and Linsen Double Caulis Plus. All are known to contain unlisted glucocorticoids, according to the Food and Drug Administration. And testing of two of the man’s supplements by the hospital confirmed the presence of the steroids.

Doctors determined that the man had essentially overdosed on the glucocorticoids—he had taken doses that exceeded the normal levels of glucocorticoids in the body. The steroids likely suppressed immune responses, leading to his infections and GI ulcers. But, more significantly, the excess steroid levels also caused his HPA axis to essentially shut down. While it’s possible to get the HPA axis back up and running after withdrawal from excessive steroid use, the amount of time that takes can vary. Further, if a person stops taking large doses of glucocorticoids abruptly, rather than gradually—as in the man’s case—and particularly after chronic use—also as in the man’s case—it can lead to an adrenal crisis. In retrospect, the man had all the signs of a crisis.

If we ID the DNA for a great antibody, anyone can now make it. //

knowing what antibodies we’d like to see people making while having no way of ensuring that they do.

One of the options we’ve developed is to just mass-produce broadly neutralizing antibodies and inject them into people. This has been approved for use against Ebola and provided an early treatment during the COVID pandemic. This approach has some practical limitations, though. For starters, the antibodies have a finite life span in the bloodstream, so injections may need to be repeated. In addition, making and purifying enough antibodies in bulk isn’t the easiest thing in the world, and they generally need to be kept refrigerated during the distribution, limiting the areas where they can be used.

So, a number of companies have been looking at an alternative: getting people to make their own. This could potentially lead to longer-lived protection, even ensuring the antibodies are present to block future infections if the DNA survives long enough.

take a deep butt breath….

Ig Nobel-winning research could one day be used to treat people with blocked airways or clogged lungs.

Last year, a group of researchers won the 2024 Ig Nobel Prize in Physiology for discovering that many mammals are capable of breathing through their anus. But as with many Ig Nobel awards, there is a serious side to the seeming silliness. The same group has conducted a new study on the feasibility of adapting this method to treat people with blocked airways or clogged lungs, with promising results that bring rectal oxygen delivery one step closer to medical reality.

, thanks to having lots of capillary vessels in its intestine. The technical term is enteral ventilation via anus (EVA).

Would such a novel breathing method work in mammals? The team thought it might be possible and undertook experiments with mice and micro-pigs to test that hypothesis. They drew upon earlier research by Leland Clark, also of Cincinnati Children’s Hospital, who invented a perfluorocarbon liquid called Oxycyte as a possible form of artificial blood. That vision never materialized, although it did provide a handy plot point for the 1989 film The Abyss, in which a rat is able to “breathe” in a similar liquid.

And Oxycyte was ideal for the group’s 2021 Ig Nobel-winning efforts. The experiments involved intra-anally administering oxygen gas or a liquid oxygenated perfluorocarbon to the unfortunate rodents and porcines. Yes, they gave the animals enemas. They then induced respiratory failure and evaluated the effectiveness of the intra-anal treatment. The result: Both treatments were pretty darned effective at staving off respiratory failure with no major complications.

In 2021, she came across a notice in the Federal Register recruiting participants for a double-blind clinical trial led by Dr. Richard Frye.

“It was like something clicked. He went from one or two words to full-on sentences within six months.” -- Kathleen Schnier

The pediatric neurologist was studying whether leucovorin could help autistic children with cerebral folate deficiency — or a shortage of vitamin B9 in the brain.

Researchers believe up to 70% of autistic children have antibodies that block the transport of folate into the brain, leading to these deficiencies and contributing to speech delays and behavioral challenges. //

With his new ability to speak, Nathaniel finally found a way to express what had been locked inside for years.

“The TV in my brain, I can say it in my mouth,” Kathleen remembers her son telling her. “It was always there, he just couldn’t say it.”

A 36-year-old man showed up to the emergency department of the Massachusetts General Hospital, severely unwell from a puzzling set of conditions. He had abnormalities in his lungs, intestines, blood, liver, and lymphatic system—and, of course, no single clear explanation. His case was such a riddle that a master clinician with an expertise in clinical reasoning was called in to help unravel it.

Patients with complex wounds need elevated care. So, we designed the Hillrom Envella Air Fluidized Therapy (AFT) Bed as our most advanced wound care surface to date. The Hillrom Envella bed can help with pain management and supports wound healing.1

The pressure redistribution surface pushes air through millions of tiny beads, creating a fluid-like environment that feels similar to floating on water. This action boosts immersion and envelopment, minimizes shear and pressure, and helps control the skin’s microclimate.2

Regardless, the editorial authors signal that Coca-Cola has become a first-line treatment for bezoars, and several case reports and studies support its use. A 2024 randomized controlled trial involving 160 patients in China with phytobezoars concluded that "Timely ingestion of Coca-Cola yields significant benefits, including a complete dissolution rate of 100 percent, a low incidence of gastric ulcers, no need for fragmentation, and reduced expenses."

While it's unclear what the woman's bezoar was made of—she didn't report eating an excessive amount of persimmons—it was most likely some type of phytobezoar. As such, doctors put her on a plan to drink 3,000 milliliters (about 8.5 cans) of cola in 12 hours. Given that the woman also had Type 2 diabetes, they prescribed diet cola. //

The next day, the woman "reported a sudden tugging sensation in her abdomen, followed by a prompt decrease in her nausea and abdominal discomfort." Taking another look with an endoscope, the doctors confirmed that the bezoar was gone.

As to how it formed in the first place, the doctors tied it to her use of semaglutide. As a GLP-1 weight-loss drug, one of its effects is slowing down stomach emptying. That in turn can create conditions for a bezoar to form.

I had been taught in school that scurvy had been conquered in 1747, when the Scottish physician James Lind proved in one of the first controlled medical experiments that citrus fruits were an effective cure for the disease. From that point on, we were told, the Royal Navy had required a daily dose of lime juice to be mixed in with sailors’ grog, and scurvy ceased to be a problem on long ocean voyages.

But here was a Royal Navy surgeon in 1911 apparently ignorant of what caused the disease, or how to cure it. Somehow a highly-trained group of scientists at the start of the 20th century knew less about scurvy than the average sea captain in Napoleonic times. Scott left a base abundantly stocked with fresh meat, fruits, apples, and lime juice, and headed out on the ice for five months with no protection against scurvy, all the while confident he was not at risk. What happened? //

One of the most striking features of the disease is the disproportion between its severity and the simplicity of the cure. Today we know that scurvy is due solely to a deficiency in vitamin C, a compound essential to metabolism that the human body must obtain from food. Scurvy is rapidly and completely cured by restoring vitamin C into the diet.

Except for the nature of vitamin C, eighteenth century physicians knew this too. But in the second half of the nineteenth century, the cure for scurvy was lost. The story of how this happened is a striking demonstration of the problem of induction, and how progress in one field of study can lead to unintended steps backward in another. //

Finally, that one of the simplest of diseases managed to utterly confound us for so long, at the cost of millions of lives, even after we had stumbled across an unequivocal cure. It makes you wonder how many incurable ailments of the modern world—depression, autism, hypertension, obesity—will turn out to have equally simple solutions, once we are able to see them in the correct light. What will we be slapping our foreheads about sixty years from now, wondering how we missed something so obvious? //

But the villain here is just good old human ignorance, that master of disguise. We tend to think that knowledge, once acquired, is something permanent. Instead, even holding on to it requires constant, careful effort.

DaveGinOly in reply to ztakddot. | September 5, 2025 at 1:32 am
A portion of deaths during the “Spanish” flu pandemic were almost certainly iatrogenic. Patients, many of them young soldiers, were treated with what we now know were fatally toxic doses of the miracle drug of the day – aspirin. Modern analysis of the day’s post mortems show many deaths displaying characteristics of salicylate poisoning – pneumonia-like wet and hemorrhaging lungs.

lichau in reply to DaveGinOly. | September 6, 2025 at 3:51 pm
Bingo.
I read that they were absolutely pounding aspirin. 20g/day or more.

When I switched to a locally compounded all-natural testosterone cream, the issue was solved. And the FDA has made it clear that it is interested in taking compounded creams for testosterone and estradiol off the market, as well. The FDA would prefer I inject myself with improved synthetics than allow me to opt for an organic alternative. //

Big Pharma loathes the idea of local providers and compounding pharmacies, because there is no money in such things. Something similar to this issue may one day affect you or someone you love. After all, there is more money to be made and more power to be had in treating sick people than in actually seeing them get better. There is more money to be made and more power to be had in forcing people to take synthetic medications than in allowing them to choose a natural alternative.

These parasites are usually found in the skin, but they can invade anything.

A century ago, somewhere around 8–10 percent of all psychiatric admissions in the US were caused by bromism. That's because, then as now, people wanted sedatives to calm their anxieties, to blot out a cruel world, or simply to get a good night's sleep. Bromine-containing salts—things like potassium bromide—were once drugs of choice for this sort of thing.

Unfortunately, bromide can easily build up in the human body, where too much of it impairs nerve function. This causes a wide variety of problems, including grotesque skin rashes (warning: the link is exactly what it sounds like) and significant mental problems, which are all grouped under the name of "bromism."

Bromide sedatives vanished from the US market by 1989, after the Food and Drug Administration banned them, and "bromism" as a syndrome is today unfamiliar to many Americans. (Though you can still get it by drinking, as one poor guy did, two to four liters of cola daily [!], if that cola contains "brominated vegetable oil." Fortunately, the FDA removed brominated vegetable oil from US food products in 2024.) //

After the escape attempt, the man was given an involuntary psychiatric hold and an anti-psychosis drug. He was administered large amounts of fluids and electrolytes, as the best way to beat bromism is "aggressive saline diuresis"—that is, to load someone up with liquids and let them pee out all the bromide in their system.

This took time, as the man's bromide level was eventually measured at a whopping 1,700 mg/L, while the "reference range" for healthy people is 0.9 to 7.3 mg/L. //

ChatGPT did list bromide as an alternative, but only under the third option (cleaning or disinfecting), noting that bromide treatments are "often used in hot tubs."

Left to his own devices, then, without knowing quite what to ask or how to interpret the responses, the man in this case study "did his own research" and ended up in a pretty dark place. The story seems like a perfect cautionary tale for the modern age, where we are drowning in information—but where we often lack the economic resources, the information-vetting skills, the domain-specific knowledge, or the trust in others that would help us make the best use of it. //

darlox Ars Centurion
12y
291
There's clearly a bell-curve of "the right amount of information" for society to function well. Too little, you end up with quacks selling cure-alls and snake oil because nobody can effectively do any research. Too much, and you end up with quacks selling cure-alls and snake oil because everybody can effectively do terrible research.

Sooner or later this will work it way out of the gene pool.... one way or another. 🤦‍♂️ //

Steel_Sloth Smack-Fu Master, in training
3y
26
Subscriptor
You should cut down on your use of table salt? Ah, that old bromide... //

Frodo Douchebaggins Ars Legatus Legionis
12y
11,409
Subscriptor
Some people are on this planet solely to become cautionary tales. //

UweHalfHand Wise, Aged Ars Veteran
5y
153
Subscriptor++

ajm8127 said:
Don't you need some chlorine? For example to form HCl and break down food in your stomach. I am sure the body uses it for other processes as well.

Remember, a BALANCED diet is what you are after.
No! ChlorINE is very dangerous war gas; it’s chlorIDE you need, the latter is a benign ion of significant biological use. Granted, it’s only one tiny electron difference, but that makes all the difference… a very renowned biophysicist corrected me quite emphatically on this point once. If you attempt to let that electron be added inside or for that matter anywhere near your body, you will regret it.