c.niemel
TL3 Regular · Pau, FR
Long-standing member. Posts carefully and infrequently, mostly in the practice and analytics categories.
Joined 13 January 2025 · last posted 15h
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Fixed versus detachable needles: the trade-offs — does this still hold? Replied, post #13 · Devices › Syringes & needles · 27 Jul 2026 · 4 likes Dead volume: residual liquid in the hub and needle after withdrawal. Typical residual is 0.01 to 0.02 mL for an insulin syringe with a fixed needle. Accounting for it…
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Tracking semaglutide's approved indications across jurisdictions, dated Replied, post #20 · Compounds › Semaglutide · 27 Jul 2026 · 20 likes Semaglutide's structure is a modified backbone with a C18 diacid attached through a spacer. The acylation is the reason for the long half-life and it is also the reason…
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Type 2 diabetes and the largest part of the evidence base — does this still hold? Replied, post #23 · Clinical › Comorbidities · 27 Jul 2026 · 0 likes Post #21 describes the usual case. This is about the unusual one. Cardiovascular disease: several compounds have cardiovascular outcome trials. SELECT was in people…
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Private prescribing in the UK: what is actually involved Replied, post #75 · Regional › UK & Ireland · 25 Jul 2026 · 0 likes Coming back to post #73, because the follow-up matters more than the original answer. I changed my mind about private prescribing after someone here asked me for the…
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Tracking a shortage from primary sources rather than rumour Replied, post #108 · Access › Shortages · 17 Jul 2026 · 25 likes Manufacturer allocation decisions during a shortage are commercial and are rarely explained, which is frustrating and is not evidence of anything.
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Micro-titration: a disputed topic, argued properly Replied, post #105 · Practice › Dosing & titration · 15 Jul 2026 · 7 likes A titration plan written down in advance is easier to stick to and easier to abandon deliberately. An improvised one becomes a series of decisions made on the worst day…
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Journal club: LEADER as the historical anchor Replied, post #103 · Evidence › Journal club · 12 Jul 2026 · 6 likes That is a cleaner way of putting what I was circling around.
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Osteoarthritis and mechanical versus metabolic improvement — one year on Replied, post #28 · Clinical › Comorbidities · 11 Jul 2026 · 0 likes The most useful thing anyone has posted about Osteoarthritis and mechanical versus metabolic in this category was a table of what had been measured and by whom. That is…
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Revisiting: The best-written scientific paper you have read Replied, post #81 · Lounge › Off topic · 10 Jul 2026 · 30 likes An update on my earlier best-written scientific paper post: the pattern held for another six weeks and then stopped, which I did not predict and cannot explain.
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Revisiting: Liver enzymes drifting down and what that usually means Replied, post #54 · Clinical › Bloodwork · 9 Jul 2026 · 0 likes This follows post #51 rather than contradicting it. Liver enzymes: elevation does not specify cause. ALT and AST can rise from many things. Bilirubin helps narrow down…
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How shortages have affected compounding permissions Replied, post #23 · Access › Shortages · 8 Jul 2026 · 0 likes Shortages end and the notices are updated. Checking the current notice takes a minute and is more reliable than a thread from March.
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Comparing documentation quality across the directory, tabulated Replied, post #9 · Sourcing › Vendor reports · 8 Jul 2026 · 0 likes The service matters to the interpretation. A documentation review and a chromatographic assay answer different questions and both are worth filing. The confident…