Just in case someone's never asked for mycoplasma serology, but isn't sure whether they're missing out, what would you tell them? Esp if they work with immunocompromised people who often have "inflammatory symptoms" (fatigue, sweats, wt loss, anorexia etc)
Asking for a friend.....

Database studies are prone to streaming; i.e. since apixaban is known to carry a lower bleeding risk, more likely to select it if higher bleed risk - can only control for coded risk factors, so some risk factors missed
So it's interesting that they still found apixaban's non-major bleed risk lower

🙋‍♂️

Points I learned were:
1."Normal" levels don't exclude deficiency. NICE suggest MMA if B12 180-350 (indeterminate) but our local haem suggests go straight to trial of Rx (MMA also problematic)
2.Many need maintenance more often than 2-3 monthly, so if Sx recur before next injection, shorten interval

Hi Calum. Yes, partly that. Partly an "adjusted calcium" type issue (ie B12 levels generally include haptocorrin-bound B12 which is inactive and gets excreted; haptocorrin increases in cancer); partly, like iron, your handling of B12 is altered in inflammation; and partly it's poorly understood

Follows inclusion of olanzapine in ASCO's recommendations in 2023 after another "positive" RCT:
doi.org/10.1200/JCO....

Hi Sarah, you could get the same outcome with a series of 200mg IM loading doses. I think the key point is that if, say, an initial total of 600mg is sufficient, then the maintenance dose needed is very much less than 800mg/day; or perhaps not necessary at all

The initial 600mg loading can be given in 50mL of NaCl as a single short subcut infusion. In this series, 85% responded to the first dose, despite being used in those with agitation refractory to multiple other drugs (midazolam, levomepromazine, clonidine)
pubmed.ncbi.nlm.nih.gov/37798082/