mRNA injected into deltoid cells lasts about 72 hours and do not travel to distant sites in the body.
I get asked about this all of the time, so I went to find the primary science on this.
A couple of quick tweets
The first paper I can find on this was in @ScienceMagazine in 1990 and showed the half-life of RNA in muscle cells to be less than 24 hours- RNA encoding the luciferase protein was injected into mouse quads and luciferase was undetectable at 60 hours. pubmed.ncbi.nlm.nih.gov/1690918/
In 2007, a study agreed:
Luciferase-encoding mRNA injected into human ear dermis peaked transcription at 17h and was undetectable at 3 days (panel d).
They also looked for luciferase expression at distal sites in the ear and saw none (panel e).
I’m going to target this thread to a wide audience, so my description of our work may leave some wanting more detail. The detail is in the online version and the supplement. Happy to answer any questions on the work as they come up.
As a critical care doc with a pediatrician wife, 4 school aged kids, and a summer of uncertainty ahead, here is how our family is approaching the coming months.
Also, some GIFs.
I offer this as a point of reference for those struggling with how to handle the dog days, not as a recipe that others should follow. This is OUR way- I don’t pretend that it is THE way. Some will think we are overly cautious, and others will think we are being cavalier. 2/
This plan operates under 4 assumptions.
(@BossletMD and I had to agree on the following, which was a discussion worth having)
Summer plan assumption 1:
If I or my immediate family members (wife and kids) contract COVID, the odds are FAR in our favor that we would be fine.
I disagree with the sentiment of this statement.
Here is why.
The following come from a self-described medical minimalist and a skeptic when it comes to new medical technologies. I am far more likely to tell people to “slow down” than to “check out this new toy”. You can ask @GrahamCarlos@ryanboente@erinmcrowley@tjelle13 2/
The statement is not published in a format that allows for comment, or this would be a letter to the editor.
I agree with much of the substance of the statement- they point out issues well worth considering that need worked out before splitting a vent is definitively safe.
Premium processing is THE WAY that these trainees are able to have visas processed in a timeline that best prepares them to practice at their place of employment starting in July. Disallowing premium processing means a delay in their visa status, which delays credentialing.
This is likely to lead to a 3-4 month delay in their being able to see patients at the conclusion of their training. This will effect 1200-1500 physicians who are completing residency here in the United States, most of which will be practicing in underserved areas.
The content of the original #thread was true to my thoughts about the topic, but was written in a way that did not give proper context to the role of the PS in the process. It was also completely tone-deaf in that the voice I used was condescending and mean. And that is not me.
So I’m considering that thread what @ANNELAMOTT would call a #ShittyFirstDraft. The following draft incorporates feedback from the @Twitter#meded community into something I hope is a bit more useful (and a lot more friendly).
Given that population health improvements often come from small benefits in large populations, and the fact that #oxygen is one of the most commonly prescribed interventions in the #ICU, there is potential for benefit if we can correctly titrate our oxygen titration.
I’m going to refer to hypoxia and hyperoxia in this #medthread, and I’d like to (somewhat arbitrarily) define these terms. I’ll call hypoxia anything below 90% and hyperoxia anything above 96%. This is based upon some of the literature I will discuss. 3/
A quick #thread on the importance of #mentorship and critical #feedback in writing. I’m targeting students, trainees, and younger faculty who struggle with the #mentoring process- I’ll share some vulnerability to demonstrate a #growthmindset- I’ll also recommend 2 books.
A couple of weeks ago I was invited by @AnnalsATS to write an editorial for a paper. I loved the topic so I quickly agreed and started ordering my thoughts. It was a quick turnaround- 2 weeks, so I had to get moving.
I worked diligently on the draft and invited @vitaincerta to co-author- she is smart as a whip and a terrific writer and I knew she would really help to shape a well-written piece. She agreed and I sent her my #ShittyFirstDraft.
I’m going to discuss how physician payment rates in the US are set and suggest a reason why #primarycare is poorly valued from a salary standpoint in the U.S. I’ll also suggest how anyone interested can work to improve payment for #primarycare.
I am targeting younger physicians and medical students - this may be too simplistic for some, and go into the weeds too much for others. But the whippersnappers are the ones that are more likely to lead change, and so that is the audience here. 2/
Disclaimer: I am an academic #pulmcc physician, not a #primarycare physician. So I’m in a procedure-heavy specialty. I'm also not an expert in health policy, so feel free to gently correct anything that seems off.