Asher Kelman
OPF Owner/Editor-in-Chief
Jérôme,
You are most helpful. Thanks so much.
Asher
You are most helpful. Thanks so much.
Asher
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Welcome to the new site. Here's a thread about the update where you can post your feedback, ask questions or spot those nasty bugs!
The Good News On The Current Pandemic Crisis
- Thread starter Asher Kelman
- Start date
Jerome Marot
Well-known member
An interesting article for our members suffering from diabetes or hypertension: https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30116-8/fulltext
"We suggest that patients with cardiac diseases, hypertension, or diabetes, who are treated with ACE2-increasing drugs, are at higher risk for severe COVID-19 infection and, therefore, should be monitored for ACE2-modulating medications, such as ACE inhibitors or ARBs. Based on a PubMed search on Feb 28, 2020, we did not find any evidence to suggest that antihypertensive calcium channel blockers increased ACE2 expression or activity, therefore these could be a suitable alternative treatment in these patients."
"We suggest that patients with cardiac diseases, hypertension, or diabetes, who are treated with ACE2-increasing drugs, are at higher risk for severe COVID-19 infection and, therefore, should be monitored for ACE2-modulating medications, such as ACE inhibitors or ARBs. Based on a PubMed search on Feb 28, 2020, we did not find any evidence to suggest that antihypertensive calcium channel blockers increased ACE2 expression or activity, therefore these could be a suitable alternative treatment in these patients."
Asher Kelman
OPF Owner/Editor-in-Chief
Excellent find!
fahim mohammed
Well-known member
Hello all.
Just to wish all here at OPF and everywhere else, may you and your loved ones all be safe and healthy.
I am not a medical person nor a scientist...but making has gotten through many a pandemics. Some with horrific losses. But we got through!
My family and my prayers for all that we get through this pandemic with minimal life losses. And maybe start to practice a little humility towards each other and the planet we all share.
Amen.
Just to wish all here at OPF and everywhere else, may you and your loved ones all be safe and healthy.
I am not a medical person nor a scientist...but making has gotten through many a pandemics. Some with horrific losses. But we got through!
My family and my prayers for all that we get through this pandemic with minimal life losses. And maybe start to practice a little humility towards each other and the planet we all share.
Amen.
Asher Kelman
OPF Owner/Editor-in-Chief
So relieved to hear from you, Fahim. We all hope you are home, well and secure! That’s good news and we are grateful for that!
Thanks for your shared and generous good wishes.
You are correct, of course:
Race, color, shape of lips and beliefs are not valid measures of worth. Only whether we care for each other’s welfare!
Imagine in Northern Italy, those over 60 can’t consume scarce resources in hospitals! So they are left to die! In Spain several old age homes found by the army to have been abandoned with no food and folk lying still, dead still in beds! Imagine, States desperately bidding, one against the other, for masks, medicines and respirators. Pandemic lessons of the past we shrugged off, But spent lavishly on Sports, better shiny toys, hipper fashions and more deadly weapons! But what of treasuring humanity and the fragile planet?
In you wishes today, Fahim you strengthen our community and uplift us! .
Asher
Thanks for your shared and generous good wishes.
You are correct, of course:
Race, color, shape of lips and beliefs are not valid measures of worth. Only whether we care for each other’s welfare!
Imagine in Northern Italy, those over 60 can’t consume scarce resources in hospitals! So they are left to die! In Spain several old age homes found by the army to have been abandoned with no food and folk lying still, dead still in beds! Imagine, States desperately bidding, one against the other, for masks, medicines and respirators. Pandemic lessons of the past we shrugged off, But spent lavishly on Sports, better shiny toys, hipper fashions and more deadly weapons! But what of treasuring humanity and the fragile planet?
In you wishes today, Fahim you strengthen our community and uplift us! .
Asher
Jerome Marot
Well-known member
Please try to make it through. We have not always been in agreement, but I would like to see more photographs of you.
Jerome Marot
Well-known member
The first results are not so good: https://www.military.com/daily-news...s-no-benefit-malaria-drug-va-virus-study.html
A malaria drug widely touted by President Donald Trump for treating the new coronavirus showed no benefit in a large analysis of its use in U.S. veterans hospitals. There were more deaths among those given hydroxychloroquine versus standard care, researchers reported.
fahim mohammed
Well-known member
Not so FAST!
Jerome is correct in his response.
The BMJ and studies in Brazil have also concluded similarly. Do you have validation evidence for the trials in your area, Asher? What about side effects?
I wish these trials are successful, but I would exercise extreme caution in calling these trials medically successful for the treatment of Covid-19.
Jerome is correct in his response.
The BMJ and studies in Brazil have also concluded similarly. Do you have validation evidence for the trials in your area, Asher? What about side effects?
I wish these trials are successful, but I would exercise extreme caution in calling these trials medically successful for the treatment of Covid-19.
Asher Kelman
OPF Owner/Editor-in-Chief
The doses used were amazingly high to me. The drug had 3 effects: it decreases binding of virus to cells, it seems to flood the cell with zinc, which itself is antiviral and stops cell to cell spread in tissue culture.
But it also decreases immune response in higher doses and that is why it’s used in treatment of lupus. I would have used it on low dose to only leverage the decrease in virus binding to cells. People seem to have focused on wiping out the virus.
In my mind, it could have been better used to decrease spread safely by only using it as if preventing malaria many decades ago when it still effective as a prophylactic.
I obtained 72,000 doses for a trial but stopped short when I saw where the research protocols were going and my ideas for low dose were not popular at all.
There are still many studies underway, including prophylaxis and we need to wait and see. I may still do a study but want to see the new data.
We have a long way to go!
Asher
But it also decreases immune response in higher doses and that is why it’s used in treatment of lupus. I would have used it on low dose to only leverage the decrease in virus binding to cells. People seem to have focused on wiping out the virus.
In my mind, it could have been better used to decrease spread safely by only using it as if preventing malaria many decades ago when it still effective as a prophylactic.
I obtained 72,000 doses for a trial but stopped short when I saw where the research protocols were going and my ideas for low dose were not popular at all.
There are still many studies underway, including prophylaxis and we need to wait and see. I may still do a study but want to see the new data.
We have a long way to go!
Asher
Jerome Marot
Well-known member
In one of the largest study of its kind, hydroxychloroquine was not found to improve outcomes for in-hospital patients: https://jamanetwork.com/journals/jama/fullarticle/2766117
Asher Kelman
OPF Owner/Editor-in-Chief
Disappointing. Still it might be that the drug might play a role in pointing to the virus machinery targets to be better tackled by other agents.
research often open windows one can peak through but not pass through!
Asher
Jerome Marot
Well-known member
Or it could simply mean that the drug is not effective against the virus and has serious side effects at the doses used for the trial.
Asher Kelman
OPF Owner/Editor-in-Chief
On the molecular level, it’s effective, but not as used clinically in desperately ill patients.
it might work as a prophylactic. At higher dose levels it alters the immune response too, so it’s complicated. Still it’s like a screw driver or probe as it already interferes with known mechanisms. Combining this in low doses might be valuable yet, with other drugs.
We should the results for prophylaxis soon!
Asher
Asher Kelman
OPF Owner/Editor-in-Chief
A ray of hope!
Getty Images: For Editorial Purposes Only
The British Medical Journal reports that inexpensive common steroids, dexamethasone and equally, hydrocortisone saved the lives of 8% of critically ill hospitalized COVID-19 patients.
Amazingly, each drug equally reduced mortality in these very seriously ill patients to end up with about 1 in 3 surviving.
This effect appears to be solely due to suppressing the dangerous overreactive inflammatory response that occurs in the patients, shutting down multiple organs.
It’s a puzzle why this virus is uniquely so aggressive, but it’s a real, albeit limited breakthrough that a further 8% of such dangerously ill patients might be rescued.
This inflammation is not just in the elderly. In California alone, we have about 39 children with this dangerous condition of multiple organ overreaction.
Still we are learning. By realizing that we have to deal with a new kind of pathology, perhaps we will begin to ask the right questions about how the virus harms people and hopefully outwit it!
As a start, I imagine other antiinflammatory agents might be tried and also far earlier in their illness. Double blind studies in such severely ill patients might be now unethical, as we cannot deprive severely ill patients of steroids, now that we know it can save lives.
Still, in those with less critical illness, such a trial might be allowed and be even more effective.
This is where seriously expert, multidisciplinary, transparent, peer-reviewed ethical evidence-based modern medicine excels. To me, this is start of important major new lines of basic research in the lab and in the clinic.
Asher
Getty Images: For Editorial Purposes Only
The British Medical Journal reports that inexpensive common steroids, dexamethasone and equally, hydrocortisone saved the lives of 8% of critically ill hospitalized COVID-19 patients.
Amazingly, each drug equally reduced mortality in these very seriously ill patients to end up with about 1 in 3 surviving.
This effect appears to be solely due to suppressing the dangerous overreactive inflammatory response that occurs in the patients, shutting down multiple organs.
It’s a puzzle why this virus is uniquely so aggressive, but it’s a real, albeit limited breakthrough that a further 8% of such dangerously ill patients might be rescued.
This inflammation is not just in the elderly. In California alone, we have about 39 children with this dangerous condition of multiple organ overreaction.
Still we are learning. By realizing that we have to deal with a new kind of pathology, perhaps we will begin to ask the right questions about how the virus harms people and hopefully outwit it!
As a start, I imagine other antiinflammatory agents might be tried and also far earlier in their illness. Double blind studies in such severely ill patients might be now unethical, as we cannot deprive severely ill patients of steroids, now that we know it can save lives.
Still, in those with less critical illness, such a trial might be allowed and be even more effective.
This is where seriously expert, multidisciplinary, transparent, peer-reviewed ethical evidence-based modern medicine excels. To me, this is start of important major new lines of basic research in the lab and in the clinic.
Asher
Last edited:
Asher Kelman
OPF Owner/Editor-in-Chief
[A word of caution. There is utterly no basis for using steroids as a prophylactic against COVID-19 or any other infection. Inflammatory responses in infections are actually mostly to our benefit.
The use of steroids without a physicians justified reasoning and prescription would be foolhardy as these drugs alter markedly many aspects of metabolism.]
The use of steroids without a physicians justified reasoning and prescription would be foolhardy as these drugs alter markedly many aspects of metabolism.]