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Monday, June 5, 2017

honor is saved

honor is saved

Our readership explodes: we have new projects, we need help! we are looking for translators and also voices for podcasts. Someone to animate via social networks would also be of great help! You like this blog, so, please help!


This was originally published here, in French. We provide this translation for your convenience, practical aspects may differ where you live.

Lanzafame saves the honor

By Charles Edouard!

In pursuit of the keys of Freedom:

It is important, especially at the beginning ... As for the 'case-by-case' basis, the question that comes just next is which is OK, which is not, not to amalgamate everything and find the Keys to Freedom ... And there, you need Science! And people who do Science!

Dr. Lanzafame made not too ambitious proposals, which were taken up on a very large scale. Well ... OK, I agree, ICCARRE should have saved the world: American invention, improved by Leibowitch and used ... nowhere outside France (for now ...). At the ANRS rhythm, overmedication and induced suicidality have good days ahead.

The Lanzafame report is of global scientific importance.

An analogy, a perspective



Let's try to be concise and clear: a strategy may be proposed to people who have already had (maintenance or secondary) and / or have people who have never taken anything; It can also be proposed to symptomatic and / or asymptomatic patients. Nice exercise of risk / benefit balance.

Merely an analogy
Cardiovascular HIV Infection
Trial as Primary Trial with Naive patients
Trial as Secondary Maintenance trials
I take, as an analogy, the same exercise, from another context. The prescription of statins (to reduce cholesterol) can be offered to a patient, say asymptomatic, who did not take it before; And also in a victim of a cardiovascular accident. The first is called primary prevention, the second is secondary prevention. I hope you can see the parallel.

BigPharma promotes the (futile) primary! Cochrane and Prescrire say, basically, primary prevention is futile, and that, ultimately, perhaps, secondary prevention might be helpful ...

The excellent Dr de Lorgeril (the Mediterranean diet) makes us loose our virginity here on his blog (French Only): OK to make a distinction between a trial as 'primary' and a trial as 'secondary', much easier to realize, since you have the patients. And especially, a new infarction is frequent (often we get the same shit more than once). Fewer patients, more data. Easier job...

Nevertheless, Lorgeril explains, there is no need to distinguish between primary prevention and secondary prevention: it is futile in primary and it is just as futile in secondary ... Why? Because the underlying mechanism is identical.

That's what I'm getting at. There's no difference between the two, because the mechanism is the same. Let's get back to our subject ... If the underlying mechanism is the same, then we should have a consistent reading between the attack and the maintenance: it's not!

one-only mechanism distinct mechanisms
Cardio (statin) HIV InfectionMono-DTG
Primary
Prevention
Secundary
Prevention
Initiation
(Naives)
Maintenance
(selected)
Maintenance
(unselected)
         


They try maintenance Mono-Tivicay ® in patients without problems (no failures, no nonobservance, etc ... not too risky), without selection (no rule like the Achilles' Heel). It's DOMONO, which does not work very well. It is BMM + P that does not work too well except for a selection algorithm (Achilles heel). The 'logic' in the head is: if one can not envisage it as 'standard' maintenance, how to consider it as First Line?

BigPharma exults: Adios mono-Tivicay® as maintenance and therefore as First Line!



It seems 'logical' ... No discussion ... End of file ... Yes ... Well ... That is 'If the mechanism is identical' ... If the mechanism is identical. That is a big 'if'...

The Lanzafame report (initiation) and DOMONO (maintenance) are small scale, so we are carefull. But, if ... it works in blind initiation and not in maintenance (blind), it means that the mechanism plays an unexpected role, to be clarified, to formalize and to use wisely, for a maintenance 'without failure'. Achilles' heel? Something else? We will see ...

One can not think of biology without Darwin ... On a territory, a mountain, unexplored, unchartered, if you arrive from the North or from the South, it is not the same!

And the benefit for patients also. Well .. I hope you see the picture! The debate, shunted for a while, is revived: is the Mono-Tivicay® enough for the naive patient?

This is crucial. Bah... The pretentious Parisian virology (a little greased, maybe) is of no use. The Kings of Garches are not on the spot. Wheareas, science is at stake!

You notice that Lanzafame has only taken the INDUCTION path, but not the MAINTENANCE path, unlike the others, that is his genius! And who has the fewest failures?

Lanzafame also saves the world ...



Lanzafame saves the honor of Medicine. It also saves the world (see next post) ... And we will address the ethical aspect: this will be sporty!

Good Weekend, good Fuck , No-Condom if <1000, and advocate for PreP, on the occasion

Comments


Samy 2017-06-12




Our readership explodes: we have new projects, we need help! we are looking for translators and also voices for podcasts. Someone to animate via social networks would also be of great help! You like this blog, so, please help!


This was originally published here, in French. We provide this translation for your convenience, practical aspects may differ where you live.

1 comment:

  1. The example of Tivicay monotherapy (tm) is that there is only one risk: in people who have been treated by the former INIs, before. So before screaming that mono does not work you have to learn, mono works in general, and dolutegravir is the most powerful ARV and having the strongest genetic barrier, it works in many people in my clinic (Pr Katlama) and I took it, by myself, for 6 months but preferred to change to Truvada (tm) with 4 times a week. I encourage to read:

    http://once-weekly-hiv-therapies.blogspot.fr/2016/06/its-achilles-stupid.html

    It is necessary to customize treatment, the success are more frequent than the failures, and when one concentrates well on the failures one sees that it could have been avoided. That is why, before the alleviation, the doctor looks at your history...

    Many are under-informed and afraid, this bars access to them. When I see all these people who complain about many side effects and who are treated, daily, for 10.15 ...

    ReplyDelete