More evidence hydroxychloroquine works

Discussion in 'Coronavirus (COVID-19) News' started by Josephwalker, Jul 28, 2020.

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  1. CenterField

    CenterField Well-Known Member Past Donor

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    The company I've used most, exists for 11 years, but I've been using their tests only for the last three years. I do not like to jump on things before they are a bit more studied.

    Well, yeah, that's how drug companies price stuff, too. They calculate how much insurers will want to pay in terms of saving money with better outcomes, avoiding to pay higher hospital fees if a patient improves and does not need to be hospitalized or is discharged sooner, etc.; at one point if it's too expensive the insurer will lose money; then they price their stuff right below that threshold. Price has something to do with the R&D costs, sure, but often will be more in tune with what they can get away with, than what the drug actually costs for them to develop and manufacture.

    I keep a very minimal relationship with them. I do not accept any invitation for dinners, any favors of any kind, and although I've been asked multiple times, I've never accepted to speak on their behalf for a fee. I use them occasionally as a conduit to obtain access to their scientific divisions to ask questions about a medication that aren't covered by the FDA monograph. I pay very little attention to the studies that come out of their sponsorship as they are invariably tainted by profound bias. A true story: I remember in a scientific meeting, walking down a hallway with panel presentations on each side, and seeing two "studies" that coincidentally (or maybe intentionally) were placed right in front of each other. One, done by the maker of drug A, extensively showing how much better than drug B it was, with drug A showing strong separation from placebo while drug B did not. The other one, done by the maker of drug B, extensively showing how much better than drug A it was, with drug B showing strong separation from placebo while drug A did not. LOL

    True, for all the scorn I've demonstrated above, I still believe in capitalism and I know that without Big Pharma, we wouldn't have 95% of helpful medications that have saved multiple lives, have increased life expectancy, and have improved the quality of life for literally billions of people.

    Not really. It would have appeared self-serving. I don't toot my own horn. I'm afraid it would have been received as "look, morons, I'm so much more competent than you are and I'm practicing with the cutting edge of science while you're hopeless ignoramuses; look at how I turned around the case you guys couldn't handle." Sure, I have enough people skills to say it gently but regardless of how I said it, I'm afraid it would still be heard this way, because doctors are narcissists.

    The proper way to do it is how I did it: a Grand Rounds presentation. We can also write a letter to the editor of a journal, or publish a clinical case conference. That case could have merited a clinical case conference. I did not take the time to write it up. But I've done it for other interesting cases, and my reports have been accepted by journals. And then you put the corresponding author's email and colleagues can ask you about it. So if someone asks, I share my successes, but spontaneously going out of my way to go toot my own horn is not ethical and is self-serving. Also, I don't want to be seen as a hired gun (which in my case would be an unpaid gun, haha, since like I said I never accept favors from these corporations - but still, there is the issue of the appearance of impropriety). I have a professional reputation to take care of.

    Another reason why I didn't submit this case to publication, is because it's an anecdote of one, in a field that is still weak in evidence and controversial. I mentioned to you that I presented to my colleagues the current literature on genomic tests. The evidence is not great. There were some studies with trends, a few with a bit more convincing results, but no silver bullet. And the studies were always non-randomized, non-blind, because of the very nature of this tool. You can't not know that you are employing it to tailor your patient's treatment. So studies were done by comparing database results, that is, looking back at charts and seeing if there were apparent better outcomes in patients for whom the practitioner had tailored the treatment by using genomic testing, as compared to similar cases for whom there was no such guidance. As you know, this approach is not without intervening factors.

    Following chain of command would mean, he wouldn't go directly to other front line doctors in another hospital. He would talk to his supervisor who would talk to that person's manager up to the CEO of his hospital (or maybe the chairman of his department) and the CEO (or chairman) would then talk to his/her counterpart in another hospital who would then pass down the protocol. That would be considered more appropriate and more ethical. Or if it's that nurse initiating it, she would talk to her supervisor, who would talk to the Chief Nursing Officer who would then address the Chief Medical Officer, etc., and the CMO might then contact Dr. Marik for guidance, etc.

    Your college roommate would know more about these things than I do, if he runs an entire hospital. I'm not currently a member of the higher administration in my hospital although I do have administrative responsibilities, and although in the past I did occupy such positions in other hospitals, but as of now I've largely walked away from lots of administrative work (which I never liked) to focus more on patient care and teaching. In the current phase of my career, I want peace and quiet more than the backstabbing game of power. Some may think that I stepped down from things, by my deliberately accepting in a new hospital a position that is hierarchically inferior to the one I had in a previous hospital. But I'll tell you, my quality of life and job satisfaction have improved.

    Frankly, I think you should see a doctor regularly for preventative care, screenings, etc. We all age and we all get sick, so try to stay ahead of the game by having stuff detected earlier for better treatments and better outcomes. It's not wise to go 27 years without seeking preventative medical care.

    Regarding side effects, as you know all drugs have them, even the ones the lay public falsely believe to be harmless, such as Tylenol, which results in fulminating and fatal liver toxicity in overdoses. The trick is to balance risks and benefits and make sure the latter outweigh the former.

    It depends on the patient's personality. More avoidant ones might not want to know. More controlling ones would want to know. In my opinion, the ethical principle of patient autonomy indicates that we need to inform and educate; a well-educated patient is a better partner in care. Even bad news need to be communicate because people need to plan for the remainder of their productive lives if they are facing a bad prognosis, etc.

    Definitely. Genetics is an ethical minefield. It's a fascinating topic for Bioethics. We need to proceed on this with a lot of prudence.

    Nah, they will bring in a young geek to fix the computer :pc: and will pay him one fourth of what they pay me... :-(

    The sad smiley, I'm kidding. By the time I'd be obsolete, I'll be long retired.
     
    Last edited: Aug 6, 2020
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  2. Bowerbird

    Bowerbird Well-Known Member

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  3. Thedimon

    Thedimon Well-Known Member

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    This was an interaction study.
    That’s enough to shut up anyone mocking HCQ. I’m not saying doctors must prescribe it. What I’m saying is that if a doctor decides HCQ is right to an individual patient then the doctor should be able to prescribe it without fears of repercussions from the board.
    The left took this issue too far in my opinion. I am not saying that the HCQ should be the drug of choice, or a mandatory treatment. Let the doctors decide this, not politicians or partisans in medical boards.
     
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  4. Bowerbird

    Bowerbird Well-Known Member

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    What part of that study shows it has a measurable in vivo effect? There is no question that there is an in vitro and even an in silico effect but where are the studies showing the in vivo effect
     
  5. Eleuthera

    Eleuthera Well-Known Member Donor

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    Very well said! The heart of the matter, bravo. :applause:
     
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  6. Thedimon

    Thedimon Well-Known Member

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    This is a new disease. If you have a dying patient who doesn’t respond to regular treatment, what do you have to lose by trying something else, even if the name of the drug came out of Trump’s mouth?
    Anyway, are missing the whole point I’m trying to make.
     
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  7. truth and justice

    truth and justice Well-Known Member

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    The drug has been shown to be ineffective in patients needing oxygen or ventilationon and has been shown to increase the percentage of deaths in those patients when compared to patients using alternative treatments or no treatment at all
     
  8. Thedimon

    Thedimon Well-Known Member

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    Good.
    Now, let’s allow the doctors who interact with and treat the patients to decide what kind of treatment they should use. Not medical boards, not state governors, not presidents/kings/emperors/gods.
     
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  9. Jestsayin

    Jestsayin Well-Known Member Past Donor

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    Fitting,
    [​IMG]
     
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  10. Josephwalker

    Josephwalker Banned

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    That pretty much says it all about the leftist mindset
     
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  11. Josephwalker

    Josephwalker Banned

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    Many doctors using it claim it's effective. Thats evidence enough for me. We don't have time for long peer reviewed studies. This is an emergency situation and the drug has a very long history of use with minimal risk.
     
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  12. Bowerbird

    Bowerbird Well-Known Member

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    I suggest you get up to speed. Research has proven it is ineffective

    Mind you that “Demon sperm” doctor is still touting it
     
    Last edited: Aug 29, 2020
  13. Bowerbird

    Bowerbird Well-Known Member

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    Yeah! Doctors who believe in DemonSperm should be allowed to continue to promote a treatment that does not work

    upload_2020-8-30_3-8-21.jpeg
     
  14. Josephwalker

    Josephwalker Banned

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    Doctors in hospitals are saying different things than researchers. Depends on who you believe I guess. Point is as others have said it's a drug that's been around a very long time and if a doctor thinks it's worth using I see no problem with using it.
     
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  15. Bowerbird

    Bowerbird Well-Known Member

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    You mean Stella Immanuel the demon sperm doctor?
     
  16. Bowerbird

    Bowerbird Well-Known Member

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    An acceleration of their death? This is not a TV soap opera where we know the patient has only minutes to live Life is different it is about possibilities and what we have found out is that HCA increases the possibility you will die
     
  17. Thedimon

    Thedimon Well-Known Member

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    There are lots of info available from other countries that shows that HCQ can work.
    Again, I’m not trying to say it should be used. What I’m saying is that partisan politics have no place in determination of what course of treatment a patient should get. HCQ was attacked solely because Trump promoted it. If any other leader talked about it, if they were wrong everyone would forget about it.
     
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  18. truth and justice

    truth and justice Well-Known Member

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    The countries that have used it are the US, Brazil and India and their death numbers are terrible
     
  19. Josephwalker

    Josephwalker Banned

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  20. Josephwalker

    Josephwalker Banned

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  21. fmw

    fmw Well-Known Member

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    Partly correct. Hydorochloroquin neither prevents nor cures Covid. But 57 clinical trials have shown that it reduces the time for the immune system of people who are not sick enough to be hospitalized to do that by an average of three days. So it is a reasonable treatment for some people.
     
  22. Bowerbird

    Bowerbird Well-Known Member

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    Wow!

    link please
     
  23. Bowerbird

    Bowerbird Well-Known Member

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  24. Bowerbird

    Bowerbird Well-Known Member

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  25. Bowerbird

    Bowerbird Well-Known Member

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    Good

    link to them

    Unless I see definitive studies supporting the use of HCQ I am not going to accept it as a viable treatment
     

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