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Medical Forum / Diseases and Disorders / AIDS / October 2005Dr. Rasnick's letter to Business Day
http://www.dr-rath-health-foundation.org.za/rasnick_aug05.htm | The authors state that, "Without trial evidence, this | information must come from observational cohort studies. However, | estimation of treatment effects in observational studies is not | straightforward..." Indeed it is not, yet that is exactly what | the authors did by using a "novel methodology to overcome this | problem". | | To generate the results that so heartened TAC, the authors had | to resort to a statistical method that they acknowledge "is not | widely used in clinical research" and in fact "may not be widely | known in the clinical research community". Yet, their results | are not obtainable without this unused and unknown methodology. The authors ofthe Lancet article Dr. Rasnick is criticizing used a relatively new statistical method, "marginal structural models", to better extract the signal of causation from the noise of confounding factors in the observational data. Any statistical method is mathematical by nature. This method will be based on assumptions about the effects a causal realationship and confounding factors will have on the observational data, and justiified by mathematical arguments. There is no sign that Dr. Rasnick has examined the assumptions and arguments supporting the new method. Therefore, when he criticizes the new method as "unused and unknown", he is criticizing the new method not for any known flaws, but for the fact that he doesn't understand it.  SignatureDavid Canzi "I am not denying anything." -- Celia Farber Where are the control groups in Rasnick's "scientific trial" of Rath's pills? Why isn't Rasnick's study placebo double blind controlled? There is not one single placebo double blind controlled study of Rath's AIDS cure. Does this stop him from announcing this in full color advertisements and press releases? Rath announced his findings in a press release before the work was published or even submitted to peer-review. Actually it was before the study was approved by any medical authority in SA. Anyway, how dare somebody use mathematics in a scientific paper. The only scientific way is to use anecdotes complete with before and after photographs and testimonials. Chris Noble Why isn't Rasnick's study placebo double blind controlled? Come on Chris if you don't need placebo blind controlled studies to show the effectiveness of giving cancer drugs and PI's to AIDS patients why start now? Orthodox studies are riddled with this trouble or am I wrong? > Why isn't Rasnick's study placebo double blind controlled? > > Come on Chris if you don't need placebo blind controlled studies to show > the effectiveness of giving cancer drugs and PI's to AIDS patients why > start now? > Orthodox studies are riddled with this trouble or am I wrong? You mean it's OK for Rasnick and other dissidents to complain that trials of HAART are not placebo double blind controlled (the trials compare different drug combinations with earlier treatments) and then conduct poorly controlled and unapproved "trials" and then announce through press releases and paid advertisements that they have the cure for AIDS? Does the word hypocrite mean anything to you? I also question Rasnicks statistical methods. It has come to light that some of Rasnick's successes were using ARVs at the time. More importantly some of the people taking Rath's pills died. What sort of statistical treatment did Rasnick use to cover up these cases of "lost to follow-up"? http://www.mg.co.za/articlePage.aspx?articleid=253582&area=/breaking_news/breaki ng_news__national/ http://allafrica.com/stories/200510130169.html Chris Noble Chris I don't know this guys work at all, I just seen a pot calling the kettle black. Mostly I am angry at our own government failure to protect us from big-pharma's agenda. We should be looking like crazy at the people that refuse AIDS drugs and live healthy long lives and not promoting them as these rare cases or calling everything they die of AIDS related without solid evidence. My wife and I were both told we had AIDS over 10 years ago, my wife had 3 T-Cells! There are a great many stories like this and will be a great many more as news gets around in the underground that the media and research is heavily biased. More and more people are going to think twice about there doctors orders and find that they are inappropriate for there bodies. I think there is solid evidence that AIDS drugs have helped people with some OI’s but the evidence and giving drugs to healthy people based only on T-Cells and a positive test is very questionable. Suppressing the questions and not providing studies to answer them is wrong > Chris I don't know this guys work at all, I just seen a pot calling the > kettle black. The pot is Rasnick. He is the one who has been insisting on the importance of double blind placebo controlled trials. But does he follow his own advice? Apparently there is one standard for orthodox science and another for Rasnick. Why do you leap to his defence? Chris Noble I'm not defending Rasnick but the lack of double blinds in AIDS research is a pet peeve of mine and it came to mind. Hell anyone that says they can cure AIDS with a product they want to sell goes right on my "kook for profit" list because I believe different people get AIDS for different reasons so one cure for all cases seems very far fetched. Hell even if it is HIV I think we could turn it into a non issue by supporting holistic living and treatment of the bodies infected. The problem is that’s EXACTLY what drug companies do not want to encourage for ANYONE. Maybe if CODEX is successful in getting vitamins regulated and therapeutic doses become very costly and profitable they will allow the studies and AIDS will dry up > I'm not defending Rasnick but the lack of double blinds in AIDS research > is a pet peeve of mine and it came to mind. Which trial of ARVs is not double blind? Do you know any? Chris Noble Which trial of ARVs is not double blind? Do you know any? Chris Noble Sorry double blind "placebo" controlled You know the kind that would help us determine between drug toxicity and HIV/AIDS damage > Which trial of ARVs is not double blind? > [quoted text clipped - 5 lines] > You know the kind that would help us determine between drug toxicity and > HIV/AIDS damage What would you predict for double blind trials comparing combinations of 2 ARVs and 3 ARVs? Which group would you expect to remain healthier longer? What would that tell you about drug toxixity and the effects of HIV? Would you ignore any of these studies? Chris Noble "What would you predict for double blind trials comparing combinations of 2 ARVs and 3 ARVs? Which group would you expect to remain healthier longer? What would that tell you about drug toxixity and the effects of HIV? Would you ignore any of these studies?" Chris, How does comparing different ARVs to each other establish whether the ARVs are better than no treatment at all? That would be like comparing apples to oranges by studying *only* different kinds of apples! How many long-term, double-blind PLACEBO controlled studies have been done on the effectiveness of ARVs over no treatment at all? Remember, after you provided me with the link for that *one* study, I asked you if that was the study which the approval of AZT was based upon? Remember, I asked you if that was the *only* double-blind placebo control ever done? How many have there been? -Paul snip >How does comparing different ARVs to each other establish whether the ARVs >are better than no treatment at all? It doesn't. But that kind of study would be deemed unethical because we have a lot of clinical data that show that ARV use dramatically reduces morbidity and mortality. This is rooted in earlier placebo-controlled studies. So to suggest a placebo-controlled study would be a) not accepted by MOST HIV+ in the community; b) therefore would not enroll; c) would not be sponsored by the NIH or hospitals or universities as their Institutional Review Boards would deem it unethical. Who would enroll in such a study? If you're a denialist, you won't WANT to risk getting the drugs. If you think ARV is going to help, you wouldn't WANT to risk placebo. Do you ever think? George M. Carter Imagine you have a new drug for treating leukaemia. You have to compare this to the best available current therapy for 2 reasons - 1. It is unethical to give half the leukaemia patients nothing (placebo) 2. You want to know if it is better OR WORSE than current best therapy - if it fares no better, it will not be developed/used. So what do you do with a "new" antiretroviral? Not what Rasnick/Rath suggest anyway... Paulee, you know full well that denialists claim the drugs cause AIDS. So why do those on 2 drugs do better than those on one/none, those on 3 do better than those on 2, and those on 4 do better than those on 3? Why does gigaHAART (6+ drugs) do better than nothing in patients with resistant virus? Perhaps for once you could answer those specific points, rather than change subject >So why do those on 2 drugs do better than those on one/none, those on 3 >do better than those on 2, and those on 4 do better than those on 3? >Why does gigaHAART (6+ drugs) do better than nothing in patients with >resistant virus? because ARVs may work on possible latent spirochetes. Dr. Rasnick treated acute infection in rabbits very well with protease inhibitors: http://aidsmyth.addr.com/news/000529syphilisdebate.htm >>So why do those on 2 drugs do better than those on one/none, those on 3 >>do better than those on 2, and those on 4 do better than those on 3? [quoted text clipped - 6 lines] > >http://aidsmyth.addr.com/news/000529syphilisdebate.htm What protease inhibitors? Inhibiting what protease? Syphilis is undoubtedly an important concomitant. Effective treatmentis critical and may be inadequate in the U.S. But it just does NOT look the same as HIV infection. The only comment on that page that is remotely intriguing is: " Half a century later, Dr. Sandra Larsen, the CDC's chief syphilis expert for many years, made a curious observation in an abstract presented at an STD meeting in 1991: "The clinical manifestations of syphilis, which have taken various forms over the centuries, have now been transformed to mimic the appearance of the opportunistic infections and cancers that may accompany HIV infection, as well as the clinical symptoms of AIDS itself."" I would like to see any evidence that in HIV-negative individuals, syphilis infection results in relevant clinical sequelae as seen in AIDS and/or a decline in CD4 count. George M. Carter >I would like to see any evidence that in HIV-negative individuals, >syphilis infection results in relevant clinical sequelae as seen in >AIDS and/or a decline in CD4 count. > > George M. Carter why this? HIV tests and spirochete antigens are not necessary independent. HIV obviously tracks the process of late stage syphilis, occuring after undetected multiple reinfections. other hiv-tests maybe tracking other cohorts. mainly drug user (p24) , because the CDC wanted them in 1983 to be tracked (sharing needle theory) >>I would like to see any evidence that in HIV-negative individuals, >>syphilis infection results in relevant clinical sequelae as seen in [quoted text clipped - 4 lines] >why this? HIV tests and spirochete antigens are not necessary >independent. You're claiming syphilis causes CD4+ depletion? >HIV obviously tracks the process of late stage syphilis, occuring after >undetected multiple reinfections. Does it? Based on what? >other hiv-tests maybe tracking other cohorts. >mainly drug user (p24) , because the CDC wanted them in 1983 >to be tracked (sharing needle theory) What the hell are you dithering about now? Syphilis...let's see, it expresses p24? It's passed by sharing syringes? Please do enlighten! Can't wait to see what you're on about now. George M. Carter > >>I would like to see any evidence that in HIV-negative individuals, > >>syphilis infection results in relevant clinical sequelae as seen in [quoted text clipped - 6 lines] > > You're claiming syphilis causes CD4+ depletion? wrong question at this point. you wanted: >I would like to see any evidence that in HIV-negative individuals, >syphilis infection ... this only makes sense, if HIV and syphilis are INDEPENDENT. its your turn, to prove that. sorry, Georgiboy >> >>I would like to see any evidence that in HIV-negative individuals, >> >>syphilis infection results in relevant clinical sequelae as seen in [quoted text clipped - 8 lines] > >wrong question at this point. No, it ain't. >you wanted: Who the f.ck are you to tell me what I want? >>I would like to see any evidence that in HIV-negative individuals, >>syphilis infection ... [quoted text clipped - 3 lines] > >sorry, Georgiboy LOL. You claim now that everybody with syphilis is HIV+????? My turn to prove nothing, copribreath. George M. Carter >LOL. You claim now that everybody with syphilis is HIV+????? of course, HIV-ccr5 positive >>LOL. You claim now that everybody with syphilis is HIV+????? > >of course, HIV-ccr5 positive So everyone with CCR5 has HIV?? Wow. Fascinating. >>LOL. You claim now that everybody with syphilis is HIV+????? >of course, HIV-ccr5 positive >So everyone with CCR5 has HIV?? No. HIV does not exist. hiv-ccr5 is just a code for ccr5only. serious scientists dont want to be trolled from glaxo trolls. http://aids-info.net/micha/hiv/aids/english.html >>>LOL. You claim now that everybody with syphilis is HIV+????? > [quoted text clipped - 3 lines] > >No. HIV does not exist. Yes. It does. >hiv-ccr5 is just a code for ccr5only. What? >serious scientists dont want to be trolled from glaxo trolls. Are you a serious scientist? I have nothing to do with pharma except mostly as a vocal critic. I do not get paid by Glaxo or any other pharmaceutical company. Who pays you? George M. Carter >Dr. Rasnick treated acute infection in rabbits very well >with protease inhibitors: http://aidsmyth.addr.com/news/000529syphilisdebate.htm I can see no reference to the relevant clinical trial. Can you give us a reference for this please? > "What would you predict for double blind trials comparing combinations of > 2 [quoted text clipped - 10 lines] > How does comparing different ARVs to each other establish whether the ARVs > are better than no treatment at all? Well for you whack jobs that think ARV is so very deadly it would certainly prove your point if it were true. However the data shows just the opposite effect adding a third ARV medication to a 2 drug combo improves outcomes. Now if you were right it should show that adding additional ARV medications would cause the patients health to crash due to your so called idea about the deadly nature of ARV. Gary Stein I would discount all there value until we have explored how much less ARV's can be used. If untreated control arms are unethical they should be done on a volunteer basis. Personally I think the drug companies already now they are drastically over prescribing and put profit before health. Just my .02 > I would discount all there value until we have explored how much less >ARV's can be used. THAT's a possibility certainly for the nuke class. Lower doses of AZT and d4T can be as effective and less toxic. Possibly so for ddI. 3TC is relatively nontoxic. > If untreated control arms are unethical they should be done on a >volunteer basis. Then you wouldn't have a control arm and the results would be suspect. > Personally I think the drug companies already now they are drastically >over prescribing and put profit before health. Just my .02 Yes, they are overpromoting and thus physicians may be overprescribing based on patient requests and/or pharma "bribes." But not necessarily with ARV. PHarma doesn't prescribed. Physicians do. George M. Carter here in french a review of probable properties of 3TC http://www.sidasante.com/azt/lamivudine_et_sida/lamivudine_et_sida.htm Pharma pays for studies, Pharma high ranking executives can go to work for the FDA and vice a versa FDA and congress are allowed to invest in pharma if this situation leads to corrupt data our doctors can not help but to over prescribe because protocol is based on study results this would go way beyond over promoting. I am no scientist but an average guy being forced to play detective to protect his family from some very scary protocols with very poor results, pediatric AIDS being a true horror story in failure for a father. Having my babies parents die from liver failure is another. Funny thing death from AIDS is barely a bleep on the radar. That bleep is enough to hire a Chinese doc and test for oxidative stress mind you. But I believe in instinct and mine says I am on the right path. My only real contribution is my story so I am exited to see how it unfolds. Hell I was sure I would die of my drug use and or AIDS 10 years ago this is all bonus time  >Pharma pays for studies, Pharma high ranking executives can go to work for >the FDA and vice a versa FDA and congress are allowed to invest in pharma >if this situation leads to corrupt data our doctors can not help but to >over prescribe because protocol is based on study results this would go >way beyond over promoting. Ah--not exactly. Pharma does pay for studies. So do we: via the NIH. (FDA approves drugs or not.) People that work for HHS don't get paid much. Conflicts of interest rules apply ostensibly to prevent corruption. They kinda work but there are lots of flaws and weaknesses (notably in enforcement). These are real issues. And pharma has totally f.cked up and distorted the value of science by turning clinical trials into little more than marketing tools. It is disgusting. Medicine should be a public venture. Not a private one as the private sector has shown that it acts on the philosophy that profits trump human life. George M. Carter > Chris I don't know this guys work at all, I just seen a pot calling the > kettle black. [quoted text clipped - 3 lines] > and live healthy long lives and not promoting them as these rare cases or > calling everything they die of AIDS related without solid evidence. What makes you think that is not being done? Gary Stein I also would not give credit to anyone with a cure for AIDS. I think AIDS has multiple causes so there can be no magic bullet. Just my .02 Good points, Chris >Why isn't Rasnick's study placebo double blind controlled? > > Come on Chris if you don't need placebo blind controlled studies to show >the effectiveness of giving cancer drugs and PI's to AIDS patients why >start now? > Orthodox studies are riddled with this trouble or am I wrong? Yes. Most good clinical studies have a placebo. However, once a "standard of care" develops, then it is considered unethical to randomize people to nothing when there already exists a treatment. There have been studies of multivitamins. Indeed, a recent one in Tanzania showed that a multi can cut the rate of progression to AIDS by 30%!! This is important. A follow up study, below, shows other benefits. I STRONGLY believe that a multi should be a standard of care for all people with HIV the world over. It is an inexpensive and effective--and very safe--intervention. It is criminal and despicable that there are virtually no efforts in this regard.; However, that being said, a.sholes like Rath totally piss me off. I wish a multi WAS a cure--but it is NOT. It is an important treatment intervention. But it doesn't stop AIDS. And for him to spew this nonsense makes it easier for those particular asswipe doctors who don't know their a.s from a hole in the ground to dismiss this intervention (and others just follow along like bleating sheep). Rath helps foster the false polemic that is anathema for those of us living with chronic infections. George M. Carter ** Villamor E, Saathoff E, Manji K, Msamanga G, Hunter DJ, Fawzi WW. Vitamin supplements, socioeconomic status, and morbidity events as predictors of wasting in HIV-infected women from Tanzania. Am J Clin Nutr. 2005 Oct;82(4):857-65. Departments of Nutrition and Community Health, Muhimbili University College of Health Sciences, Dar es Salaam, Tanzania. BACKGROUND: Wasting is a strong independent predictor of mortality in HIV-infected persons. Vitamin supplements delay the disease progression, but their effect on wasting is not known. Data are lacking on the risk factors for wasting in African HIV-infected persons. OBJECTIVES: The objectives were to examine the effect of vitamin supplements on wasting in HIV-infected women and to assess the effects of sociodemographic characteristics, morbidity events, and immunologic progression on the risk of wasting. DESIGN: HIV-infected women (n = 1078) from Tanzania were randomly assigned to receive 1 of 4 daily oral regimens: multivitamins (B complex, C, and E), vitamin A plus beta-carotene, multivitamins that included vitamin A plus beta-carotene, or placebo. The endpoints of the study included first episodes of a midupper arm circumference <22 cm or a body mass index (BMI; in kg/m(2)) <18 and the incidence of weight loss episodes during a median 5.3 y of follow-up. RESULTS: Multivitamins alone significantly reduced the risk of a first episode of a midupper arm circumference <22 cm (relative risk: 0.66; 95% CI: 0.47, 0.94; P = 0.02). In multivariate-adjusted Cox models, the woman's age, education level, and height were inversely related to the incidence of wasting. Episodes of diarrhea, nausea or vomiting, lower respiratory tract infections, oral ulcers, thrush, severe anemia, and low CD4(+) cell counts were each significantly related to an increased risk of wasting. CONCLUSIONS: Vitamins C and E and the vitamin B complex have a protective effect on wasting in HIV-infected women. Prevention of diarrhea, severe respiratory tract infections, and anemia are likely to decrease the burden of wasting. |
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