Treatment Scores - Journal Club - Masks for COVID-19

Treatment Scores are about coming up with a statistic that patients can understand, since the math of medical statistics can be ridiculous. Here is my first attempt to explain a (November 29, 2022) pragmatic #COVID mask study. It's about N95 masks versus medical masks. There were about 500 patients in each group.

The primary outcome was confirmed COVID-19 on reverse transcriptase polymerase chain reaction (RT-PCR) test.

The primary outcome in the intention-to-treat analysis, RT-PCR–confirmed COVID-19, occurred in 52 of 497 (10.46%) in the medial mask group versus 47 of 507 (9.27%) in the N95 respirator group (HR, 1.14 [95% CI, 0.77 to 1.69]). 

So, N95 masks were 1.19% better than medical masks in this study for the outcome measured.

https://www.acpjournals.org/doi/10.7326/M22-1966

The primary outcome is a test. It is not whether the patient lives or dies. So, one always has to ask, does the primary outcome make a difference to the patient in the real world?

Movie review: Blacklight starring Liam Neeson

Blacklight, starring Liam Neeson begins with ignorant propaganda against the political right. All white people are racist right? 

The political right also all live in trailers and have Confederate flags. "Trailer trash" anyone? This political stereotype is so wrong. The actual political right believes in "maximum individual freedom" as opposed to government tyranny. That's it. 

My rating for the movie: 6/10. 

Dusty (Taylor John Smith) tries to bring in evidence about corruption in the FBI.

Liam Neeson, as Travis Block, doesn't figure out he's on the wrong side until Dusty is murdered.

Mira Jones (Emmy Raver-Lampman) plays a hapless but ambitious reporter. 

Actor Aiden Quinn, as character Gabriel Robinson, plays the bad guy in the FBI. The FBI is corrupt, which is certainly believable after all we have learned about the FBI over the years.

The action in the movie is pretty good; however, it's all filmed too dark, which ruins a lot of the film. 

Liam Neeson, as always, is an excellent lead actor for a dramatic action film.

The director of the movie is Mark Williams.

The cinematography is by Shelly Johnson. So, I have to assume he is probably responsible for the overly dark film where you cannot see the actor's faces. Bad lighting is a waste of talent. When will this horrible lighting trend be over with?

Please correct me if I am wrong about anything.

#homeschool your kids. Teach Gen Z, and their kids, the principles of freedom. The political right believes in maximum individual freedom no matter how the right is portrayed in movies. The political left believes in centralized government power, and centralized power results in tyranny.

Put the Patient First

"The good physician treats the disease; the great physician treats the patient who has the disease." — Sir William Osler

Sir William Osler is considered the father of bedside medicine. 

Today, Dr Osler's advice is more pertinent than ever. I constantly hear about the medical system treating reimbursement instead of treating the patient. Our system is not a great system when it puts reimbursement from the government, or reimbursement from the insurance company, first. Why don't we create a system that puts the patient first? We have the technology to do it today.

To fix the system, patients need power and control over their money, so the first question when you go get healthcare would be, "How can we help you?" Not, "Are you Medicare or Insurance?"

We also need to stop having Guidelines. What we call guidelines today are usually just medical opinions from a government group. For example, we should call them CDC Opinions or NIH Opinions to recognize that any individual physician around the world might actually be the greater expert. Calling them opinions instead of guidelines would also recognize the subjective nature of the field of medicine. Medicine is not yet a hard science.

Guidelines are not evidence-based medicine.

Evidenced-based medicine means taking into account the values and preferences of the patient. Thus, evidence-based medicine is personalized medicine, not guidelines.

COVID-19 Lessons

An excellent article by John PA Ioannides, MD, and Professor Stephen H. Powis, points out that mathematical models did not do well during COVID-19.

The authors even suggest that models should not be called studies, but perhaps, "semi-formal speculations" instead.

I heartily agree with this. Models are not studies they are opinions. And, in addition COVID-19 guidelines should not be called guidelines, but should be called COVID-19 opinions. There should be no censorship, and physicians, and physician groups, all over the world should be free to post their opinions, and the evidence used to arrive at those opinions.

Observational studies also did not do well during COVID-19:

"In fact, the large background heterogeneity makes concrete assessment of the effectiveness of any and all non-pharmacological measures based on observational data extremely difficult, if not impossible."

For those interested in medical etymology the phrase "forme fruste" is used, which means the frustrated or weakened manifestation of a disease.

I highly recommend reading this article about COVID-19 lessons and going to some of the references described within the article.

Healthcare Freedom means no censorship, and having transparency, in medicine.

REFERENCE:
COVID-19 models and expectations - Learning from the pandemic - PubMed


https://pubmed.ncbi.nlm.nih.gov/36241518/ 

Ioannidis JPA, Powis SH. COVID-19 models and expectations - Learning from the pandemic. Adv Biol Regul. 2022 Oct 8:100922. doi: 10.1016/j.jbior.2022.100922. Epub ahead of print. PMID: 36241518; PMCID: PMC9546779.


Age-stratified infection fatality rate of COVID-19 in the non-elderly informed from pre-vaccination national seroprevalence studies | medRxiv

This study by Dr John Ioannides, et al. is highly educational, because the infection fatality rate (IFR) is a key statistic for an emerging virus.

The study looked at the infection fatality rate (IFR) for covid-19 around the world.

The most fascinating paragraph was this one:

"The median IFR was 0.0003% at 0-19 years, 0.003% at 20-29 years, 0.011% at 30-39 years, 0.035% at 40-49 years, 0.129% at 50-59 years, and 0.501% at 60-69 years."

The authors do an excellent job describing how they collected their data. The authors also do an excellent job listing the potential flaws of their study.

In my opinion, John P.A. Ioannidis, MD, who has multiple degrees, is one of the best physician mathematicians in the world.

SOURCE:
Angelo Maria Pezzullo, Cathrine Axfors, Despina G. Contopoulos-Ioannidis, Alexandre Apostolatos, John P.A. Ioannidis
medRxiv 2022.10.11.22280963; doi: https://doi.org/10.1101/2022.10.11.22280963
This article is a preprint and has not been peer-reviewed [what does this mean?]. It reports new medical research that has yet to be evaluated and so should not be used to guide clinical practice.
https://www.medrxiv.org/content/10.1101/2022.10.11.22280963v1 

Innate Immunity Stimulation during the COVID-19 Pandemic: Challenge by Parvulan

This medical article is extremely interesting: "Innate Immunity Stimulation during the COVID-19 Pandemic: Challenge by Parvulan"

A killed strain of bacteria was administered to patients to increase their immunity:

"Corynebacterium parvum administration to 4000 fragile immune-depressed and multimorbid patients treated with a killed C. parvum strain to enhance innate immunity, integrating the adaptative immune response for long-standing antinfectious resistance."

It was 4,000 patients, and it was a retrospective survey, but some of the outcomes were very interesting.

The authors suggest that this treatment improved the physical and mental health of the patients, which in turn probably made them better off during the covid-19 pandemic.

"Our results confirm that C. parvum is quite safe and effective in supporting immune-compromised patients when epidemic or pandemic events increase ... risk...."

This was particularly surprising:

"A quick (48-72 hours) symptoms improvement and/or complete regression of the herpetic eruptions was observed in 1000 affected patients with disappearance or relieve of herpetic neuralgia (reduced in 80% of cases); also full recovery or frequency reduction (30%) of recurrent cystitis and prostatitis in 120 affected patients."

The authors are part of the Second Opinion Medical Consultation Network.

As noted in the article, Corynebacterium parvum has been  renamed Cutibacterium acnes.

LINK
The link to the full text article is here:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9076318/ 

REFERENCE
Palmieri B, Manenti A, Galotti F, VadalĂ  M. Innate Immunity Stimulation during the COVID-19 Pandemic: Challenge by Parvulan. J Immunol Res. 2022 Apr 29;2022:4593598. doi: 10.1155/2022/4593598. PMID: 35528612; PMCID: PMC9076318.

Uncles and Etymology

 

Learning big words should start very early in life, just like learning a second language. 

Uncles and Etymology is a book to read aloud to children to teach them to read, love science, math, experiments, and big words. It also teaches life lessons. It has black and white illustrations.



Men and their Prostates

In my experience, men have no idea what is going on inside their prostates. Men suffer acute prostatitis symptoms and chronic BPH symptoms that slowly creep up on them with age. There is an astonishing lack of awareness, because men are not taught what they really need to know. The Prostatitis Syndromes 2nd Edition teaches men the inside information that is hidden from them. Read it before your prostate locks up and you can't urinate. 

Don't end up with chronic urinary symptoms, chronic pain, waking at night to urinate, dribbling after urination, an enlarged prostate, or living with a permanent catheter.

Ten Commandments Resurrection - MOVIE

Ten Commandments Resurrection, the movie, was inspired by a Near Death Experience (NDE). Ten Commandments Resurrection begins with an actress reading from the Ten Commandments in startling fashion. There is a visual metaphor for “going into the light.” The Book of Exodus begins with Moses attempting to lead the slaves, against many obstacles, to the Promised Land. Does Moses make it to the Promised Land? What were the lessons from “going into the light?” This movie is an adaptation of the 1923 public domain movie by Cecil B. DeMille. The once silent movie now has sound. Enjoy the 42-minute feature film!

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Healthcare Savings Accounts


Healthcare is broken. One way to fix healthcare would be Health Savings Accounts for everyone. HSAs would give patients all the power and control, and patients could take advantage of price transparency and treatment transparency in healthcare using the Internet. Because of the Internet, there has never been a better time for healthcare freedom and healthcare transparency. 
#HSAs4all #HSAsForAll