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From: ironjustice on 16 Aug 2008 00:33 High altitude sickness is the 'human model of increased red cell production'. One treatment to counteract this thickened blood is drawing blood / phlebotomy. These drugs seem to alleviate / replace this drawing of .. blood. "sildenafil / viagra" "Acetazolamide, dexamethasone, nifedipine, tadalafil, sildenafil, and salmeterol " Medication and Dosage Considerations in the Prophylaxis and Treatment of High-Altitude Illness* Andrew M. Luks, MD and Erik R. Swenson, MD * From the Division of Pulmonary and Critical Care Medicine (Dr. Luks), University of Washington; and Division of Pulmonary and Critical Care Medicine (Dr. Swenson), Puget Sound Veterans Health Care System, Seattle, WA. Correspondence to: Andrew M. Luks, MD, Acting Instructor, Division of Pulmonary and Critical Care Medicine, University of Washington, Box 356522, 1959 NE Pacific Ave, Seattle, WA 98195-6522; e-mail: aluks(a)u.washington.edu Abstract With increasing numbers of people traveling to high altitude for work or pleasure, there is a reasonable chance that many of these travelers have preexisting medical conditions or are receiving various medications at the time of their sojourn. As with all travelers to high altitude, they are at risk for altitude illnesses such as acute mountain sickness, high-altitude cerebral edema, and high-altitude pulmonary edema. While there are clear recommendations for pharmacologic measures to prevent or treat these illnesses, these recommendations are oriented toward healthy individuals and do not take into account the presence of preexisting medical conditions. In this review, we consider how the choice and dose of the medications used in the management of altitude illnessacetazolamide, dexamethasone, nifedipine, tadalafil, sildenafil, and salmeterolare affected by a patients underlying medical conditions. We discuss the indications and current dosing recommendations for individuals without underlying disease, and then consider how drug selection or dosing regimens will be affected by the presence of renal insufficiency, hepatic insufficiency, other important medical conditions, and the potential for serious drug interactions. We include comments about interactions with antimalarial medications and antibiotics used in the treatment of travelers diarrhea, as well as the safety of use during pregnancy. By giving these issues adequate consideration, clinicians can increase the chances that properly evaluated patients with underlying medical conditions will enjoy a safe trip to high altitude. Key Words: acetazolamide acute mountain sickness altitude dexamethasone high-altitude cerebral edema high-altitude pulmonary edema nifedipine sildenafil tadalafil doi:10.1378/chest.07-1417 (Chest. 2008; 133:744-755) © 2008 American College of Chest Physicians -------------------------------- "The death rate was almost 55% vs. 0%" Hypervolemia .. and .. erythrocytosis / polycythemia / increased red blood cell production / increased blood viscosity / thick blood .. are ONE and the .. same. "hypervolemia, polycythemia, high blood viscosity" -------------------------------------------------------------------------------- http://tinyurl.com/35dug "This is the largest published study measuring blood volume and patient outcomes. Congestive heart failure is the number one cause for admission to hospitals for patients over 65 years of age and results in annual healthcare costs exceeding $38 billion. The study followed severely ill congestive heart failure patients for a median follow up of 719 days. During the first year, the major finding was a 39% death rate in patients that were hypervolemic (excess blood volume) vs. 0% death rate or those who were normovolemic/ hypovolemic (normal blood volume/ mildly reduced blood volume). For those hypervolemic patients that were followed for a median duration of 719 days, the death rate was almost 55% vs. 0% for those patients who were normovolemic to slightly hypovolemic. " ---------------------------------------------------------------- Definitions of hypervolemia on the Web: A blood disorder consisting of an increase in the volume of circulating blood. wordnet.princeton.edu/perl/webwn ------------------------------------------------------------------------- http://jap.physiology.org/cgi/content/full/98/1/384 "hypervolemia, polycythemia, high blood viscosity" ------------------------------------------------------------------------- "The only treatment for thick blood is to be bled." · the production of red blood cells, which carry oxygen through the body, increase as the body acclimates to high altitude, allowing more oxygen to be "grabbed" from every breath. The body also responds to the lower oxygen levels by putting more red blood cells into circulation. Up to a point, this is a good thing. However, if it goes too far, the blood becomes thick and prone to clotting. Clots which get dislodged float around and can cause strokes, heart attacks, and pulmonary embolisms. The only treatment for thick blood is to be bled. http://www.k2news.com/lesson21.htm Who loves ya. Tom Jesus Was A Vegetarian! http://tinyurl.com/634q5a Man Is A Herbivore! http://tinyurl.com/4rq595 DEAD PEOPLE WALKING http://tinyurl.com/zk9fk
From: ironjustice on 16 Aug 2008 12:06 On Aug 15, 9:33 pm, ironjustice <teamtan...(a)hotmail.com> wrote: salmeterol << This drug salmeterol is used in high altitude sickness and it also seems to improve symptoms of those with COPD. COPD when treated with bloodletting has a high rate of alleviation of symptoms. Altitude doctors tell you to bleed those with altitude sickness. Salmeterol is used to treat altitude sickness. COPD and altitude sickness BOTH manifest **increased red blood cells**. Are they just **substituting** the drugs FOR the **recommended** bloodletting ? In the meantime anyone without **cash** FOR the drugs ..? Just like obesity where one person eats while 800 starving people .. watch .. Bloodletting is the **recommended** treatment for increased red blood cell production and these doctors better start .. following .. **standard of care** .. ? Drugs are to be used as a 'standin' .. **second** TO bloodletting. THAT is how it reads. ---------------------------- Hope for Patients with COPD Newswise -- For the first time, a drug therapy appears to reduce lung function loss in patients with moderate to severe chronic obstructive pulmonary disease (COPD), according to the results of a randomized, double-blind, placebo-controlled trial in 42 countries. The Toward a Revolution in COPD Health (TORCH) study investigated the effects of combined salmeterol, a ©¬-agonist, and fluticasone propiniate, an inhaled cortical steroid, either alone or in combination, on mortality, exacerbations, health-related quality of life and rate of decline in lung function as measure by forced expiratory volume in one second (FEV1) in patients with COPD. The results are published in the second issue for August of the American Journal of Respiratory and Critical Care Medicine, published by the American Thoracic Society. "Pharmacotherapy with salmeterol plus fluticasone propionate, or the components, reduces the rate of decline on FEV1 in patients with moderate to severe COPD, thus slowing disease progression," wrote Bartolome R. Celli, M.D., lead author of the study and professor at Tufts University School of Medicine. "To date, smoking cessation is the only intervention that has conclusively been shown to alter the rate of decline in FEV1," remarked Dr. Celli. This is the first demonstration of an effective pharmacothrerapy in COPD. The TORCH study randomized more than 6,000 patients with moderate to severe COPD from 42 countries to receive either salmeterol (SAL; 50 ¥ìg), fluticasone propionate (FP; 500 ¥ìg), the two in combination (SFC; 50/500 ¥ìg), or placebo. After baseline FEV1 was recorded, patients were re-evaluated every 24 weeks to determine the rate of decline in FEV1. "The rate of decline in FEV1 was slowest in patients on SFC and fastest in those randomized to the placebo arm," wrote Dr. Celli. "From week 24 onward, the adjusted rate of decline in FEV1 was 39ml/ year for SFC, 42 ml/year for both SAL and FP and 55 ml/year for placebo." Although the study was not formally powered to detect differences in rate of decline of FEV1, the results were highly significant (p<0.001.) The rate of decline in treatment groups was similar across a number of variables, including sex, age, ethnicity and body mass index. Furthermore, the slower rate of decline in FEV1 appeared to be associated with a lower risk of exacerbation. "Although treatment did not abolish the accelerated decline in lung function [that occurs with COPD], it did ameliorate it substantially," wrote Dr. Celli, while noting that "the mechanism responsible for the effect on rate of decline is not clear, as all treatments have potentially significant nonbronchodilator effects." Clarifying those mechanisms is the goal of the next phase of the research, with the comparison between a long-acting bronchodilator drug and placebo with respect to FEV1 decline. In the meantime, "the TORCH study brings some clarity to the treatment picture and provides some hopeful signs for patients with COPD," wrote Samy Suissa, Ph.D., of McGill University, in the accompanying editorial. "This study also demonstrates that no treatment [placebo] is not an option for patients with moderate to severe COPD." -------------------------------------------------------------------------------- (c) 2008 Newswise. All Rights Reserved. Who loves ya. Tom Jesus Was A Vegetarian! http://tinyurl.com/634q5a Man Is A Herbivore! http://tinyurl.com/4rq595 DEAD PEOPLE WALKING http://tinyurl.com/zk9fk > High altitude sickness is the 'human model of increased red cell > production'. > > One treatment to counteract this thickened blood is drawing blood / > phlebotomy. > These drugs seem to alleviate / replace this drawing of .. blood. > > "sildenafil / viagra" > > "Acetazolamide, dexamethasone, nifedipine, tadalafil, sildenafil, and > salmeterol " > > Medication and Dosage Considerations in the Prophylaxis and Treatment > of High-Altitude Illness* > Andrew M. Luks, MD and Erik R. Swenson, MD > * From the Division of Pulmonary and Critical Care Medicine (Dr. > Luks), University of Washington; and Division of Pulmonary and > Critical Care Medicine (Dr. Swenson), Puget Sound Veterans Health Care > System, Seattle, WA. > > Correspondence to: Andrew M. Luks, MD, Acting Instructor, Division of > Pulmonary and Critical Care Medicine, University of Washington, Box > 356522, 1959 NE Pacific Ave, Seattle, WA 98195-6522; e-mail: > al...(a)u.washington.edu > > Abstract > > With increasing numbers of people traveling to high altitude for work > or pleasure, there is a reasonable chance that many of these travelers > have preexisting medical conditions or are receiving various > medications at the time of their sojourn. > As with all travelers to high altitude, they are at risk for altitude > illnesses such as acute mountain sickness, high-altitude cerebral > edema, and high-altitude pulmonary edema. > While there are clear recommendations for pharmacologic measures to > prevent or treat these illnesses, these recommendations are oriented > toward healthy individuals and do not take into account the presence > of preexisting medical conditions. In this review, we consider how the > choice and dose of the medications used in the management of altitude > illness--acetazolamide, dexamethasone, nifedipine, tadalafil, > sildenafil, and salmeterol--are affected by a patient's underlying > medical conditions. > We discuss the indications and current dosing recommendations for > individuals without underlying disease, and then consider how drug > selection or dosing regimens will be affected by the presence of renal > insufficiency, hepatic insufficiency, other important medical > conditions, and the potential for serious drug interactions. We > include comments about interactions with antimalarial medications and > antibiotics used in the treatment of traveler's diarrhea, as well as > the safety of use during pregnancy. > By giving these issues adequate consideration, clinicians can increase > the chances that properly evaluated patients with underlying medical > conditions will enjoy a safe trip to high altitude. > > Key Words: acetazolamide * acute mountain sickness * altitude * > dexamethasone * high-altitude cerebral edema * high-altitude pulmonary > edema * nifedipine * sildenafil * tadalafil > doi:10.1378/chest.07-1417 > (Chest. 2008; 133:744-755) > (c) 2008 American College of Chest Physicians > > -------------------------------- > "The death rate was almost 55% vs. 0%" > > Hypervolemia .. and .. erythrocytosis / polycythemia / increased red > blood cell production / increased blood viscosity / thick blood .. are > ONE and the .. same. > > "hypervolemia, polycythemia, high blood viscosity" > ---------------------------------------------------------------------------------- > > http://tinyurl.com/35dug > > "This is the largest published study measuring blood volume and > patient outcomes. Congestive heart failure is the number one cause for > admission to hospitals for patients over 65 years of age and results > in annual healthcare costs exceeding $38 billion. > > The study followed severely ill congestive heart failure patients for > a median follow up of 719 days. During the first year, the major > finding was a 39% death rate in patients that were hypervolemic > (excess blood volume) vs. 0% death rate or those who were normovolemic/ > hypovolemic (normal blood volume/ > mildly reduced blood volume). For those hypervolemic patients that > were followed for a median duration of 719 days, the death rate was > almost 55% vs. 0% for those patients > who were normovolemic to slightly hypovolemic. " > ---------------------------------------------------------------- > Definitions of hypervolemia on the Web: > > A blood disorder consisting of an increase in the volume of > circulating blood. > wordnet.princeton.edu/perl/webwn > > ------------------------------------------------------------------------- > > http://jap.physiology.org/cgi/content/full/98/1/384 > > "hypervolemia, polycythemia, high blood viscosity" > ------------------------------------------------------------------------- > > "The only treatment for thick blood is to be bled." > > ¡¤ the production of red blood cells, which carry oxygen through the > body, increase as the body acclimates to high altitude, allowing more > oxygen to be "grabbed" from every breath. > > The body also responds to the lower oxygen levels by putting more red > blood cells into circulation. Up to a point, this is a good thing. > However, if it goes too far, the blood becomes thick and prone to > clotting. Clots which get dislodged float around and can cause > strokes, heart attacks, and pulmonary embolisms. The only treatment > for thick blood is to be bled. > > http://www.k2news.com/lesson21.htm > > Who loves ya. > Tom > > Jesus Was A Vegetarian!http://tinyurl.com/634q5a > > Man Is A Herbivore!http://tinyurl.com/4rq595 > > DEAD PEOPLE WALKINGhttp://tinyurl.com/zk9fk
From: ironjustice on 17 Aug 2008 01:30 On Aug 16, 9:06 am, ironjustice <teamtan...(a)hotmail.com> wrote:nifedipine << Oral Nifedipine to Treat Iron Overload This study is currently recruiting participants. Verified by National Institutes of Health Clinical Center (CC), May 2008 Sponsored by: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Information provided by: National Institutes of Health Clinical Center (CC) ClinicalTrials.gov Identifier: NCT00712738 Purpose This study will determine if nifedipine, a medication used to treat high blood pressure, can help treat iron overload, a condition in which the body contains too much iron. Iron overload can be caused by the body's inability to regulate iron or by medical treatments, such as multiple blood transfusions. Over time, it can cause problems with the liver, heart and glands. Treatments include reducing iron intake in the diet or removing the excess iron using medical therapies. Recently, nifedipine was found to cause iron loss in the urine of small animals. This study will see if the drug can increase the removal of iron into the urine in humans as well. Who loves ya. Tom Jesus Was A Vegetarian! http://tinyurl.com/634q5a Man Is A Herbivore! http://tinyurl.com/4rq595 DEAD PEOPLE WALKING http://tinyurl.com/zk9fk > On Aug 15, 9:33 pm, ironjustice <teamtan...(a)hotmail.com> wrote: > salmeterol << > > This drug salmeterol is used in high altitude sickness and it also > seems to improve symptoms of those with COPD. > COPD when treated with bloodletting has a high rate of alleviation of > symptoms. > > Altitude doctors tell you to bleed those with altitude sickness. > Salmeterol is used to treat altitude sickness. > COPD and altitude sickness BOTH manifest **increased red blood > cells**. > > Are they just **substituting** the drugs FOR the **recommended** > bloodletting ? > > In the meantime anyone without **cash** FOR the drugs ..? > > Just like obesity where one person eats while 800 starving people .. > watch .. > > Bloodletting is the **recommended** treatment for increased red blood > cell production and these doctors better start .. following .. > **standard of care** .. ? > Drugs are to be used as a 'standin' .. **second** TO bloodletting. > THAT is how it reads. > ---------------------------- > > Hope for Patients with COPD > > Newswise -- For the first time, a drug therapy appears to reduce lung > function loss in patients with moderate to severe chronic obstructive > pulmonary disease (COPD), according to the results of a randomized, > double-blind, placebo-controlled trial in 42 countries. > > The Toward a Revolution in COPD Health (TORCH) study investigated the > effects of combined salmeterol, a ©¬-agonist, and fluticasone > propiniate, an inhaled cortical steroid, either alone or in > combination, on mortality, exacerbations, health-related quality of > life and rate of decline in lung function as measure by forced > expiratory volume in one second (FEV1) in patients with COPD. > > The results are published in the second issue for August of the > American Journal of Respiratory and Critical Care Medicine, published > by the American Thoracic Society. > > "Pharmacotherapy with salmeterol plus fluticasone propionate, or the > components, reduces the rate of decline on FEV1 in patients with > moderate to severe COPD, thus slowing disease progression," wrote > Bartolome R. Celli, M.D., lead author of the study and professor at > Tufts University School of Medicine. "To date, smoking cessation is > the only intervention that has conclusively been shown to alter the > rate of decline in FEV1," remarked Dr. Celli. This is the first > demonstration of an effective pharmacothrerapy in COPD. > > The TORCH study randomized more than 6,000 patients with moderate to > severe COPD from 42 countries to receive either salmeterol (SAL; 50 > ¥ìg), fluticasone propionate (FP; 500 ¥ìg), the two in combination (SFC; > 50/500 ¥ìg), or placebo. After baseline FEV1 was recorded, patients > were re-evaluated every 24 weeks to determine the rate of decline in > FEV1. > > "The rate of decline in FEV1 was slowest in patients on SFC and > fastest in those randomized to the placebo arm," wrote Dr. Celli. > "From week 24 onward, the adjusted rate of decline in FEV1 was 39ml/ > year for SFC, 42 ml/year for both SAL and FP and 55 ml/year for > placebo." > > Although the study was not formally powered to detect differences in > rate of decline of FEV1, the results were highly significant > (p<0.001.) The rate of decline in treatment groups was similar across > a number of variables, including sex, age, ethnicity and body mass > index. Furthermore, the slower rate of decline in FEV1 appeared to be > associated with a lower risk of exacerbation. > > "Although treatment did not abolish the accelerated decline in lung > function [that occurs with COPD], it did ameliorate it substantially," > wrote Dr. Celli, while noting that "the mechanism responsible for the > effect on rate of decline is not clear, as all treatments have > potentially significant nonbronchodilator effects." Clarifying those > mechanisms is the goal of the next phase of the research, with the > comparison between a long-acting bronchodilator drug and placebo with > respect to FEV1 decline. > > In the meantime, "the TORCH study brings some clarity to the treatment > picture and provides some hopeful signs for patients with COPD," wrote > Samy Suissa, Ph.D., of McGill University, in the accompanying > editorial. "This study also demonstrates that no treatment [placebo] > is not an option for patients with moderate to severe COPD." > --------------------------------------------------------------------------------- > > (c) 2008 Newswise. All Rights Reserved. > > Who loves ya. > Tom > > Jesus Was A Vegetarian!http://tinyurl.com/634q5a > > Man Is A Herbivore!http://tinyurl.com/4rq595 > > DEAD PEOPLE WALKINGhttp://tinyurl.com/zk9fk > > > > > High altitude sickness is the 'human model of increased red cell > > production'. > > > One treatment to counteract this thickened blood is drawing blood / > > phlebotomy. > > These drugs seem to alleviate / replace this drawing of .. blood. > > > "sildenafil / viagra" > > > "Acetazolamide, dexamethasone, nifedipine, tadalafil, sildenafil, and > > salmeterol " > > > Medication and Dosage Considerations in the Prophylaxis and Treatment > > of High-Altitude Illness* > > Andrew M. Luks, MD and Erik R. Swenson, MD > > * From the Division of Pulmonary and Critical Care Medicine (Dr. > > Luks), University of Washington; and Division of Pulmonary and > > Critical Care Medicine (Dr. Swenson), Puget Sound Veterans Health Care > > System, Seattle, WA. > > > Correspondence to: Andrew M. Luks, MD, Acting Instructor, Division of > > Pulmonary and Critical Care Medicine, University of Washington, Box > > 356522, 1959 NE Pacific Ave, Seattle, WA 98195-6522; e-mail: > > al...(a)u.washington.edu > > > Abstract > > > With increasing numbers of people traveling to high altitude for work > > or pleasure, there is a reasonable chance that many of these travelers > > have preexisting medical conditions or are receiving various > > medications at the time of their sojourn. > > As with all travelers to high altitude, they are at risk for altitude > > illnesses such as acute mountain sickness, high-altitude cerebral > > edema, and high-altitude pulmonary edema. > > While there are clear recommendations for pharmacologic measures to > > prevent or treat these illnesses, these recommendations are oriented > > toward healthy individuals and do not take into account the presence > > of preexisting medical conditions. In this review, we consider how the > > choice and dose of the medications used in the management of altitude > > illness--acetazolamide, dexamethasone, nifedipine, tadalafil, > > sildenafil, and salmeterol--are affected by a patient's underlying > > medical conditions. > > We discuss the indications and current dosing recommendations for > > individuals without underlying disease, and then consider how drug > > selection or dosing regimens will be affected by the presence of renal > > insufficiency, hepatic insufficiency, other important medical > > conditions, and the potential for serious drug interactions. We > > include comments about interactions with antimalarial medications and > > antibiotics used in the treatment of traveler's diarrhea, as well as > > the safety of use during pregnancy. > > By giving these issues adequate consideration, clinicians can increase > > the chances that properly evaluated patients with underlying medical > > conditions will enjoy a safe trip to high altitude. > > > Key Words: acetazolamide * acute mountain sickness * altitude * > > dexamethasone * high-altitude cerebral edema * high-altitude pulmonary > > edema * nifedipine * sildenafil * tadalafil > > doi:10.1378/chest.07-1417 > > (Chest. 2008; 133:744-755) > > (c) 2008 American College of Chest Physicians > > > -------------------------------- > > "The death rate was almost 55% vs. 0%" > > > Hypervolemia .. and .. erythrocytosis / polycythemia / increased red > > blood cell production / increased blood viscosity / thick blood .. are > > ONE and the .. same. > > > "hypervolemia, polycythemia, high blood viscosity" > > ----------------------------------------------------------------------------------- > > >http://tinyurl.com/35dug > > > "This is the largest published study measuring blood volume and > > patient outcomes. Congestive heart failure is the number one cause for > > admission to hospitals for patients over 65 years of age and results > > in annual healthcare costs exceeding $38 billion. > > > The study followed severely ill congestive heart failure patients for > > a median follow up of 719 days. During the first year, the major > > finding was a 39% death rate in patients that were hypervolemic > > (excess blood volume) vs. 0% death rate or those who were normovolemic/ > > hypovolemic (normal blood volume/ > > mildly reduced blood volume). For those hypervolemic patients that > > were followed for a median duration of 719 days, the death rate was > > almost 55% vs. 0% for those patients > > who were normovolemic to slightly hypovolemic. " > > ---------------------------------------------------------------- > > Definitions of hypervolemia on the Web: > > > A blood disorder consisting of an increase in the volume of > > circulating blood. > > wordnet.princeton.edu/perl/webwn > > > ------------------------------------------------------------------------- > > >http://jap.physiology.org/cgi/content/full/98/1/384 > > > "hypervolemia, polycythemia, high blood viscosity" > > ------------------------------------------------------------------------- > > > "The only treatment for thick blood is to be bled." > > > ¡¤ the production of red blood cells, which carry oxygen through the > > body, increase as the body acclimates to high altitude, allowing more > > oxygen to be "grabbed" from every breath. > > > The body also responds to the lower oxygen levels by putting more red > > blood cells into circulation. Up to a point, this is a good thing. > > However, if it goes too far, the blood becomes thick and prone to > > clotting. Clots which get dislodged float around and can cause > > strokes, heart attacks, and pulmonary embolisms. The only treatment > > for thick blood is to be bled. > > >http://www.k2news.com/lesson21.htm > > > Who loves ya. > > Tom > > > Jesus Was A Vegetarian!http://tinyurl.com/634q5a > > > Man Is A Herbivore!http://tinyurl.com/4rq595 > > > DEAD PEOPLE WALKINGhttp://tinyurl.com/zk9fk- Hide quoted text - > > - Show quoted text -
From: ironjustice on 17 Aug 2008 19:45 On Aug 16, 10:30 pm, ironjustice <ironjust...(a)aol.com> wrote:Are they just **substituting** the drugs FOR the **recommended** bloodletting ? << "Acetazolamide decreased hematocrit by 7.1% erythropoietin by 67%" That would mean it lowers the red blood cells .. Yep .. " blunts erythropoiesis". -------------------------------------------------------------------------------- Original Article Acetazolamide A Treatment for Chronic Mountain Sickness Jean-Paul Richalet, Maria Rivera, Patrick Bouchet, Eduardo Chirinos, Igor Onnen, Olivier Petitjean, Annick Bienvenu, Francçoise Lasne, Stéphane Moutereau and Fabiola León-Velarde Laboratoire Réponses Cellulaires et Fonctionnelles à l'Hypoxie, Université Paris 13, Bobigny; Service de Physiologie et Explorations Fonctionnelles, and Service de Pharmacie, Hôpital Avicenne, AP-HP, Bobigny; INSERM U280, Lyon; Laboratoire National de Dépistage du Dopage, Chatenay-Malabry; Laboratoire de Biochimie, Hôpital Henri Mondor, AP-HP, Créteil, France; and Laboratorio de Transporte de OxÃgeno, Universidad Peruana Cayetano Heredia, Lima, Peru Correspondence and requests for reprints should be addressed to Jean- Paul Richalet, Ph.D., Laboratoire EA 2363, UFR SMBH, 74 rue Marcel Cachin, 93017 Bobigny Cedex, France. E-mail: richalet(a)smbh.univ- paris13.fr ABSTRACT Rationale: Chronic mountain sickness or Monge's disease is characterized by an excessive polycythemia in high-altitude dwellers, with a prevalence of 5 to 18% above 3,200 m. To date, no pharmacologic treatment is available. Objectives: We evaluated the efficacy of acetazolamide in the treatment of chronic mountain sickness and the importance of nocturnal hypoxemia in its pathophysiology. Methods: A double-blind placebo-controlled study was performed in three groups of patients from Cerro de Pasco, Peru (4,300 m), treated orally for 3 weeks with placebo (n = 10), 250 mg of acetazolamide (n = 10), or 500 mg of acetazolamide (n = 10), daily. Results: Acetazolamide decreased hematocrit by 7.1% (p < 0.001) and 6.7% (p < 0.001), serum erythropoietin by 67% (p < 0.01) and 50% (p < 0.001), and serum soluble transferrin receptors by 11.1% (p < 0.05) and 3.4% (p < 0.001), and increased serum ferritin by 540% (p < 0.001) and 134% (p < 0.001), for groups treated with 250 and 500 mg of acetazolamide, respectively. Acetazolamide (250 mg) increased nocturnal arterial O2 saturation by 5% (p < 0.01) and decreased mean nocturnal heart rate by 11% (p < 0.05) and the number of apneaâhypopnea episodes during sleep by 74% (p < 0.05). The decrease in erythropoietin was attributed mainly to the acetazolamide-induced increase in ventilation and arterial O2 saturation. Conclusions: Acetazolamide, the first efficient pharmacologic treatment of chronic mountain sickness without adverse effects, reduces hypoventilation, which may be accentuated during sleep, and blunts erythropoiesis. Its low cost may allow wide development with a considerable positive impact on public health in high-altitude regions. Key Words: altitude ⢠erythropoietin ⢠hypoxia ⢠nocturnal ventilation ⢠soluble transferrin receptors Published ahead of print on August 26, 2005, doi:10.1164/rccm. 200505-807OC American Journal of Respiratory and Critical Care Medicine Vol 172. pp. 1427-1433, (2005) © 2005 American Thoracic Society doi: 10.1164/rccm.200505-807OC Who loves ya. Tom Jesus Was A Vegetarian! http://tinyurl.com/634q5a Man Is A Herbivore! http://tinyurl.com/4rq595 DEAD PEOPLE WALKING http://tinyurl.com/zk9fk > On Aug 16, 9:06 am, ironjustice <teamtan...(a)hotmail.com> > wrote:nifedipine << > > Oral Nifedipine to Treat Iron Overload > > This study is currently recruiting participants. > Verified by National Institutes of Health Clinical Center (CC), May > 2008 > > Sponsored by:  National Institute of Diabetes and Digestive and Kidney > Diseases (NIDDK) > > Information provided by: National Institutes of Health Clinical Center > (CC) > ClinicalTrials.gov Identifier: NCT00712738 > >  Purpose > This study will determine if nifedipine, a medication used to treat > high blood pressure, can help treat iron overload, a condition in > which the body contains too much iron. Iron overload can be caused by > the body's inability to regulate iron or by medical treatments, such > as multiple blood transfusions. Over time, it can cause problems with > the liver, heart and glands. Treatments include reducing iron intake > in the diet or removing the excess iron using medical therapies. > Recently, nifedipine was found to cause iron loss in the urine of > small animals. This study will see if the drug can increase the > removal of iron into the urine in humans as well. > > Who loves ya. > Tom > > Jesus Was A Vegetarian!http://tinyurl.com/634q5a > > Man Is A Herbivore!http://tinyurl.com/4rq595 > > DEAD PEOPLE WALKINGhttp://tinyurl.com/zk9fk > > > > > On Aug 15, 9:33 pm, ironjustice <teamtan...(a)hotmail.com> wrote: > > salmeterol << > > > This drug salmeterol is used in high altitude sickness and it also > > seems to improve symptoms of those with COPD. > > COPD when treated with bloodletting has a high rate of alleviation of > > symptoms. > > > Altitude doctors tell you to bleed those with altitude sickness. > > Salmeterol is used to treat altitude sickness. > > COPD and altitude sickness BOTH manifest **increased red blood > > cells**. > > > Are they just  **substituting** the drugs FOR the **recommended** > > bloodletting ? > > > In the meantime anyone without **cash** FOR the drugs ..? > > > Just like obesity where one person eats while 800 starving people .. > > watch .. > > > Bloodletting is the **recommended** treatment for increased red blood > > cell production and these doctors better start .. following .. > > **standard of care** .. ? > > Drugs are to be used as a 'standin' .. **second** TO bloodletting. > > THAT is how it reads. > > ---------------------------- > > > Hope for Patients with COPD > > > Newswise -- For the first time, a drug therapy appears to reduce lung > > function loss in patients with moderate to severe chronic obstructive > > pulmonary disease (COPD), according to the results of a randomized, > > double-blind, placebo-controlled trial in 42 countries. > > > The Toward a Revolution in COPD Health (TORCH) study investigated the > > effects of combined salmeterol, a Ã-agonist, and fluticasone > > propiniate, an inhaled cortical steroid, either alone or in > > combination, on mortality, exacerbations, health-related quality of > > life and rate of decline in lung function as measure by forced > > expiratory volume in one second (FEV1) in patients with COPD. > > > The results are published in the second issue for August of the > > American Journal of Respiratory and Critical Care Medicine, published > > by the American Thoracic Society. > > > "Pharmacotherapy with salmeterol plus fluticasone propionate, or the > > components, reduces the rate of decline on FEV1 in patients with > > moderate to severe COPD, thus slowing disease progression," wrote > > Bartolome R. Celli, M.D., lead author of the study and professor at > > Tufts University School of Medicine. "To date, smoking cessation is > > the only intervention that has conclusively been shown to alter the > > rate of decline in FEV1," remarked Dr. Celli. This is the first > > demonstration of an effective pharmacothrerapy in COPD. > > > The TORCH study randomized more than 6,000 patients with moderate to > > severe COPD from 42 countries to receive either salmeterol (SAL; 50 > > μg), fluticasone propionate (FP; 500 μg), the two in combination (SFC; > > 50/500 μg), or placebo. After baseline FEV1 was recorded, patients > > were re-evaluated every 24 weeks to determine the rate of decline in > > FEV1. > > > "The rate of decline in FEV1 was slowest in patients on SFC and > > fastest in those randomized to the placebo arm," wrote Dr. Celli. > > "From week 24 onward, the adjusted rate of decline in FEV1 was 39ml/ > > year for SFC, 42 ml/year for both SAL and FP and 55 ml/year for > > placebo." > > > Although the study was not formally powered to detect differences in > > rate of decline of FEV1, the results were highly significant > > (p<0.001.) The rate of decline in treatment groups was similar across > > a number of variables, including sex, age, ethnicity and body mass > > index. Furthermore, the slower rate of decline in FEV1 appeared to be > > associated with a lower risk of exacerbation. > > > "Although treatment did not abolish the accelerated decline in lung > > function [that occurs with COPD], it did ameliorate it substantially," > > wrote Dr. Celli, while noting that "the mechanism responsible for the > > effect on rate of decline is not clear, as all treatments have > > potentially significant nonbronchodilator effects." Clarifying those > > mechanisms is the goal of the next phase of the research, with the > > comparison between a long-acting bronchodilator drug and placebo with > > respect to FEV1 decline. > > > In the meantime, "the TORCH study brings some clarity to the treatment > > picture and provides some hopeful signs for patients with COPD," wrote > > Samy Suissa, Ph.D., of McGill University, in the accompanying > > editorial. "This study also demonstrates that no treatment [placebo] > > is not an option for patients with moderate to severe COPD." > > ---------------------------------------------------------------------------Â------ > > > (c) 2008 Newswise.  All Rights Reserved. > > > Who loves ya. > > Tom > > > Jesus Was A Vegetarian!http://tinyurl.com/634q5a > > > Man Is A Herbivore!http://tinyurl.com/4rq595 > > > DEAD PEOPLE WALKINGhttp://tinyurl.com/zk9fk > > > > High altitude sickness is the 'human model of increased red cell > > > production'. > > > > One treatment to counteract this thickened blood is drawing blood / > > > phlebotomy. > > > These drugs seem to alleviate / replace this drawing of .. blood. > > > > "sildenafil / viagra" > > > > "Acetazolamide, dexamethasone, nifedipine, tadalafil, sildenafil, and > > > salmeterol " > > > > Medication and Dosage Considerations in the Prophylaxis and Treatment > > > of High-Altitude Illness* > > > Andrew M. Luks, MD and Erik R. Swenson, MD > > > * From the Division of Pulmonary and Critical Care Medicine (Dr. > > > Luks), University of Washington; and Division of Pulmonary and > > > Critical Care Medicine (Dr. Swenson), Puget Sound Veterans Health Care > > > System, Seattle, WA. > > > > Correspondence to: Andrew M. Luks, MD, Acting Instructor, Division of > > > Pulmonary and Critical Care Medicine, University of Washington, Box > > > 356522, 1959 NE Pacific Ave, Seattle, WA 98195-6522; e-mail: > > > al...(a)u.washington.edu > > > > Abstract > > > > With increasing numbers of people traveling to high altitude for work > > > or pleasure, there is a reasonable chance that many of these travelers > > > have preexisting medical conditions or are receiving various > > > medications at the time of their sojourn. > > > As with all travelers to high altitude, they are at risk for altitude > > > illnesses such as acute mountain sickness, high-altitude cerebral > > > edema, and high-altitude pulmonary edema. > > > While there are clear recommendations for pharmacologic measures to > > > prevent or treat these illnesses, these recommendations are oriented > > > toward healthy individuals and do not take into account the presence > > > of preexisting medical conditions. In this review, we consider how the > > > choice and dose of the medications used in the management of altitude > > > illness--acetazolamide, dexamethasone, nifedipine, tadalafil, > > > sildenafil, and salmeterol--are affected by a patient's underlying > > > medical conditions. > > > We discuss the indications and current dosing recommendations for > > > individuals without underlying disease, and then consider how drug > > > selection or dosing regimens will be affected by the presence of renal > > > insufficiency, hepatic insufficiency, other important medical > > > conditions, and the potential for serious drug interactions. We > > > include comments about interactions with antimalarial medications and > > > antibiotics used in the treatment of traveler's diarrhea, as well as > > > the safety of use during pregnancy. > > > By giving these issues adequate consideration, clinicians can increase > > > the chances that properly evaluated patients with underlying medical > > > conditions will enjoy a safe trip to high altitude. > > > > Key Words: acetazolamide * acute mountain sickness * altitude * > > > dexamethasone * high-altitude cerebral edema * high-altitude pulmonary > > > edema * nifedipine * sildenafil * tadalafil > > > doi:10.1378/chest.07-1417 > > > (Chest. 2008; 133:744-755) > > > (c) 2008 American College of Chest Physicians > > > > -------------------------------- > > > "The death rate was almost 55% vs. 0%" > > > > Hypervolemia .. and .. erythrocytosis / polycythemia / increased red > > > blood cell production / increased blood viscosity / thick blood .. are > > > ONE and the .. same. > > > > "hypervolemia, polycythemia, high blood viscosity" > > > ---------------------------------------------------------------------------Â-------- > > > >http://tinyurl.com/35dug > > > > "This is the largest published study measuring blood volume and > > > patient outcomes. Congestive heart failure is the number one cause for > > > admission to hospitals for patients over 65 years of age and results > > > in annual healthcare costs exceeding $38 billion. > > > > The study followed severely ill congestive heart failure patients for > > > a median follow up of 719 days. During the first year, the major > > > finding was a 39% death rate in patients that were hypervolemic > > > (excess blood volume) vs. 0% death rate or those who were normovolemic/ > > > hypovolemic (normal blood > > ... > > read more »- Hide quoted text - > > - Show quoted text -
From: ironjustice on 17 Aug 2008 20:16
On Aug 17, 4:45 pm, ironjustice <teamtan...(a)hotmail.com> wrote: Are they just **substituting** the drugs FOR the **recommended** bloodletting ? << "Inhibitory action of dexamethasone on erythropoiesis" Inhibition by dexamethasone of erythropoietin-induced amplification of the erythropoietin-responsive cell compartment. Exp Hematol. 1981 Apr;9(4):444-8. Giglio MJ, Alippi RM, Bozzini CE. Erythropoietin-responsive cells (ERC) were reduced to very low levels in post-hypoxic polycythemic mice by intraperitoneal injection of 60 mg/kg-mouse of busulfan. Repeated injections of 5 units erythropoietin (Ep), 1, 2, and 3 days after busulfan repopulated the ERC compartment. Therefore, injection of a small test dose of Ep on day 5 induced a considerable wave of erythropoiesis. When busulfan-treated polycythemic mice received 5 mg of dexamethasone together with Ep injections they responded to the test dose of Ep with very minor increases in iron incorporation, which would indicate that a very small increase in the ERC population induced by Ep took place. These results suggest that the inhibitory action of dexamethasone on erythropoiesis is exerted not only by inhibiting the Ep-induced differentiation of ERC into proerythroblasts, but also by inhibiting the effect of the hormone on the amplification of the ERC compartment. PMID: 7238657 Who loves ya. Tom Jesus Was A Vegetarian! http://tinyurl.com/634q5a Man Is A Herbivore! http://tinyurl.com/4rq595 DEAD PEOPLE WALKING http://tinyurl.com/zk9fk > On Aug 16, 10:30 pm, ironjustice <ironjust...(a)aol.com> wrote:Are they > just  **substituting** the drugs FOR the **recommended** > bloodletting ? << > > "Acetazolamide decreased hematocrit by 7.1% erythropoietin by 67%" > > That would mean it lowers the red blood cells .. > > Yep ..  " blunts erythropoiesis". > > ---------------------------------------------------------------------------Â----- > > Original Article > > Acetazolamide > A Treatment for Chronic Mountain Sickness > Jean-Paul Richalet, Maria Rivera, Patrick Bouchet, Eduardo Chirinos, > Igor Onnen, Olivier Petitjean, Annick Bienvenu, Francçoise Lasne, > Stéphane Moutereau and Fabiola León-Velarde > Laboratoire Réponses Cellulaires et Fonctionnelles à l'Hypoxie, > Université Paris 13, Bobigny; Service de Physiologie et Explorations > Fonctionnelles, and Service de Pharmacie, Hôpital Avicenne, AP-HP, > Bobigny; INSERM U280, Lyon; Laboratoire National de Dépistage du > Dopage, Chatenay-Malabry; Laboratoire de Biochimie, Hôpital Henri > Mondor, AP-HP, Créteil, France; and Laboratorio de Transporte de > OxÃgeno, Universidad Peruana Cayetano Heredia, Lima, Peru > > Correspondence and requests for reprints should be addressed to Jean- > Paul Richalet, Ph.D., Laboratoire EA 2363, UFR SMBH, 74 rue Marcel > Cachin, 93017 Bobigny Cedex, France. E-mail: richa...(a)smbh.univ- > paris13.fr > ABSTRACT > > Rationale: Chronic mountain sickness or Monge's disease is > characterized by an excessive polycythemia in high-altitude dwellers, > with a prevalence of 5 to 18% above 3,200 m. To date, no pharmacologic > treatment is available. > > Objectives: We evaluated the efficacy of acetazolamide in the > treatment of chronic mountain sickness and the importance of nocturnal > hypoxemia in its pathophysiology. > > Methods: A double-blind placebo-controlled study was performed in > three groups of patients from Cerro de Pasco, Peru (4,300 m), treated > orally for 3 weeks with placebo (n = 10), 250 mg of acetazolamide (n = > 10), or 500 mg of acetazolamide (n = 10), daily. > > Results: Acetazolamide decreased hematocrit by 7.1% (p < 0.001) and > 6.7% (p < 0.001), serum erythropoietin by 67% (p < 0.01) and 50% (p < > 0.001), and serum soluble transferrin receptors by 11.1% (p < 0.05) > and 3.4% (p < 0.001), and increased serum ferritin by 540% (p < 0.001) > and 134% (p < 0.001), for groups treated with 250 and 500 mg of > acetazolamide, respectively. > Acetazolamide (250 mg) increased nocturnal arterial O2 saturation by > 5% (p < 0.01) and decreased mean nocturnal heart rate by 11% (p < > 0.05) and the number of apneaâhypopnea episodes during sleep by 74% (p > < 0.05). > The decrease in erythropoietin was attributed mainly to the > acetazolamide-induced increase in ventilation and arterial O2 > saturation. > > Conclusions: Acetazolamide, the first efficient pharmacologic > treatment of chronic mountain sickness without adverse effects, > reduces hypoventilation, which may be accentuated during sleep, and > blunts erythropoiesis. Its low cost may allow wide development with a > considerable positive impact on public health in high-altitude > regions. > > Key Words: altitude ⢠erythropoietin ⢠hypoxia ⢠nocturnal ventilation > ⢠soluble transferrin receptors > Published ahead of print on August 26, 2005, doi:10.1164/rccm. > 200505-807OC > American Journal of Respiratory and Critical Care Medicine Vol 172. > pp. 1427-1433, (2005) > © 2005 American Thoracic Society > doi: 10.1164/rccm.200505-807OC > > Who loves ya. > Tom > > Jesus Was A Vegetarian!http://tinyurl.com/634q5a > > Man Is A Herbivore!http://tinyurl.com/4rq595 > > DEAD PEOPLE WALKINGhttp://tinyurl.com/zk9fk > > > > > On Aug 16, 9:06 am, ironjustice <teamtan...(a)hotmail.com> > > wrote:nifedipine << > > > Oral Nifedipine to Treat Iron Overload > > > This study is currently recruiting participants. > > Verified by National Institutes of Health Clinical Center (CC), May > > 2008 > > > Sponsored by:  National Institute of Diabetes and Digestive and Kidney > > Diseases (NIDDK) > > > Information provided by: National Institutes of Health Clinical Center > > (CC) > > ClinicalTrials.gov Identifier: NCT00712738 > > >  Purpose > > This study will determine if nifedipine, a medication used to treat > > high blood pressure, can help treat iron overload, a condition in > > which the body contains too much iron. Iron overload can be caused by > > the body's inability to regulate iron or by medical treatments, such > > as multiple blood transfusions. Over time, it can cause problems with > > the liver, heart and glands. Treatments include reducing iron intake > > in the diet or removing the excess iron using medical therapies. > > Recently, nifedipine was found to cause iron loss in the urine of > > small animals. This study will see if the drug can increase the > > removal of iron into the urine in humans as well. > > > Who loves ya. > > Tom > > > Jesus Was A Vegetarian!http://tinyurl.com/634q5a > > > Man Is A Herbivore!http://tinyurl.com/4rq595 > > > DEAD PEOPLE WALKINGhttp://tinyurl.com/zk9fk > > > > On Aug 15, 9:33 pm, ironjustice <teamtan...(a)hotmail.com> wrote: > > > salmeterol << > > > > This drug salmeterol is used in high altitude sickness and it also > > > seems to improve symptoms of those with COPD. > > > COPD when treated with bloodletting has a high rate of alleviation of > > > symptoms. > > > > Altitude doctors tell you to bleed those with altitude sickness. > > > Salmeterol is used to treat altitude sickness. > > > COPD and altitude sickness BOTH manifest **increased red blood > > > cells**. > > > > Are they just  **substituting** the drugs FOR the **recommended** > > > bloodletting ? > > > > In the meantime anyone without **cash** FOR the drugs ..? > > > > Just like obesity where one person eats while 800 starving people .. > > > watch .. > > > > Bloodletting is the **recommended** treatment for increased red blood > > > cell production and these doctors better start .. following .. > > > **standard of care** .. ? > > > Drugs are to be used as a 'standin' .. **second** TO bloodletting. > > > THAT is how it reads. > > > ---------------------------- > > > > Hope for Patients with COPD > > > > Newswise -- For the first time, a drug therapy appears to reduce lung > > > function loss in patients with moderate to severe chronic obstructive > > > pulmonary disease (COPD), according to the results of a randomized, > > > double-blind, placebo-controlled trial in 42 countries. > > > > The Toward a Revolution in COPD Health (TORCH) study investigated the > > > effects of combined salmeterol, a Ã-agonist, and fluticasone > > > propiniate, an inhaled cortical steroid, either alone or in > > > combination, on mortality, exacerbations, health-related quality of > > > life and rate of decline in lung function as measure by forced > > > expiratory volume in one second (FEV1) in patients with COPD. > > > > The results are published in the second issue for August of the > > > American Journal of Respiratory and Critical Care Medicine, published > > > by the American Thoracic Society. > > > > "Pharmacotherapy with salmeterol plus fluticasone propionate, or the > > > components, reduces the rate of decline on FEV1 in patients with > > > moderate to severe COPD, thus slowing disease progression," wrote > > > Bartolome R. Celli, M.D., lead author of the study and professor at > > > Tufts University School of Medicine. "To date, smoking cessation is > > > the only intervention that has conclusively been shown to alter the > > > rate of decline in FEV1," remarked Dr. Celli. This is the first > > > demonstration of an effective pharmacothrerapy in COPD. > > > > The TORCH study randomized more than 6,000 patients with moderate to > > > severe COPD from 42 countries to receive either salmeterol (SAL; 50 > > > μg), fluticasone propionate (FP; 500 μg), the two in combination (SFC; > > > 50/500 μg), or placebo. After baseline FEV1 was recorded, patients > > > were re-evaluated every 24 weeks to determine the rate of decline in > > > FEV1. > > > > "The rate of decline in FEV1 was slowest in patients on SFC and > > > fastest in those randomized to the placebo arm," wrote Dr. Celli. > > > "From week 24 onward, the adjusted rate of decline in FEV1 was 39ml/ > > > year for SFC, 42 ml/year for both SAL and FP and 55 ml/year for > > > placebo." > > > > Although the study was not formally powered to detect differences in > > > rate of decline of FEV1, the results were highly significant > > > (p<0.001.) The rate of decline in treatment groups was similar across > > > a number of variables, including sex, age, ethnicity and body mass > > > index. Furthermore, the slower rate of decline in FEV1 appeared to be > > > associated with a lower risk of exacerbation. > > > > "Although treatment did not abolish the accelerated decline in lung > > > function [that occurs with COPD], it did ameliorate it substantially," > > > wrote Dr. Celli, while noting that "the mechanism responsible for the > > > effect on rate of decline is not clear, as all treatments have > > > potentially significant nonbronchodilator effects." Clarifying those > > > mechanisms is the goal of the next phase of the research, with the > > > comparison between a long-acting bronchodilator drug and placebo with > > > respect to FEV1 decline. > > > > In the meantime, "the TORCH study brings some clarity to the treatment > > > picture and provides some hopeful signs for patients with COPD," wrote > > > Samy Suissa, Ph.D., of McGill University, in the accompanying > > > editorial. "This study also demonstrates that no treatment [placebo] > > > is not an option for patients with moderate to severe COPD." > > > ---------------------------------------------------------------------------ÂÂ------ > > > > (c) 2008 Newswise.  All Rights Reserved. > > > > Who loves ya. > > > Tom > > > > Jesus Was A Vegetarian!http://tinyurl.com/634q5a > > > > Man Is A Herbivore!http://tinyurl.com/4rq595 > > > > DEAD PEOPLE WALKINGhttp://tinyurl.com/zk9fk > > > > > High altitude sickness is the 'human model of increased red cell > > > > production'. > > > > > One treatment to counteract this thickened blood is drawing blood / > > > > phlebotomy. > > > > These drugs seem to alleviate / replace this drawing of .. blood. > > > > > "sildenafil / viagra" > > ... > > read more »- Hide quoted text - > > - Show quoted text - |