Sunshine State

To ima smisla za lekove, terapije, medical devices... za postojece indikacije...ali, zar zaista ocekujes da jedna pharma kompanija ima razlog da ulaze stotine miliona dolara da razvija vakcine za jos nepostojece, nepoznate, potencijalne ili neke pretpostavljene viruse? Jos je ovaj virus slican vec poznatim SARS-u i MERS-u..

Odoh malo u Frusku goru....Sedam u svoja kola ispred svoje kuce, vozim se do sume, setam, vracam se. Nemoj niko da mi kaze da ugrozavam ikog, udisuci cist fruskogorski vazduh! Razmisljam, koliko ce kancera ostati nedijagnostikovano tokom ovog perioda, koliko ce mozdanih i srcanih udara biti jer ljudi ne idu na redovne kontrole,.... Moja mama uzima warfarin zbog A-fib i mora redovno da kontrolise INR da bi moglo da se adjust-uje doza leka. Zvali danas, jer joj je sutra redovna kontrola, kaze ne moze. Ne daj boze da je INR van granica, moze da se stvori tromb tokom aritmije i da dobije mozdani udar....

Oh, moji lijecnici su vrlo optimisticni 😞 "I have asked my sponsors to consider reducing the frequency of safety and/or efficacy testing by amendment, because this epidemic problem could be on and off for two years or more. So, in the long term, I suggested that the time is opportune to reassess whether the safety and efficacy testing is being done too frequently. In many of our studies, we at XXXX agree that it is true."

Moj mali holandski gradic nema jos nijednog zarazenog, ❤️ iako je broj zarazenih u NL vec 2051 😞

Sad kad me Mek napadne 😄

@vilhelmina ili ko zna - sta su Svedjani, Danci i Norvezani uradili poslednjih par dana, pa im brojke novozarazenih padaju - ca 50-ak dnevno? Sta god da su, izgleda da funkcionise (osim ako su smanjili broj testiranja) - prepisujmo od njih!

Zivim blizu Fruske Gore - autom malo do Rohalj baza, pa setnja po pustoj sumi - radim od kuce, sedim po 9-10 sati, okruzena vestima, komentarima, etc... moram zarad psihickog, a i fizickog, mira izaci

@bohumilo To se zove price gouging i kaznjivo je, bar u US

Tacno je, vec postojeci lekovi, ako se pokazu uspesni, mogu da se koriste kao off label lekovi. Koleginica mi prosledila ovu vest veceras (taj lek sam vec navodila par stranica ranije): https://www.genova24.it/2020/03/coronavirus-a-genova-il-primo-paziente-ufficialmente-guarito-era-stato-curato-con-remdesivir-232794/ Genova. Prvi pacijent zaražen koronavirusom službeno je izliječen u Genovi. Matteo Bassetti, direktor klinike za zarazne bolesti bolnice San Martino u Genovi, najavio je to tijekom streaming konferencije za novinare s predsjednikom Giovannijem Totijem i ostalim menadžerima Ligurskog zdravstva. "Imamo prvo istinsko izliječenje, podvrgnuto dva tampona, oba negativna - rekao je Bassetti - pacijent hospitaliziran 7. ožujka, star 79 godina. Sada se može vratiti svojoj kući u Lombardiju ". Važna vijest je da je čovjek liječen Remdesivirom, učinkovitim eksperimentalnim lijekom protiv ebole, koji je San Martino naručivao izravno u Washingtonu, gdje se proizvodi: "Čini se da djeluje", kaže Bassetti, "i ova stvar nas čini oduševljenima." Liječnik je rekao da će stići i druge zalihe lijeka koji će se i dalje koristiti pacijentima hospitaliziranim u Genovi zajedno s drugima, poput Tocilizumaba, koji se obično koristi protiv artritisa, ali koristan za borbu protiv upale pluća.

Malo me stigla neka panika posle vasih kataklizmicnih predvidjanja, pa samu sebe obradovah kad sam videla da je karantin u Kini uspeo da odrzi broj zarazenih ispod 0.15 % stanovnistva - u slucaju Srbije to bi bilo oko 10 000, i uz neku prosecnu smrtnost od oko 2-3 %, umrlo bi oko 200-300 ljudi. I jedan je previse, da se razumemo, ali verovatno i od obicnog gripa umre par stotina ljudi godisnje.

Znaci Kina je uspela da karantinom zadrzi broj zarazenih na oko 0.13 %

Gledam worldometer - koja neravnomernost u smrtnosti, ca. u % Kina 4 % Italija 8 % Nemacka 0.25 % US 1.6 % Norveska 0.2 % J. Koreja 1%

Mozemo i u pozoriste virtuelno: https://www.narodnopozoriste.rs/narodno-pozoriste-pocinje-sa-emitovanjem-predstava-putem-interneta

Doktor je naveo jedan simptom koji nije spominjan na listi najcesce navodjenih simptoma - dve trecine su opisale gubitak mirisa i ukusa koji traje nekoliko dana, toliko da jedna majka cak nije osecala "miris" sadrzaja pelene njene bebe: Fast alle Infizierten, die wir befragt haben, und das gilt für gut zwei Drittel, beschrieben einen mehrtägigen Geruchs- und Geschmacksverlust. Das geht so weit, dass eine Mutter den Geruch einer vollen Windel ihres Kindes nicht wahrnehmen konnte. Evo njegovog objasnjenja - slicno onom od strane WHO - testirati, testirati, testirati: U Italiji su testirani samo vrlo teški simptomatski slučajevi. Na primer, trenutna studija iz Shenzhena je otkrila da se deca zaraze patogenom jednako često kao i odrasli, ali oni razvijaju samo blage ili nikakve simptome. Ako se prati studija i pretpostavi se da 91% Covid-19 ima samo blage ili umerene simptome, Italijani su se u početku usredotočili na preostalih 9 %. Pored toga, mrtvi se naknadno testiraju i na Sars-CoV-2. I u Kini se na početku naglo povećao broj smrtnih slučajeva, ali ne i broj zaraza, jer su se skoncentrisali na mrtve. Sada je obrnuto, jer u Kini ima puno više testiranja. U Nemačkoj su od pocetka testirani i pacijenti sa samo blagim simptomima. Na primer, naš indeksni pacijent u Bonnu imao je samo ogrebotinu u grlu; siguran sam da se to nikad ne bi testiralo u Italiji.

Bold - pa to je super vest, jer u tom slucaju na 40 000 zarazenih imamo 20 umrlih, te je smrtnost manja nego kod redovnog gripa! Naravno, uvek postoji mogucnost onog sto @ciao napisa, sto otezava neke zakljucke Ja uopste nisam odusevljena holandskim zdravstvenim sistemom (bar ono sto licno znam), ali brojke (opet te brojke) kazu drugacije: https://worldpopulationreview.com/countries/best-healthcare-in-the-world/ Healthcare outcomes are changes in health that result from specific measures or investments. Healthcare outcomes include amenable mortality, readmission, and patient experience. The Healthcare Access & Quality (HAQ) Index ranks healthcare outcome scores on a scale of 0 to 100, with 100 being the best. Countries with the best healthcare systems in the world have scores between 90-96.1. The Netherlands holds the highest score of 96.1.

Neko pametniji ( @Doorn ) da objasni ovoliku razliku u brojkama/procentima u dve EU zemlje sa, relativno, istim standardom, zdravstvom, etc...Naravno, velicina / naseljenost drzave igra vaznu ulogu, no svejedno, smrtnost ne bi trebala da bude toliko razlicita: Nemacka: zarazenih 8000 umrlih 20 (0.25 %) serious 2 Holandija: zarazenih 1705 - umrlih 43 (2.5 %) serious 45

Razmisljam naglas i racunam, uzimajuci u obzir brojke lekara iz Johns Hopkins - ako ima 25-50 zarazenih na jednog potvrdjeno zarazeno, brojke u ovom trenutku za US su onda ovako: Zarazenih: 4700, znaci 120 k - 250 k (in reality) Umrlih: 93 U kriticnom stanju: 12

Johns Hopkins professor estimates at least 50,000 people have coronavirus in US “Don’t believe the numbers when you see, even on our Johns Hopkins website, that 1,600 Americans have the virus,” Makary said. “No, that means 1,600 got the test, tested positive. There are probably 25 to 50 people who have the virus for every one person who is confirmed.” https://thehill.com/policy/healthcare/487562-johns-hopkins-professor-estimates-at-least-50000-people-have-coronavirus-in

Ako je zaista tako (ovde opet dolazimo do toga koliko je sve nepoznato i nepotrvrdjeno), odakle jos uvek 233 (1/3) active cases na Diamond Princess, koji je u karantinu jos od 1 februara? A tu su kontrolisani uslovi, pretpostavljam da je ozbiljan karantin/izolacija, pa vec 6 nedelja traje agonija, uz trecinu jos uvek aktivnih slucajeva.

Evo na TC sam, opet nam lekari iz US ponavljaju da se wave in the US ocekuje u julu, avgustu... 😞

Gde pise "dugotrajna terapija", recimo u ovom dole? Izdvajam: "... that prolonged illness or the complications of respiratory infections may be more common when NSAIDs are used..... The finding in two randomised trials that advice to use ibuprofen results in more severe illness or complications helps confirm that the association seen in the observational studies is indeed likely to be causal" Prof Paul Little, Professor of Primary Care Research, University of Southampton, said: “There is now a sizeable literature from case control studies in several countries that prolonged illness or the complications of respiratory infections may be more common when NSAIDs are used – both respiratory or septic complications (1-10) and cardiovascular complications (11, 12). The observational evidence is always difficult to interpret due to so called protopathic bias/confounding by indication (i.e. were the NSAIDs prescribed at an early stage of the complications developing and so the NSAID use reflects the complications or a more severe illness rather than causing it), but where this has been controlled for the associations still persists(2). The finding in two randomised trials that advice to use ibuprofen results in more severe illness or complications (13, 14) helps confirm that the association seen in the observational studies is indeed likely to be causal. Advice to use paracetamol is also less likely to result in complication

Pa ne pricam ja, pricaju neki pametniji od mene: Prof Paul Little, Professor of Primary Care Research, University of Southampton, said: “There is now a sizeable literature from case control studies in several countries that prolonged illness or the complications of respiratory infections may be more common when NSAIDs are used – both respiratory or septic complications (1-10) and cardiovascular complications (11, 12). The observational evidence is always difficult to interpret due to so called protopathic bias/confounding by indication (i.e. were the NSAIDs prescribed at an early stage of the complications developing and so the NSAID use reflects the complications or a more severe illness rather than causing it), but where this has been controlled for the associations still persists(2). The finding in two randomised trials that advice to use ibuprofen results in more severe illness or complications (13, 14) helps confirm that the association seen in the observational studies is indeed likely to be causal. Advice to use paracetamol is also less likely to result in complications(13).” Prof Ian Jones, Virologist at the University of Reading, said: “The advice relates to Ibuprofen’s anti-inflammatory properties, that is, it dampens down the immune system, which may slow the recovery process. In addition, it is likely, based on the substantial literature around SARS I and the similarities this new virus (SARS-CoV-2) has to SARS I, that the virus reduces a key enzyme which part-regulates the water and salt concentration in the blood and could be part of the pneumonia seen in extreme cases. Ibuprofen aggravates this while paracetamol does not. It is recommended that people use paracetamol to reduce temperature if you are feverish.” Prof Paul Little, Professor of Primary Care Research, University of Southampton, said: “There is now a sizeable literature from case control studies in several countries that prolonged illness or the complications of respiratory infections may be more common when NSAIDs are used – both respiratory or septic complications (1-10) and cardiovascular complications (11, 12). The observational evidence is always difficult to interpret due to so called protopathic bias/confounding by indication (i.e. were the NSAIDs prescribed at an early stage of the complications developing and so the NSAID use reflects the complications or a more severe illness rather than causing it), but where this has been controlled for the associations still persists(2). The finding in two randomised trials that advice to use ibuprofen results in more severe illness or complications (13, 14) helps confirm that the association seen in the observational studies is indeed likely to be causal. Advice to use paracetamol is also less likely to result in complications(13).” Prof Ian Jones, Virologist at the University of Reading, said: “The advice relates to Ibuprofen’s anti-inflammatory properties, that is, it dampens down the immune system, which may slow the recovery process. In addition, it is likely, based on the substantial literature around SARS I and the similarities this new virus (SARS-CoV-2) has to SARS I, that the virus reduces a key enzyme which part-regulates the water and salt concentration in the blood and could be part of the pneumonia seen in extreme cases. Ibuprofen aggravates this while paracetamol does not. It is recommended that people use paracetamol to reduce temperature if you are feverish.” Dr Tom Wingfield, Senior Clinical Lecturer and Honorary Consultant Physician, Liverpool School of Tropical Medicine, said: “In the UK, paracetamol would generally be preferred over non-steroidal anti-inflammatory drugs (“NSAIDS”) such as ibuprofen to relieve symptoms caused by infection such as fever. This is because, when taken according to the manufacturer’s and/or a health professional’s instructions in terms of timing and maximum dosage, it is less likely to cause side effects. Side effects associated with NSAIDs such as ibuprofen, especially if taken regularly for a prolonged period, are stomach irritation and stress on the kidneys, which can be more severe in people who already have stomach or kidney issues. It is not clear from the French Minister’s comments whether the advice given is generic “good practice” guidance or specifically related to data emerging from cases of Covid-19 but this might become clear in due course. It should also be noted that, in the UK, we would not commonly use cortisone to relieve infection-related symptoms such as fever.” Dr Rupert Beale, Group Leader in Cell Biology of Infection at The Francis Crick Institute “There is a good reason to avoid ibuprofen as it may exacerbate acute kidney injury brought on by any severe illness, including severe COVID-19 disease. There isn’t yet any widely accepted additional reason to avoid it for COVID-19. Patients taking cortisone or other steroids should not stop them except on advice from their doctor. The Society for Endocrinology has issued advice for patients who are taking hydrocortisone or other steroids for pituitary or adrenal deficiency. https://www.endocrinology.org/news/item/14050/Coronavirus-advice-statement-for-patients-with-adrenal%2fpituitary-insufficiency.”

Ja razumem o cemu pricas, i prva stvar i u mojoj struci, kao i u medicini je "do no harm" - da nije tako, pola lekova bi bilo na trzistu posle dva meseca, a ne posle 10 godina ispitivanja. U konkretnom slucaju, ibuprofen vs. paracetamol - koji je, actually, harm, ako neko poslusa, pa uzme paracetamol umesto ibuprofen? Nikakav, ili skoro zanemarljiv ... stoga, ne vidim cemu tolika buna oko ovog - ja licno, i inace, uzimam paracetamol (acetaminophen)/caffeine (Panadol extra, ), a ne ibuprofen/ Brufen/Advil

Sacekacu s povratkom dok ne postignete herd immunity! Popicemo kafu negde na leto 🙂

Ma da, svi cemo skociti da pijemo masnu sodu, ako nam ti/mediji kazu - daj malo vise poverenja bar u ljude koji ovde kuckaju. Hajde hipoteticki - ako se potvrdi da je ibuprofen stvarno stetan, kako ces to objasniti umrlima, koji su (mozda), umrli zbog toga, a mogli su da uzmu paracetamol?