It may be Vitamin D's day in the sun

Begin forwarded message:

From: nataphcvhiv@...
Subject: NATAP/IAS: HPV Increased HIV Transmission Risk
Date: August 1, 2009 8:18:58 AM EDT
To: hiv@...,�nataphcvhiv@...,�natapindustry@...,�natapdoctors@...
NATAP http://natap.org/ _______________________________________________

5th IAS:�Preliminary analyses suggest a higher rate of HIV seroconversion among men who were HPV positive at baseline�- (08/01/09)

_______________________________________________
NATAP nataphcvhiv mailing list -- nataphcvhiv@...

This is an annoucement-only mailing list. Do not reply.

To unsubscribe: send a blank email to nataphcvhiv-request@... with a subject of unsubscribe.

For more information, see http://seven.pairlist.net/mailman/listinfo/nataphcvhiv

_______________________________________________

#30058

From: Barrowster <barrowster@...>
Date: Sat Aug 1, 2009 4:52 am
Subject: Los Angeles Times: It may be Vitamin D's day in the sun

johnftl59

Offline

Article licensing and reprint options

It may be Vitamin D's day in the sun

It may have untapped potential in fighting or preventing disease. But are we getting enough of it in our systems? A panel will discuss whether to increase the recommended daily intake.

By Shari Roan

8:57 PM PDT, July 31, 2009

Vitamin supplements have been both heralded and hyped over the years, only to ultimately fall from grace once research proves them to be little more than placebos in our quest for longer life or better health. But at least one substance may have true merit -- vitamin D.

Long considered just a supplement consumed with calcium for bone health, this humble vitamin may have untapped potential in fighting or preventing disease, suggests an explosion of new research. Not only has it shown promise in reducing the risk of, among other things, diabetes, pancreatic cancer, breast cancer and cardiovascular disease, but it also seems to improve infertility, weight control and memory.

Two advocacy groups have sprung up in the United States to promote the substance. Food industry executives are exploring ways to fortify more products. And PubMed, an international database of medical literature, shows that 2,274 studies referencing the vitamin have been published -- just this year.

"Vitamin D is one hot topic," says Connie Weaver, a professor of foods and nutrition at Purdue University in Indiana.

Next week, hope and hype may collide. An Institute of Medicine committee will convene in Washington to discuss whether the recommended daily intake of vitamin D and calcium should be increased. There, researchers overwhelmed by the vitamin's potential will square off against skeptics who say much more study is needed before people are urged to take vitamin D supplements. Getting the newly suggested amounts would be difficult otherwise.

The last time guidelines were issued on the vitamin was in 1997, long before an onslaught of scientific information suggested people are getting too little. Currently, the recommended daily intake is 200 to 600 international units with an upper limit of 2,000 IU.

Some researchers are advocating at least 600 IU a day, with an upper limit of 10,000 IU. Giving impetus to this push are the facts that many people seem to be deficient and that the nutrient appears to play a role in many conditions.

Other scientists say it's too soon to urge everyone to take supplements. An influential report released in June by the Agency for Healthcare Research and Quality found little conclusive evidence to support increasing the recommended amounts.

"I think there is a consensus that we might benefit from higher vitamin D levels," says James C. Fleet, a professor of foods and nutrition at Purdue University and a long-time researcher on the vitamin and prostate cancer. "But the committee is going to ask whether there is existing scientific evidence that is strong enough to make a change."

Vitamin D has long been known to be crucial to bone and muscle health by improving calcium absorption in the intestines and the way calcium is regulated in bones.

More recent research shows that receptors for it are found in almost every organ and tissue system in the body, suggesting that deficiencies may affect many types of cell functions.

When exposed to sunlight, the skin makes the vitamin, but not everyone spends the five minutes a day or so outside that is necessary for synthesis -- and many more people today wear sunscreen to prevent skin cancer.

"A large portion of people fall into the at-risk category, and they would benefit from being brought out of that category," Fleet says. "The question is: Is the current requirement enough to keep most people out of the at-risk category?"

A study of 13,000 Americans, published in March in the Archives of Internal Medicine, found that 50% to 75% have suboptimal levels by current standards. A level of 20 nanograms per milliliter of 25-hydroxyvitamin D -- the form most commonly measured in blood -- has traditionally been considered sufficient.

Most people 50 and older aren't meeting the current recommendations, Weaver says.

The vitamin is found in relatively few dietary sources -- some fortified foods, such as milk and some cereals, and naturally only in some fatty fish, such as salmon. Three cups of fortified milk provides only 300 IU.

"The largest source is sunshine, but not everyone can depend on that," Weaver says. "The elderly, dark-skinned people, higher-latitude dwellers all have trouble getting enough from sun." In darker-skinned people, melatonin in the skin blocks absorption of the ultraviolet rays needed to make the vitamin; older people don't appear to synthesize it from the sun as well as younger people.

Some scientists argue that levels of 40 to 60 ng/mL would be far better for disease prevention. That would require daily intake much higher than the current 200 to 600 IU.

The July issue of the Annals of Epidemiology(09)X0007-4, devoted to vitamin D research, links the vitamin to lower risks of cancers of the breast, colon, ovary and prostate. Animal and lab studies also demonstrate its importance in many of the cellular mechanisms that control cancer, such as cell growth, cell death, inflammation and DNA repair.

Five studies on colorectal cancer and breast cancer, taken together, showed that people with levels higher than 34 to 52 ng/mL had a 50% reduced cancer risk, says Cindy D. Davis, a researcher at the National Cancer Institute's Nutritional Science Research Group.

Such studies are not proof that the vitamin influences disease development, points out Dr. Karen E. Hansen, an assistant professor at the University of Wisconsin who studies bone health. "People with higher vitamin D may just be healthier for other reasons," she says.

But evidence linking higher blood levels to diabetes and cardiovascular disease is also mounting. A study in December in the Journal of the American College of Cardiology found that deficiency may increase the risk of cardiovascular disease. Other studies have tied lower levels to an increased risk of hypertension, diabetes, stroke and congestive heart failure.

Even for bone health, some studies suggest that about 700 to 800 IU a day are needed to prevent fractures in people over 50, Hansen says. She recommends 800 IU a day, with calcium, to her patients.

Meanwhile, studies show that the previous estimation of a toxic dose -- 2,000 IU a day -- is most likely too conservative. Toxic doses can lead to a dangerous level of calcium in the blood, high blood pressure and even kidney failure.

"It's likely they will increase their recommendation for all ages," Hanson said of the Institute of Medicine committee, which will release its report next year.

But not everyone is convinced the advice should be changed. In a report ordered by the federal government to assist the committee, researchers concluded there is a lack of strong evidence to support altering recommendations. The committee is not expected to change calcium recommendations.

"We did not find data that indicate a specific level of vitamin D intake is associated with adverse outcomes or beneficial health outcomes," said Dr. Thomas A. Trikalinos, co-director of the Tufts Evidence-based Practice Center, which prepared the report.

He said the report was meant to inform the committee and did not make recommendations.

"The report sees the totality of the evidence and tries to put everything into perspective," Trikalinos says.

Already, however, the American Society of Clinical Oncology has recommended a higher intake for breast cancer patients who are deficient.

In October, the American Academy of Pediatrics said children should get 400 IU a day, double the current recommendation.

In November, 18 University of California researchers issued a statement saying 2,000 IU is appropriate for most people.

"I think some of the more vocal advocates are pushing the medical community to move forward" before adequate research is completed, Fleet says.

Dozens of more scientifically rigorous studies are in progress that could help resolve the questions about how much people should consume.

"I think they held this [Institute of Medicine] meeting two to four years too early," Fleet says. "They are working without the big wave of vitamin D research that was initiated after people started pushing for it."

shari.roan@...

If you want other stories on this topic, search the Archives at latimes.com/archives.

partners:

#30057

From: John Walton <johnwaltonade@...>
Date: Fri Jul 31, 2009 8:31 pm
Subject: Solution search for facial Lipo.

johnwaltonade

Offline

Hi all,

Recently I was introduced to Redexis Ultra dermal filler, it is a product that is suited for facial LIpo. A syringe of this Hyaluronic acid based product cost 250$ in canada. The thing is I also found some sort of generic variety of these. These generics cost a mere 60$ per syringe. These generics are asian origin. Does anyone have concrete info on the possible use of these asian brands? These products could help us reduce the cost of treatment. I am considering using myself as a guinea pig (efficacy test). Word anyone?

J.W

#30056

From: poztravelman@...
Date: Fri Jul 31, 2009 7:53 pm
Subject: Poz Cruise Cancellations

pozcruiseret...

Offline

Hello,

As the travel agent and co-host with Nelson Vergel I wanted to advise you that we have had a handful of cancellations for our 5th Annual Poz Cruise.

I have space for inside, outside and balcony cabins.. The inside cabin costs $736.41 including the taxes which amounts to about $93 per day which of course includes meals, entertainment, private parties and needless to say informative talks from Nelson. Pus you get $50 per person spending money on the ship.

We sail from Ft Lauderdale on October 10 - 18 with stops in San Juan, St Thomas, Antigua, Tortola and Nassau!!!

Info on this cruise as well as the spring poz cruise from Long Beach can be seen at www.hivcruise.com

I hope a few of you can join us.

Thanks,

Paul

#30055

From: Barrowster <barrowster@...>
Date: Fri Jul 31, 2009 7:41 pm
Subject: HPV Status Changes Everything in Oropharyngeal Cancer (printer-friendly)

johnftl59

Offline

This is probably GOOD news, for us, as HPV related head and neck cancers are probably more common in HIV Positive people, especially those who do not use tobacco and alcohol.

www.medscape.com

From Medscape Medical News

HPV Status Changes Everything in Oropharyngeal Cancer

Nick Mulcahy

July 30, 2009 � Clinicians who diagnose oropharyngeal cancer should now test their patients' tumor tissue for human papillomavirus (HPV), say experts. HPV-positive cancers of the head and neck have dramatically better prognoses and are more responsive to chemotherapy and radiotherapy than HPV-negative cancers, which have a poor prognosis, experts noted at a press conference organized by the American Association for Cancer Research.

Dr. Kevin Cullen (Courtesy of American Association for Cancer Research)

"Clinicians can tell the HPV-positive patient, 'You are going to do very well on chemotherapy and radiation'," said Kevin Cullen, MD, from the University of Maryland Marlene and Stewart Greenebaum Cancer Center in Baltimore. He also said that patients with HPV-negative oropharyngeal cancers should explore the option of surgery and other alternative treatments.

The recommendation to test for HPV status is not new. As previously reported by Medscape Oncology, HPV and oropharyngeal cancers have been linked for some time. However, a new study led by Dr. Cullen makes an important contribution to the understanding of this link, which is why this study was the focus of the press conference.

The study shows, for the first time, that the well-known difference in survival between black and white patients with squamous cell carcinoma of the head and neck is related to HPV status in a subset of these cancers � specifically those that are oropharyngeal (at the base of the tongue and on the tonsil).

The difference in survival is actually not racially based. Instead, it is due to the fact that blacks are much more likely to have difficult-to-treat HPV-negative oropharyngeal cancer than whites, and thus have greater mortality, said Dr. Cullen. The study was published online July 29 in Cancer Prevention Research.

Dr. Otis Brawley (Courtesy of American Association for Cancer Research)

The study was hailed as both "practice changing" and an "extremely important finding with tremendous public-health implications," by Scott Lippman, MD, from the University of Texas MD Anderson Cancer Center in Houston, who moderated the press conference and is editor-in-chief of Cancer Prevention Research.

HPV is not protective. It just causes a different kind of cancer that has a more favorable outcome.

Some of the public-health implications arise from the fact that HPV is an infection, and its increasing presence among patients with oropharyngeal cancer seems to be tied to the rise in oral sex among young whites � but not blacks � in the United States. "A search of the literature that oncologists do not read shows that sexual practices can differ by race," notes Otis Brawley, MD, from the American Cancer Society in an accompanying editorial. Other public-health implications are related to the fact that oropharyngeal cancer that is HPV-negative is likely to be a consequence of alcohol and tobacco use.

Dr. Brawley pointed out that an oral-sex-acquired HPV infection is in no way helpful. "HPV is not protective. It just causes a different kind of cancer that has a more favorable outcome," he said.

How They Discovered the Link

The new study and its conclusions come from both retrospective and prospective data.

In a retrospective analysis of 106 blacks and 95 whites with squamous cell carcinoma of the head and neck treated at the University of Maryland, the investigators found that the 2 groups had very different survival: for blacks, median survival was 23.7 months; for whites, it was 52.1 months. However, the investigators then decided to consider the racial difference specifically for oropharyngeal cancer. When they did this, the difference in median survival widened further: for whites, it was 69.4 months and for blacks it was 25.2 months.

"We then realized that if we took out all of the cases of oropharyngeal cancer, the survival differences between blacks and whites might disappear," said Dr. Cullen. Sure enough, among the cases of nonoropharyngeal cancers, the median survival was nearly identical: for whites it was 17.1 months and for blacks it was 17.5 months.

There was no survival difference between blacks and whites with head and neck cancers of the nonoropharyngeal type; the survival difference between races was confined to oropharyngeal cancer.

This led the investigators to examine pretreatment biopsy specimens from a prospective trial of head and neck cancers, known as TAX 324, in which patients were treated with chemotherapy and radiation (N Engl J Med. 2007;25:1705-1715).

In TAX 324, 196 white patients and 28 black patients were assessed for HPV status, write Dr. Cullen and his coauthors.

As with the University of Maryland data, the median overall survival in TAX 324 was significantly worse for black patients (20.9 months) than for white patients (70.6 months; P = .03).

However, patients with HPV-negative oropharyngeal cancer � regardless of race � had worse outcomes than patients with HPV-positive cancer. HPV-negative patients had a median survival of 26.6 months, whereas the survival rate for HPV-positive patients could not be calculated because most were still alive.

We need to think of HPV-positive and HPV-negative patients as having 2 different diseases.

In short, the survival dramatically improved in HPV-positive oropharyngeal patients, compared with HPV-negative patients.

Overall, 4% of black patients and 34% of white patients were HPV-positive. Blacks fared worse in the study than whites because they were more likely to have the difficult-to-treat HPV-negative cancer. In other words, survival and oropharyngeal cancer is not really a matter of race but of whether or not a patient has HPV infection.

"We need to think of HPV-positive and HPV-negative patients as having 2 different diseases," said Dr. Cullen.

A Changing Demographic, Oral Sex and a Possible Epidemic

At the press conference, Dr. Cullen provided some background on head and neck cancer. "About half of all head and neck cancer is oropharyngeal, and about half of those oropharyngeal cancers are HPV-related," he said.

The typical profile of a patient with oropharyngeal cancer has greatly changed in the past 20 years or so, said Dr. Lippman.

In the past, the disease was primarily that of older patients and was related to tobacco and alcohol use; their disease was typically HPV-negative. In recent years, "the demographics are totally different," said Dr. Lippman. Patients tend to be executives, educated, white, and in better shape, he said. They are also likely to be HPV-positive.

The experts at the press conference suggested that the increase in the practice of oral sex among white, especially younger, Americans, has led to the increasing incidence of oral HPV infection and related HPV-positive oropharyngeal cancer.

Young black Americans are less likely to have oral sex and they are more likely to first have genital sex, said Dr. Brawley. This might explain why blacks are less likely to have HPV-positive oropharyngeal cancer. In the case of black Americans, their HPV infections are more likely to be genital, which in turn provides them with some immunity in the oral cavity. Thus, when blacks have oropharyngeal cancer, it tends to be the difficult-to-treat HPV-negative type, he explained.

Why exactly HPV-positive oropharyngeal cancer is more responsive to treatment is not known, said Martin Blaser, MD, from New York University Langhorne Medical Center in New York City.

Dr. Lippman warned of a potential "epidemic" of oropharyngeal cancer. "This is likely to become one of the most common cancers we see," he said.

Vaccination for HPV is a likely strategy to deal with HPV-related oropharyngeal cancer, said Dr. Brawley. One of the targets of HPV vaccination, HPV-16, is associated with a significant percentage of oropharyngeal cancers, he said. Both boys and girls would receive vaccinations as part of such a strategy, he added.

The researchers have disclosed no relevant financial relationships.

Cancer Prev Res. Published online before print July 29, 2009.

[CLOSE WINDOW]

Authors and Disclosures

Journalist

Nick Mulcahy

Nick Mulcahy is a senior journalist for Medscape Hematology-Oncology. Before joining Medscape, Nick was a freelance medical news writer for 15 years, working for companies such as the International Medical News Group, MedPage Today, HealthDay, McMahon Publishing, and Advanstar. He is also the former managing editor of breastcancer.org. He can be contacted at nmulcahy@....

Medscape Medical News � 2009 Medscape, LLC
Send press releases and comments to news@....

#30054

From: "Michael" <michael@...>
Date: Fri Jul 31, 2009 6:33 pm
Subject: Statins and muscle damage

medibolics_m...

Offline

I prefer low carb diets, with high dose fish oil and Niaspan to statins, and my
blood fats are all in the healthy ranges. Not that some people won't need a
statin. But I'd try red rice yeast first. Add Niaspan and high dose fish oil,
which both can be paid for by insurance and medical coverage -- and you might
not need a statin. After statin-induced muscle damage comes kidney damage, which
can potentially kill you. If you are taking a statin be sure to take CoQ10, at
least 100 mg per day, or MORE if you can, to try to reduce some of the damage.

Michael Mooney
www.michaelmooney.net
www.medibolics.com
-----------------------------

http://www.ivanhoe.com/channels/p_printStory.cfm?storyid=21885

Reported July 10, 2009
Statins can Damage Muscles

(Ivanhoe Newswire) -- Because of their importance in reducing the risk of
cardiovascular disease, statins are one of the most widely prescribed
medications in the world. One well-known side effect of taking statins is muscle
weakness and pain. Researchers are now finding that structural muscle damage may
be present in patients who have statin-associated muscle complaints. In some
cases, muscle biopsies have shown underlying structural injury to the muscles
even in patients who had discontinued medication before the biopsies were taken.

A new study by researchers from the University of Bern, Switzerland, and the
Tufts-New England Medical Center in Boston, Massachusetts, looked at muscle
biopsies from 83 patients, 20 of whom had never taken statins. They found
significant muscle injury in patients who had taken statins, including several
who had discontinued medication before the biopsy.

"Although in clinical practice, the majority of patients with muscle symptoms
improve rapidly after cessation of therapy, our findings support that a subgroup
of patients appears to be more susceptible to statin-associated myotoxicity,
suffering persistent structural injury," Dr. Annette Draeger from the University
of Bern and coauthors are quoted as saying.

The researchers note there is a need to evaluate alternative treatment
strategies for patients with significant muscle symptoms.

SOURCE: Canadian Medical Association Journal, July 2009.

#30053

From: "Michael" <michael@...>
Date: Fri Jul 31, 2009 6:38 pm
Subject: Veggie Cuts Cancer Forty Percent

medibolics_m...

Offline

Veggie Cuts Cancer Forty Percent
(Michael says: Vitamins can only do so much! Eat your veggies!)

Reported July 2009

BALTIMORE (Ivanhoe Newswire) -- Just about everybody knows if you want to stay
healthy and fight off disease, you've got to eat your veggies.

In every grocery store, there are foods that aren't so good for you and foods
that can fight disease. Pharmacologists estimate that up to 40 percent of all
cancers could be prevented by eating more fruits and vegetables. Now add
broccoli sprouts to the list.

"What we've found is that broccoli sprouts, the little baby broccoli plants that
are a few days old, are very, very rich in what we think is probably the most
important naturally occurring chemical in broccoli," Jed Fahey, Sc.D., a
pharmacologist at John Hopkins University in Baltimore, Md., told Ivanhoe.

A new study by Dr. Fahey shows that munching on this tiny, little-known veggie
may help protect the stomach from a common bacterial infection that can cause
gastritis, ulcers and stomach cancer.

"Our best guess is that about an ounce or two a day is a good amount of broccoli
sprouts to eat," Dr. Fahey said.

All broccoli contains a bio-chemical called sulforaphane, which has been shown
to help fight off cancer. But baby broccoli sprouts contain huge levels of this
cancer fighting ingredient.

"The levels of sulforaphane in broccoli sprouts are 10-, 20-, 30-, 50-times
higher than the levels in market stage broccoli or heads of broccoli," Dr. Fahey
said.

Researchers believe high levels of sulforaphane slow down or reduce the level of
harmful bacteria in the gastrointestinal tract which can cause inflammation of
the stomach lining and could lead to cancer.

A tiny, easy way to stay healthy and fight disease

Sulforaphane can also be found in lower levels in: brussels sprouts, cabbage,
cauliflower, bok choy, kale, collards, turnips, radishes, arugula and
watercress.

The American Association of Pharmaceutical Scientists contributed to the
information contained in the TV portion of this report.

#30052

From: Dean Shaw <cdeans56@...>
Date: Fri Jul 31, 2009 4:36 pm
Subject: RE: Moving to San Francisco, need a doctor referall

cdeans56

Offline

Stephen Knox is a GP with a large HIV practice. I loved him!!! Tell him Dean S. in D.C.sent you, if you see him.

To: dfwpozguy@...; PozHealth@yahoogroups.com
From: PoWeRTX@...
Date: Mon, 27 Jul 2009 17:22:53 -0400
Subject: Re: [PozHealth] Moving to San Francisco, need a doctor referall

Dr Rick Loftus in SF is great and he would be my doctor if I lived there

Regards,

Nelson Vergel
powerusa.org

In a message dated 7/27/2009 4:24:12 P.M. Central Daylight Time, dfwpozguy@yahoo.com writes:

Hi Everyone,

Currently living in LA and have Dr Gottlieb, great doctor, really like him lots! Thanks again Nelson for that wonderful referral.

We are moving to San Francisco soon and would love to find someone who is as good. Doctor that listens and understands you.

Someone told me of Dr Shawn Hassler on Market street, anyone goes to him? Any feedback would be helpful.

Thanks again

Hugs to everyone!

Windows Live� Hotmail�: Celebrate the moment with your favorite sports pics. Check it out.

Reply | Forward | Messages in this Topic (4)

#30051

From: Roger Ramjet <roger92103@...>
Date: Fri Jul 31, 2009 2:06 pm
Subject: Re: Re: Fw: M.D.'s in the San Diego, CA area

roger92103

Offline

Thanks for comments and I couldn't agree more that the whole (fantastic) point of this group is to exchange information. But in taking me to task you also reinforce my point - you are brining up something that happened seven years ago, just *maybe* he is a better doctor now.

ON THE OTHER HAND - My partner had a similar experience to yours - he was a patient of Dr Shawn Harrity around 2003-04 and she wouldn't take him off zerit even though he asked her repeatedly to do so. She took offense when he tried to discuss his progress with her, as if he was questioning her judgment for wanting to participate in his own health care. And when he developed lipoatrophy, got another doctor to give him a different meds regime, and then went back to see her, she basically blamed my partner for not being proactive and getting himself off zerit. So even though there are people who think she's great, and this was about six years ago, we will never forgive her. So I get your point about Dr Shamblaw, and I am sorry that that happened to you, having been through such a similar thing with my partner, although with a different doctor.

Thank heaven there are better drugs now, that don't ravage people in this way.

--- On Thu, 7/30/09, J <ld_ng2003@...> wrote:

From: J <ld_ng2003@...>
Subject: Re: [PozHealth] Re: Fw: M.D.'s in the San Diego, CA area
To: PozHealth@yahoogroups.com
Date: Thursday, July 30, 2009, 12:26 PM

I used to have Dr. Shamblaw as my physician around 2002. After I became resistant to some meds, he switched me to d4T. A year later I had really bad lipoatrophy and I switched to the other doctor in his practice. Well, the other doctor told me that he had talked repeatedly to Shamblaw about getting his patients off d4T, but he obviously didn't listen. Now everytime I look in the mirror I think of Shamblaw.
Apart from that, on 2 occasions that I had appointments to go over my labs, he came in the examining room and asked me what was wrong. I told him we had to go over the labs, and both time he apologized and said that they hadn't come back yet. So not only did he not even spend 15 seconds to prepare for the visit, but he also wasted half a day of mine both times.
On the plus side, Dr. Shamblaw is very friendly.
I also know that other people have had a very different experience with Dr. Shamblaw, but I don't agree with the previous person who said that "it's time to stop dumping on a guy who is very committed... ". Why would users on this board want people to only talk about their good experiences and not their bad ones? What would be the point? Censorship is never a good idea...

From: Roger Ramjet <roger92103@yahoo. com>
To: PozHealth@yahoogrou ps.com; hoppefaith@aol. com
Sent: Wednesday, July 29, 2009 6:10:36 AM
Subject: Re: [PozHealth] Re: Fw: M.D.'s in the San Diego, CA area

Shamblaw seems to have a bad rep, in fact when my partner and I started with him he did always seem in a hurry and kind of irritable. But it turns out another doctor in town had died and Shamblaw had taken most of his patients so he was very stressed out, seeing a 150% patient load. Lately he has been good humored and friendly and whenever I go I wait less than 10 minutes. I don't have any investment in who you choose but I think it may be time to stop dumping on a guy who is very committed to the gay and HIV communities in San Diego.

--- On Tue, 7/28/09, hoppefaith@aol. com <hoppefaith@aol. com> wrote:

From: hoppefaith@aol. com <hoppefaith@aol. com>
Subject: [PozHealth] Re: Fw: M.D.'s in the San Diego, CA area
To: PozHealth@yahoogrou ps.com
Date: Tuesday, July 28, 2009, 10:25 AM

I use Houghton,.. I don;t know if he has the hiv ID specialty, but my vl has been unded for years and my care is easy.. For a complex case with treatment resistance,, etc.. I don;t know if I;d use him.. I used to use shamblaw and found him to be always running very late and he was rude.. I;ve been to Caperna for the anal paps and the wait can be long in the clinic.. If you have good insurance (and a complex case.)the VA hospital in san diego does take some patients,, I used to see Douglas Richman, one of the best in the US. Susan Little is also there,.. Mind you.. you do get your blood drawn in a military hospital ,where people might be training and mistakes might happen at the blood draw center, , but at the VA they cover all stuff in the labs like your creatinine clearance levels.. etc.. And those two docs are very good and the setting there is easy and relaxed and on time.. Both those docs are researchers also,, good if your case is complex. Email me if you need more info.. good luck

An Excellent Credit Score is 750. See Yours in Just 2 Easy Steps!

#30050

From: PoWeRTX@...
Date: Fri Jul 31, 2009 2:05 pm
Subject: Fw: NATAP: Tanning Beds Cancer Risk-New Study Reports

nelsonvergel

Offline

Tanning Beds Cited as High Cancer Risk

By Charles Bankhead, Staff Writer, MedPage Today

Published: July 29, 2009

HOUSTON, July 29 -- Tanning beds have moved to the highest-risk cancer category of radiation sources in an update from the International Agency for Research on Cancer (IARC).

Citing evidence from case-control studies and a meta-analysis, the IARC monograph working group "raised the classification of the use of UV-emitting tanning devices to Group 1, 'carcinogenic to humans,' " the authors reported in the August issue of The Lancet Oncology.

In a meta-analysis published in 2006, the IARC working group concluded that people who begin using tanning devices before age 30 have a 75% greater risk of cutaneous melanoma than the general population (Int J Cancer 2006; 120:1116-22).

The working group also cited case-control studies showing "consistent evidence of an association between the use of UV-emitting tanning devices and ocular melanoma."

The IARC reclassified all forms of ultraviolet radiation as a single carcinogenic entity. Historically, mutations caused by exposure solar radiation had been attributed to UVB. However, the same mutation was identified in UVA-induced skin tumors in mice.

UVA, UVB, and UVC previously had been classified individually as "probably carcinogenic to humans" (group 2A in the IARC system). In the updated report, the IARC moved UV radiation as a whole into the highest-risk category, eliminating distinctions between UVA, UVB, and UVC.

With regard to other sources, the IARC working group found insufficient evidence to conclude that welders face an increased risk of UV radiation-induced ocular melanoma. However, the group said, "a full review of the carcinogenic hazards of welding will be undertaken with high priority."

The working group also classified all forms of ionizing radiation as group 1. Forms of radiation affected by the action included radon, plutonium, radium, phosphorus-32, and radioiodines.

Working group member Nicholas Priest is an employee of Atomic Energy of Canada. Co-author Ron Mitchel is a consultant to Atomic Energy of Canada.

Co-author Colin Muirhead disclosed a financial relationship with the UK Ministry of Defense. Co-author J. Hall disclosed a financial relationship with Electricite de France. Co-author A. Green disclosed a relationship with L'Oreal Recherche.�

#30049

From: david gordon <davidleogordon@...>
Date: Fri Jul 31, 2009 1:29 pm
Subject: +Re:hemolytic anemia

davidleogordon

Offline

Not to be alarmist but have your friend get a blood test to find out about Multiple Myeloma. MM is a blood plasma cancer which reveals itself in a few ways. Hemolytic Anemia, elevated creatinine levels, bone pain. If caught in it�s early stage (MGUS) onset to MM can be slowed.

I was diagnosed with this cancer in April of 2009. I worked out daily and lived a pretty healthy life. I was also on Truvada long term, had tcells @ 1000 and no detectable viral load for years. I wish him luck and lot�s of energy and hope he�ll be back to the triathlons soon.

�

--
David Gordon
davidleogordon@...
917.428.4829

#30048

From: Nelson Vergel <nelsonvergel@...>
Date: Fri Jul 31, 2009 6:12 am
Subject: Fw: Quality of Life Improved in Lipoatrophy and Sitting Pain

nelsonvergel

Offline

As you know, lipoatrophy is one of the most significant side effects of long term HIV treatment and disease. This side effect challenges HIV-positive people with profound physical, psychological and social issues. Much attention in the past has been focused on facial lipoatrophy as a cosmetic and stigmatizing issue.

However, an under reported and significant problem may be affecting more of your patients than you are aware of. Lipoatrophy in the buttocks and thighs makes sitting painful, even debilitating, and dramatically affects your patient's in social and work situations. It causes them to withdraw from many daily activities which contribute to the quality of life.

From: "Joe A. Bollert, PhD" <jbollert@...>
To: nelsonvergel@...
Sent: Thursday, July 30, 2009 2:30:31 AM
Subject: Quality of Life Improved in Lipoatrophy and Sitting Pain

Clinical Summary

HIV/AIDS associated facial and limb lipoatrophy well known
Under reported: lipoatrophy in the buttocks often leads to significant sitting pain
Sitting pain leads to unnecessary suffering and decreased quality of life
Padded undergarment designed by AIDS survivor & tested by HIV physicians
Patients reported significant pain relief & dramatically improved quality of life

Lipoatrophy & Sitting Pain
Interviews with long term HIV survivors have indicated a surprisingly high percentage of patients who suffer, many significantly, from sitting pain. Many have not mentioned the problem to their physicians.

LipoWear, LLC, a therapeutic clothing company, recently completed the development and clinical testing of a pain relieving, padded undergarment, SitRelief Shorts, designed specifically for HIV patients.

SitRelief Shorts were clinically tested in HIV patients with lipoatrophy and significant sitting pain by Jorge Rodriguez, MD and Derrick Knowles, MD of Newport Beach, CA and Korey Jorgensen, MD and Tom Lochner, MD of Laguna Beach, CA. The results were dramatic!

Sitting Pain Relief
Dr. Rodriguez, the lead investigator, reported "The impact of sitting pain in patients with lipoatrophy of the buttocks is significant and dramatically affects their quality of life. For the patients in the study, the average baseline sitting time without pain was 11 minutes which dramatically increased to 3 hours with the padded shorts".

Dr. Jorgensen reported "My patients benefited significantly. Patient comments such as 'the shorts changed my life' and 'I can't imagine life without them' underscore the nature of the problem and the range of day to day activities affected when people cannot sit comfortably and have significant sitting pain."

Quality of Life Improved
Clinical trial data was analyzed at the University of California Irvine Center for Statistical Consulting. In addition to significant improvement in sitting comfort, there was dramatic improvement in multiple parameters of an HIV Quality of Life Survey, including Physical Function, Social Function, Mental Health and Cognitive Function.

The following areas improved significantly: depression, doing more around the house, doing more outside the house, feeling isolated, lacking energy to socialize and spending quality time with friends. In addition, trouble remembering things and short attention span improved.

As a result of sitting pain relief, subjects reported being able to participate longer and concentrate better in a wide variety of activities including: church, computer time, concerts, doing bills, driving, meetings, movies, plane travel, reading, restaurants, school, seminars, socializing, theater, watching TV, work, and writing letters.

This expansion in activities contributed to the improved Quality of Life in the multiple areas. In addition, SitRelief Shorts restored a normal body contour resulting in clothing fitting better.

Created by an AIDS Patient
SitRelief Shorts were conceived by Terry Delonas, Cofounder of LipoWear, and a long term AIDS survivor. "Having personally suffered the debilitating effects of lipoatrophy and sitting pain for several years and witnessing the problems in many others, I felt there was an important medical need to be met by designing SitRelief Shorts. Based on the results of the first study and the patient comments, we are pleased to have produced a product that can dramatically impact the lives of patients with this problem" said Delonas.

If you would like more information on SitRelief Shorts, the padded undergarment, to provide to your patients please contact me and I will send brochures for your office. You may also refer your patients to www.lipowear.com for more information and ordering.

LipoWear's founders are dedicated to helping those with lipoatrophy and sitting pain and donate 10% of corporate profits to AIDS Service Organizations.

Sincerely,

Joe A. Bollert, PhD
Cofounder
LipoWear, LLC
2102 Business Center Dr.
Irvine, CA 92612
714-323-2116
Fax 413-440-0120
jbollert@...

Quick Links...

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

This email was sent to nelsonvergel@... by jbollert@....

Update Profile/Email Address | Instant removal with SafeUnsubscribe™ | Privacy Policy.

Email Marketing by

LipoWear | 2102 Business Center Dr., | Irvine | CA | 92612

#30047

From: George310541w <george310541@...>
Date: Fri Jul 31, 2009 7:20 am
Subject: Who Should Get the H1N1 Vaccine First?

george310541

Offline

Date: Thursday, July 30, 2009, 10:44 PM

http://news.yahoo.com/s/time/20090731/hl_time/08599191361500

Who Should Get the H1N1 Vaccine First?

By ALICE PARK Alice Park – Thu Jul 30, 10:25 pm ET

World health officials are carefully watching the H1N1/09 swine-flu virus as it makes its way through the Southern Hemisphere, which is currently in the thick of its flu season. They are particularly interested in seeing how severely the virus affects infected people in parts of Africa, South America and Australia, since their illnesses could be a good predictor of how aggressive the virus will be when flu season returns to the rest of the world in the fall.

So far, the H1N1/09 flu appears to be mild overall and treatable with existing antiviral therapies. But given that the virus continues to cause some serious cases of illness and death, the U.S. Centers for Disease Control and Prevention (CDC) isn't taking any chances. On Wednesday, July 29, the agency called an urgent meeting of its Advisory Committee on Immunization Practices, which decides who gets vaccinated against which diseases and when. The committee was asked to generate guidelines for H1N1/09 vaccination, if and when the agency determines that such immunizations become necessary, in addition to those for seasonal flu. (Read "The Year in Medicine 2008: From A to Z.")

The 15-member panel of doctors, scientists, vaccine experts, public-health officials and a citizen representative came up with five core populations they believe should receive the first wave of H1N1/09 immunization. These include pregnant women, people living in households with babies under 6 months old (since infants cannot be immunized, they must be protected by preventing illness in those around them), emergency medical personnel who are likely to be in contact with infected patients, young people between 6 months and 24 years old, and nonelderly individuals who have underlying conditions, such as asthma, respiratory illness or a compromised immune system, that put them at higher risk of flu complications.

Notably absent from the target list are the elderly, those over age 65, who are generally considered a high-risk group when it comes to seasonal influenza. Based on the populations who were hardest hit by H1N1/09 last spring, first in Mexico and then across other continents, CDC experts believe that the elderly will not be as vulnerable to H1N1/09 in the fall as younger adults might be. In fact, health officials have relegated the elderly to the back of the line for H1N1/09 vaccinations - after the five target groups have received their shots, the next eligible group would be younger, healthy adults who have no underlying medical conditions that would complicate the flu. Only after those populations have been inoculated would the elderly be permitted to receive vaccination. "People who are 65 and over are at high risk of influenza complications from seasonal influenza," Dr. Anne Schuchat, director of the CDC's National Center for Immunization and Respiratory Disease, told reporters on Wednesday. "It's important that they get the seasonal-flu shot. But the H1N1 outbreaks have so far spared that population. So I would tell them that their risk of illness from this virus is very low compared to that of younger people." (See the most common hospital mishaps.)

That could still change, but at least for now, says Schuchat, local and state health authorities will have some guidelines for deciding who should get vaccinated if it becomes necessary. That could be useful since initial lots of the vaccine, which will have to be given in two doses, may not be sufficient to vaccinate everyone who wants it; some targeting of the first shots will be necessary. Manufacturers around the world are currently preparing and testing vaccines - the first are expected to be ready in October - but Schuchat stressed on Wednesday that the CDC has not yet decided whether it will recommend H1N1/09 vaccination at all.

#30046

From: Neal Weaver <nealnsd@...>
Date: Fri Jul 31, 2009 12:56 am
Subject: Re: Fw: M.D.'s in the San Diego, CA area

stellabeer2000

Offline

There is Tom Buehner, who practices part time with Houghton and the rest
of the time at the San Yisidro Health Clinic - at their offices on Elm
Street.
I have seen Tom for a few years and he has been great. My case is very
complicated - mutliple drug resistances and many OI's. I am now finally
VL undectable and feeling great.

There is also Adam Zweig of the Scripps Clinc. I don't know much about
this
guy, He advertises in gay media. The Scripps Clinic is a great place -
completely
computerized, so you don't have to worry about making copies of tests,
etc.

The Owen Clinic at UCSD is good - some great doctors. The place there
often seems disorganized and the waits can be long. However, knowing
this
going in may be of help.

There is a geat guidebook published by Being Alive San DIego. It is a
total
list of Dr's - public and private. LIsts of Dentist's and so forth. I
had heard they
were all out. But perhaps there is an onlinet version
They are at 619-291-1400.

Good luck

#30045

From: lsmyle <lsmyle@...>
Date: Fri Jul 31, 2009 12:40 am
Subject: Re: hemolytic anemia

larrysmyle

Offline

Sanford,
Are you saying that you also have it? Do you have any clue what the
incidence is among HIVers and that it is HIV related? My friend was
told that it was idiopathic, so it obviously occurs in non-HIV+. I'm
hoping John or Jules has some information.
My best to you,
Larry
On Jul 30, 2009, at 12:46 PM, Sanford Gross wrote:

> A problem with which I am becoming increasingly familiar,
> unfortunately.
> I would welcome some discussion from the group on HIV-induced anemia.
>
>
> Sanford
>
> Sanford M. Gross, OD, FAAO
> Associate Professor
> Illinois College of Optometry
> 3241 South Michigan Ave
> Chicago, Illinois 60616
>
>>>> <lsmyle@...> 7/30/2009 12:13 PM >>>
> Group,
> I just spoke to my close friend who it turns out has hemolytic
> anemia. This guy has done triathalons up until last month (he's 65!)
> but has stopped due to the lack of energy. He, of course, is quite
> concerned. His anti-viral regimen is Truvada, Norvir and Reyataz. He
> has no resistance issues. Any thoughts or insights?
> Larry
>
> <Sanford Gross.vcf>

Reply | Forward | Messages in this Topic (3)

#30044

From: Nelson Vergel <nelsonvergel@...>
Date: Thu Jul 30, 2009 7:44 pm
Subject: MSG getting people fat?

nelsonvergel

Offline

http://health.yahoo.com/experts/weightloss/2200/the-surprising-ingredient-causing-weight-gain/

Regards,

Nelson Vergel
powerusa dot org

#30043

From: "Michael" <michael@...>
Date: Fri Jul 31, 2009 12:14 am
Subject: Re: Check out Soy Safe for Men: Study

medibolics_m...

Offline

This study was created by food industry concerns who cannot be trusted to give
you anything close to honest information. Is this data accurate? I'll have to
spend time analyzing it, but I doubt it. One thing they don't talk about is a
potential for soy to cause problems with thyroid function.

To read a more objective analysis of the consumption of soy, read
http://www.whale.to/a/whole_soy_story.html and then
http://www.westonaprice.org/soy/promotion.html.

It's not food to be consumed in any significant quantity, except as fermented
soy, and then in small amounts.

Michael Mooney
www.michaelmooney.net
www.medibolics.com

--- In PozHealth@yahoogroups.com, PoWeRTX@... wrote:
>
> _Soy  Safe for Men: Study_
>
(http://www.gourmetretailer.com/gourmetretailer/content_display/news/e3i52c27f7d\
d43be459115559f6e19ad9a6)
> **************Hot Deals at Dell on Popular Laptops perfect for Back to
> School
>
(http://pr.atwola.com/promoclk/100126575x1223106546x1201717234/aol?redir=http:%2\
F%2Faltfarm.mediaplex.com%2Fad%2Fck%2F12309%2D81939%2D1629%2D8)
>

Reply | Forward | Messages in this Topic (2)

#30042

From: julev <JuLev@...>
Date: Thu Jul 30, 2009 9:16 pm
Subject: NATAP/IAS: Neuro Disorders Despite <50 c/ml

jules72orange

Offline

Begin forwarded message:

From: julev <julev@...>
Subject: NATAP/IAS: Neuro Disorders Despite <50 c/ml
Date: July 30, 2009 6:05:33 AM EDT
To: hiv@...,�
Neurocognitive Disorders Despite Undetectable HIV RNA

Reported by Jules Levin

The CHARTER Study investigators in the poster at IAS said decline in cognition was associated with detectable HIV RNA in CSF and being HCV+. The MOST Study reported at CROI found that viral failure in plasma for patients on PI monotherapy, in this case Kaletra, was associated with increased levels of HIV RNA in CSF. Christine Katlama reported in her darunavir monotherapy study at IAS there were 3 CNS disorders on darunavir monotherapy with 2 cases of "discordant plasma/CNS symptomatic HIV replication in 2 patients on DRV/r monotherapy".�

CROI:�Unexpectedly high failure rate in LPV/r monotherapy arm, involving CNS, and association with low nadir CD4 count in the MOST study�-�(06/02/09)
"With the exception of one patient (CSF HIV RNA 82 cp/ml, randomized to CT) all patients had undetectable HIV RNA in CSF at baseline.�At study termination, 3 patients had increased CSF VL while blood VL was < 400cp/ml Table 3.�CSF VL was more than 1log above blood VL in the three isolated CSF failure cases."

IAS: CHARTER, Half in US HIV Group Have Neurocognitive Impairment, Which Improves With NNRTIs�-written by Mark Mascolini - (07/29/09)
52% of 1555 HIV-infected people in the US CHARTER cohort had some type of neurocognitive impairment.
Among people with a nadir CD4 count above 200 and an undetectable viral load in blood, about 30% had some degree of impairment. That rate jumped to about 45% to 50% in people with a CD4 nadir above 200 and detectable viral load and in people with a CD4 nadir under 200 and detectable or undetectable viral load.�
-- For the entire cohort, worse neurocognitive impairment correlated with (1) a�lower nadir CD4 count, (2) an AIDS diagnosis, (3) worse comorbidity severity, and (4) taking antiretrovirals (which indicated more advanced HIV infection). For the 843 people in the incidental comorbidity group, worse neurocognitive impairment correlated with (1) nadir CD4 count below 200, (2) nadir CD4 count as a function of viral load, (3) and taking antiretrovirals.
--low�nadir CD4 count may represent "a 'legacy' event whose neurologic consequences persist once triggered." If that speculation proves true, it would be another reason to promote prompter HIV diagnosis and treatment everywhere.

IAS: Persistence and Progression of HIV-associated Neurocognitive Impairment (NCI) in the Era of Combination Antiretroviral Therapy (CART) and the Role of Comorbidities: The CHARTER Study�- (07/30/09)
OBJECTIVE:�To examine the prevalence and predictors of HIV associated NCI in the CART era, within an HIV+ sample reflective of clinic populations with varying degrees of comorbidity.
Having a 'comorbidity' increased by 50-100% the rate of moderate of severe neurocognitive impairment in this analysis within CHARTER. Overall, 52% of patients had mild, moderate or severe cognitive impairment. For patients with 'incidental' comorbidity 40% had 'mild/moderate/severe' NCI, for patients with 'contributing' comorbidity 60% had 'mild/moderate/severe' NCI, and for parients with 'confounding' comorbidity 85% had 'mild/moderate/severe' NCI.
--Of note, patients with nadir CD4 >200 & undetectable plasma HIV RNA had a 30% probability of impairment, patients with nadir CD4 >200 or CD4 nadir <200 & detectable plasma VL had a 50% probability of impairment, and patients with CD4 nadir <200 & & undetectable plasma VL had a 45% risk for impairment. SO detectable viral load in plasma & low nadir CD4 appear to be associated with probability of impairment BUT even if VL in plasma is undetectable if nadir CD$ was <200 there still is 30% probability for impairment. SO what can patients do? There are anecdotally several lifestyle thongs to do: eat a mediterranean diet, vigorous physical exercise, and mental exercise. In this study having�HCV�was associated with neurocognitive decline.

IAS: One Third With Undetectable HIV RNA Have Asymptomatic Neurocognitive Impairment�- written by Mark Mascolini - (07/20/09)
In this study in London, One third of 45 people taking suppressive antiretroviral therapy had asymptomatic neurocognitive impairment on a 40-minute computerized test [1]. younger people studied in this the British HIV clinic appeared to have worse impairment....Fourteen of 45 study participants (31%) had asymptomatic neurocognitive impairment, which affected about half of 24-to-39-year-olds studied but lower proportions of 40-to-49-year-olds, 50-to-56-year-olds, and 57-to-67-year-olds. This correlation with younger age reached statistical significance....investigators speculated that the higher neurocognitive impairment rate in younger adults could reflect their increased susceptibility to HIV's effects on the brain

High rates of asymptomatic neurocognitive impairment (aNCI) in HIV-1 infected subjects receiving stable combination anti-retroviral therapy (CART) with undetectable plasma HIV RNA
L. Garvey^1,2, D. Yerrakalva¹, A. Winston^1,2

¹Imperial College London, Department of Infectious Diseases, London, United Kingdom,�²Imperial College NHS Healthcare Trust, Department of HIV Medicine, London, United Kingdom

Background:�In the post-CART era�neurocognitive�impairment (NCI) remains prevalent and can affect quality of life and adherence to antiretroviral-therapy. A paucity of data exists describing the prevalence of NCI in HIV-1 infected patients stable on CART.�
Aim:�To assess the proportion of HIV-1 infected subjects stable on CART with asymptomatic NCI (aNCI) in a large UK clinic.�
Methods:�Asymptomatic patients receiving CART with plasma HIV RNA < 50 copies/mL for at least 3 months were eligible to participate. A validated computerised�neurocognitive�assessment was performed (CogState^TM). aNCI was defined as per standard criteria: performance greater than 1SD below the age-stratified normative mean in at least two cognitive domains. Factors associated with the presence of aNCI were assessed by linear regression modelling.�
Results:�45 (84% male) subjects participated. Mean age was 48 (SD 11) years and mean current CD4 count 546 (SD 271) cells/uL. aNCI was observed in14/45 (31%) subjects. No statistically significant associations were observed between presence of aNCI and current or nadir CD4 count, time since HIV diagnosis or type of HAART (NNRTI versus boosted PI) (p>0.27 for all observations). Interestingly aNCI was statistically significantly associated with younger age (p=0.03, r=0.32, 95%CI -0.026, -0.01,�see figure 1).

#30041

From: PoWeRTX@...
Date: Thu Jul 30, 2009 9:09 pm
Subject: Fw: HIV ban removal

nelsonvergel

Offline

Put your money where your heart is

Sent via BlackBerry by AT&T

From: "Nebula Li"
Date: Thu, 30 Jul 2009 15:28:38 -0400
Subject: HIV ban removal

**** Apologies for cross-postings ****

Dear colleagues—

We are writing to you because your organization has signed onto letters in the past urging the administration to end the HIV ban on travel and immigration. As you may know, the Department of Health and Human Services has issued proposed regulations to end the ban.

An ad hoc working group of advocates drafted a sign-on letter to submit to the United States Centers for Disease Control and Prevention (CDC) as joint public comment on the proposed regulation to remove the so-called HIV travel ban. Immigration Equality is collecting signatures on our website at http://www.immigrationequality.org/template3.php?pageid=1140. To make the CDC'S August 17th deadline for submission, Immigration Equality is taking signatures through August 12th.

Additionally, if you wish to, you may sign onto our individual comment petition at http://www.immigrationequality.org/template3.php?pageid=1142 .

If you have any questions, please feel free to email me.

--Vickie

Victoria Neilson

Legal Director

Immigration Equality

40 Exchange Place, 17th Flr.

New York, NY 10005

(212) 714-2904 x. 25

vneilson@...

www.immigrationequality.org

#30040

From: "Sanford Gross" <SGross@...>
Date: Thu Jul 30, 2009 7:46 pm
Subject: Re: hemolytic anemia

SGross@...

A problem with which I am becoming increasingly familiar, unfortunately.
I would welcome some discussion from the group on HIV-induced anemia.


Sanford

Sanford M. Gross, OD, FAAO
Associate Professor
Illinois College of Optometry
3241 South Michigan Ave
Chicago, Illinois 60616

>>> <lsmyle@...> 7/30/2009 12:13 PM >>>
Group,
I just spoke to my close friend who it turns out has hemolytic anemia. This guy
has done triathalons up until last month (he's 65!) but has stopped due to the
lack of energy. He, of course, is quite concerned. His anti-viral regimen is
Truvada, Norvir and Reyataz. He has no resistance issues. Any thoughts or
insights?
Larry

1 of 1 File(s)

Sanford Gross.vcf

Reply | Forward | Messages in this Topic (3)

#30039

From: J <ld_ng2003@...>
Date: Thu Jul 30, 2009 7:26 pm
Subject: Re: Re: Fw: M.D.'s in the San Diego, CA area

ld_ng2003

Offline

I used to have Dr. Shamblaw as my physician around 2002. After I became resistant to some meds, he switched me to d4T. A year later I had really bad lipoatrophy and I switched to the other doctor in his practice. Well, the other doctor told me that he had talked repeatedly to Shamblaw about getting his patients off d4T, but he obviously didn't listen. Now everytime I look in the mirror I think of Shamblaw.
Apart from that, on 2 occasions that I had appointments to go over my labs, he came in the examining room and asked me what was wrong. I told him we had to go over the labs, and both time he apologized and said that they hadn't come back yet. So not only did he not even spend 15 seconds to prepare for the visit, but he also wasted half a day of mine both times.
On the plus side, Dr. Shamblaw is very friendly.
I also know that other people have had a very different experience with Dr. Shamblaw, but I don't agree with the previous person who said that "it's time to stop dumping on a guy who is very committed...". Why would users on this board want people to only talk about their good experiences and not their bad ones? What would be the point? Censorship is never a good idea...

From: Roger Ramjet <roger92103@...>
To: PozHealth@yahoogroups.com; hoppefaith@...
Sent: Wednesday, July 29, 2009 6:10:36 AM
Subject: Re: [PozHealth] Re: Fw: M.D.'s in the San Diego, CA area

Shamblaw seems to have a bad rep, in fact when my partner and I started with him he did always seem in a hurry and kind of irritable. But it turns out another doctor in town had died and Shamblaw had taken most of his patients so he was very stressed out, seeing a 150% patient load. Lately he has been good humored and friendly and whenever I go I wait less than 10 minutes. I don't have any investment in who you choose but I think it may be time to stop dumping on a guy who is very committed to the gay and HIV communities in San Diego.

--- On Tue, 7/28/09, hoppefaith@aol. com <hoppefaith@aol. com> wrote:

From: hoppefaith@aol. com <hoppefaith@aol. com>
Subject: [PozHealth] Re: Fw: M.D.'s in the San Diego, CA area
To: PozHealth@yahoogrou ps.com
Date: Tuesday, July 28, 2009, 10:25 AM

I use Houghton,.. I don;t know if he has the hiv ID specialty, but my vl has been unded for years and my care is easy.. For a complex case with treatment resistance,, etc.. I don;t know if I;d use him.. I used to use shamblaw and found him to be always running very late and he was rude.. I;ve been to Caperna for the anal paps and the wait can be long in the clinic.. If you have good insurance (and a complex case.)the VA hospital in san diego does take some patients,, I used to see Douglas Richman, one of the best in the US. Susan Little is also there,.. Mind you.. you do get your blood drawn in a military hospital ,where people might be training and mistakes might happen at the blood draw center, , but at the VA they cover all stuff in the labs like your creatinine clearance levels.. etc.. And those two docs are very good and the setting there is easy and relaxed and on time.. Both those docs are researchers also,, good if your case is complex. Email me if you need more info.. good luck

An Excellent Credit Score is 750. See Yours in Just 2 Easy Steps!

#30038

From: LvrOfNatur@...
Date: Thu Jul 30, 2009 6:59 pm
Subject: swine flu vaccine

rachelsmename

Offline

Hi all,

As people with HIV/AIDS, should we be getting both the swine flu vaccine and the regular flu vaccine?

Rachel

Reply | Forward | Messages in this Topic (7)

#30037

From: versguy <versguy2002@...>
Date: Thu Jul 30, 2009 6:55 pm
Subject: HMO doctor in L.A.

versguy2002

Offline

Can anone recommend a good doctor around hollywood,west hollywood,beverly hills?
I have healthnet hmo.
�

#30036

From: lsmyle@...
Date: Thu Jul 30, 2009 5:13 pm
Subject: hemolytic anemia

larrysmyle

Offline

Group,

I just spoke to my close friend who it turns out has hemolytic anemia. This guy has done triathalons up until last month (he's 65!) but has stopped due to the lack of energy. He, of course, is quite concerned. His anti-viral regimen is Truvada, Norvir and Reyataz. He has no resistance issues. Any thoughts or insights?

Larry

Reply | Forward | Messages in this Topic (3)

#30035

From: Nelson Vergel <nelsonvergel@...>
Date: Thu Jul 30, 2009 4:13 am
Subject: Tell Congress to Make Health Care Reform Work for People With HIV/AIDS!

nelsonvergel

Offline

Tell Congress to Make Health Care Reform Work for People With HIV/AIDS!

June 19, 2009

Health care reform is moving fast through Congress, and provisions are at risk that would protect people living with HIV and AIDS, as well as those living with HIV/viral hepatitis coinfection. Opponents are citing high costs, but the reality is that 50% of people living with HIV and AIDS in the U.S. do not have regular health care!

Health care is a human right, and a critical investment for healthy families, a healthy work force and a healthy economy. Your help is vital NOW to ensure Senate committees keep key components of the legislation that protect people living with HIV and AIDS.

How you can help: CALL your two U.S. Senators in their Washington, DC office. Ask to speak to the staff person who handles HIV and health care issues. You might get their voicemail, or you might speak to them in person. Either way, tell them:

"My name is ____________ and I live in (city/state). I am very concerned that health care reform will not meet the needs of people living with HIV/AIDS. Any final health care legislation must eliminate the disability requirement for Medicaid and ensure that all low-income people, including childless adults, have early access to care. It must also include language from the Early Treatment for HIV Act which expands access to Medicaid for people living with HIV. Finally, it must have a public plan option to best ensure affordable access to comprehensive care for people with HIV. All three provisions are crucial to ensure that people with HIV/AIDS have early access to care and treatment that keep them healthy and productive. I urge Senator ______________ to do everything in his/her power to fight for these important provisions."

You can reach your senators by calling the Capitol Switchboard at 1-202-224-3121. If you don't know who your Senators are, go to www.congress.org and enter your zip code in the upper right corner. Phone calls are particularly effective because Congress is moving quickly. However, if you prefer to send an email, go to your Senator's website (linked from www.senate.gov). You will find instructions on sending emails to that office. Cut and paste the phone message, make sure your name and the Senator's name is included, and add a short personal note explaining why this issue is important to you.

The move to reform health care in the United States must ensure that everyone living with HIV benefits from early and reliable access to lifesaving care and treatment. Coordinated action by our entire community is needed to make sure Congress knows how important these three core provisions are for all of us:

Expanding Medicaid for all low-income people, including childless adults, by eliminating current requirements that tie Medicaid to disability status. This would give approximately 42% of all people living with HIV who are currently uninsured immediate access to health care through Medicaid.

Including Early Treatment for HIV Act (ETHA) language which gives states the option to expand Medicaid access to low-income people living with HIV whose incomes are above established Medicaid income eligibility rules. This will give states the option to expand coverage for people living with HIV/AIDS, reaching more than 75% who are currently uninsured.

Including a strong public plan option to help provide affordable access to comprehensive care for people HIV - nearly 30 percent of whom have no insurance. This would offer a national standard for coverage and greater dependability, consistency and security for people with HIV than private plans, which can charge higher prices and/or close, merge or change benefits at will.

All three of these priorities are crucial to ensure the best possible expansion of care and treatment for people with HIV/AIDS and must be part of any final health care reform package.

Decisions are being made quickly and Congress needs to hear directly from people who are most impacted by this legislation. Please take a minute to make two important phone calls today!

For more information: Go to www.taepusa.org for background information and analyses of various health care reform proposals and the impact on people with HIV/AIDS.

This article was provided by Treatment Action Group.

Regards,

Nelson Vergel
powerusa dot org

#30033

From: James Finegan <jrfinegandc@...>
Date: Wed Jul 29, 2009 10:30 pm
Subject: RE Need help with major muscle pain

JRFineganDC

Offline

I had similar problems and a similar regime three years ago.  As it advanced I
began to fail dramatically.  It ultimately turned out to be statins, first
Lipitor and then Crestor.  It took about 6 weeks to begin to recover after
coming off them.  Talk to your cardiologist first!

#30032

From: PoWeRTX@...
Date: Wed Jul 29, 2009 11:11 am
Subject: Fwd: NATAP/IAS: Metabolic Complications-Pablo Tebas MD

nelsonvergel

Offline

NATAP http://natap.org/
_______________________________________________

Metabolic Complications of HIV infection Update form the 5^th IAS Conference in Cape Town

Pablo Tebas MD, University of Pennsylvania

The 5th IAS Conference on HIV Pathogenesis, Treatment and Prevention (IAS 2009) took place in Cape Town, South Africa between July 19th and the 22nd of 2009. The event is organized by the IAS, in partnership with South African-based NGO, Dira Sengwe.

This conference, which alternates with the International AIDS conference every other year, is smaller in size and more focused on the scientific aspects of the HIV infection than the International AIDS Conference, which took place in Mexico City last summer and will be in Vienna next year. The last of these International AIDS Conferences in the US was in 1990 in San Francisco California. Since then they have been boycotted in protest of a law that was passed in 1987 that restricted access to the US to patients living with HIV. It has taken more than 20 years for that legislation to be repealed. Last year WECA103, 2009. our US Congress voted to repeal the 1987 restrictions on HIV-positive immigrants as part of a package of AIDS reforms proposed by President George W. Bush (although I am not a fan of GW, “give Caesar what belongs to Caesar”). The Obama administration hopefully will take the last steps in repealing this absurd law. Many of us hope that this will mean the return of this conference to the US, which will provide a symbolic gesture of the return of the US to regular club of nations that do not restrict the access to patients living with HIV infection. The CDC is seeking public comment on the new normative till August and then the foolishness of this rule will finally be over.

This was a very well organized conference with some important presentations that have the potential of changing practices across the globe. I will mention briefly them, although they will not be the focus of this article, as they will be discussed by others. The most important study was the CIPRA HT 101 , presented by Fitzgerald et al. ¹ that demonstrated that starting therapy between 200 and 350 CD4 cells/mm3 not only decreases the incidence of tuberculosis, but also death. This study settles the issue of when to start antiretroviral therapy in the developing world –when the CD4 is below 350- and moves the question to how international and domestic programs across the globe are going to implement that new recommendation in the middle of the economic recession that we have now. Starting therapy earlier is probably even more important in the developing world than in developed countries because HIV positive individuals do not have the cushion of a reasonable Health system. The other two studies that I think were very important are: 1) the Mma Bana study from Botswana ²that showed that giving HAART to the mother during breastfeeding can decrease the incidence of HIV in the baby to very low levels (1%), similar to the numbers we are accustomed to in the developed world. 2) the BAN study³ from Malawi that showed that by giving nevirapine to the breastfeeding baby (and not necessarily treating the mother, can reduce transmission to 2%. This strategy is easier to implement, as the cost is clearly smaller than the Mma Bana approach.

The conference was framed by two impressive speakers. The first day the former president of South Africa, and current Deputy President, took the podium. Kgalema Petrus Motlanthe was president for a few months after Mbeki left power during the fall of 2008, and until the new president Zuma took over in May of 2009. Motlanthe, like Mandela, was a prisoner in Roben Island, only a few miles from the Conference Center and a reminder to all of us of the dark years of apartheid in this beautiful country. In contrast with his predecessor that during the first years of presidency gave an ear to some HIV denialists, Molanthe from the beginning, wanted to address the problem of HIV in South Africa from a scientific perspective. His speech was moving and political, as expected in these meetings. The last day of the conference, Nelson Mandela’s wife, Graca Machel, an activist for women’s and children’s rights, took the podium and gave an impassioned speech asking the developing world and the G8 to live to their commitments and to African governments to take care of their citizens. Her speech was one of the highlights of the conference from the political point of view.

Lets get back to business. I will focus in what I thought were the most important metabolic presentations of the meeting. As expected the session about metabolic complications was over taken by presentations related to the presumed increased risk of MI after abacavir use that have dominated these discussions for the last 18 months.

Dominique Costagliola, the lead investigator of the French ANRS CO4 study, presented last February in CROI, was asked to summarize the state of the knowledge regarding abacavir and cardiovascular risk4. Her presentation was a real shocker, as she was very, very critical about the evidence that sustain that abacavir use is associated with increased cardiovascular risk. If you remember, Dominque Costagliola presented data from the ANRS that seemed to confirm to some degree the association of abacavir and MI. This time she basically said that her original data did not show an association between abacavir and MIs, that it looked that there was an association because they sliced the data further after they found no association between abacavir and MIs only because DAD had suggested that there was an association, and that she believes that there are reasons why people chose abacavir over tenofovir that give the appearance of an increased CVD risk when using abacavir. It really sounded like a retraction, and I think everybody was surprised. Although she did not explain clearly the reasons behind her change in position, it seems that on further analysis of the French cohort study, if IVDU (intravenous drug use) was controlled, there was no association of abacavir and MI… It is well known that IVDU, particularly cocaine, is associated with cardiovascular risk. So the association that they observed in the ANRS study may be explained by intravenous drug use. For reasons that I do not quite get, if you are an IVDU in France you are more likely to receive abacavir than if you are not. (from Jules: she told me when they eliminated patients with current cocaine use & IVDU from the analysis of the database abacavir was no longer associated with MIs). Another of her comments focused on the role that ongoing HIV viremia has in cardiovascular events.

Then, Roger Bedimo presented data from the VA cohort⁵, a large observational cohort with more than 19000 patients and 278 myocardial infarctions. In this study there was no clear association between abacavir use and MI (cumulative use). In a non adjusted statistical analysis the use of abacavir was associated with a marginally (non) significant increased risk of heart attack (hazard ratio [HR] 1.27, or 27% increased risk). However, after adjusting for chronic kidney disease, the main reason why clinicians use abacavir over tenofovir the association attenuated and became non significant. The association attenuated even further after controlling for traditional heart disease risk factors. The study also pointed out that abacavir was more likely used in individuals with chronic kidney disease, and that chronic kidney disease was associated with myocardial infarction.

These two presentations clearly showed the main problem of observational cohorts: their inability to control for unknown bias that “drift” the use of a particular drug to a particular population, that may be associated with a particular outcome and at the end gives the impression that the drug is associated with that particular event. Clinicians and researchers should look at observational cohorts with extreme care, as it is very easy to reach the wrong conclusion. As an example, DAD published in the year 2007 that being on antiretroviral therapy (particularly protease inhibitors) was a risk factor to have a myocardial infarction, however we know that stopping antiretroviral therapy increases your cardivovascular risk. Looking at the original data you would think that stopping therapy should be a good thing regarding cardiovascular risk, and the SMART study was based in part on the assumption that the use of antiretroviral therapy was associated with significant metabolic toxicities, so that it would be reasonable to try to minimize total drug exposure, however stopping therapy was clearly not the answer to the problem of metabolic toxicities associated with ART treatment. Things are much more complicated than that.

There was a poster from the Quebec cohort that presented evidence that seemed to corroborate DAD observations regarding abacavir and MI risk⁶. In that study, 125 MIs in HIV infected patients were matched with 1084 controls. The use abacavir, didanosine, stavudine, zalcitabine and PIs lopinavir and ritonavir associated with increase in MI risk. The study did not control for chronic kidney disease and attempted to control for traditional risk factors by looking at the concomitant use of treatment drugs like antihypertensive, antidiabetic, lipid lowering or antiplatelet medications. No other more robust attempts to control bias were included in this study.

Causality is a complicated business and requires more than a statistical association. Sir Bradford Hill, a British mathematician, outlined many years ago the minimal conditions needed to establish a causal relationship between two things. They include the strength of the association, the consistency, the specificity, the temporality, the biological plausibility, the dose response, experiment and analogy. A full discussion of these criteria is beyond the scope of this review, but my point is that if any clinician or researcher reviews critically the evidence linking abacavir use to myocardial infarctions, it is clear the evidence has not proven causality yet, and may never be able to do so.

If abacavir is associated with MIs, the next step is to find out what is the biological mechanism; what is the biological plausible explanation that would justify this increased risk? The evidence presented so far has not been consistent in this regard either. During the meeting a secondary analysis of the BICOMBO study was presented that tried to address the biological plausibility question. In this study individuals with well controlled viral replication were randomized to switch to an abacavir containing regimen or a tenofovir containing regimen.

Esteban Martinez et al. ⁷looked at changes in markers of inflammation, glucose metabolism and coagulation ( C-reactive protein, monocyte chemottractant protein-1, osteoprotegrin, adiponectin, IL-6, IL-10, tumor necrosis factor-alpha, ICAM-1, VCAM-1, selectin E and P, D-dimer, and insulin) and showed no difference between the arms (or within the arms). The study is small and somewhat underpowered to provide the final answer, but definitely does not suggest that there is a clear mechanism to explain the presumed increased cardiovascular risk associated with abacavir use.

There were other interesting “metabolically related” studies that cached my eye that fortunately were outside the abacavir wars:

Low vitamin D levels are extremely common among HIV positive individuals and the general population. In a study of 1007 patients from England⁸, the prevalence of very low levels of vitamin D was very high (35%) and was associated with black race, use of NNRTIs, evaluation during winter time and low CD4 count. Remember that association does not mean causation, so NNRTI use does not necessarily is the cause of low vitamin D…The study is important because it contributes a large, diverse cohort, to the well known evidence at this point that the presence of hypovitaminosis D is extremely frequent in the HIV infected population.

Another important study looked at the prevalence of low bone mineral density among participants of ART as prevention trials in Botswana(PrEP trials)⁹. Most of the currently ongoing trials of pre-exposure prophylaxis use tenofovir as the main component of the intervention. Little is known about the bone effects of tenofovir in a healthy, HIV negative population, or for that matter, the frequency of osteopoenia and osteoporosis among Africans. The study showed a low BMD in ≥1 anatomic site in 123 (57%) of the participants, which should bring a word of caution to these trials and its future implementation. However, it was not clear to me what was the standard population they were using to obtain the T scores. If they were using a North American population (as it looks like they did) , that may not be completely adequate and can profoundly affect the results of this study.

There have been several promising studies suggesting that the use of uridine in patients with lipoatrophy ^10-11 can quickly reverse it. The way that uridine works is by replenishing the nucleoside reservoirs that have been “depleted” by the continuous use of thymidine analogs. Uridine theoretically should work better if the patient is receiving thymidine analogs (ZDV or D4T), something that is not very likely anymore, as several studies have demonstrated that discontinuing the use of thymidine analogs improves subcutaneous fat. A. Calmy and the group of Andrew Carr in Australia conducted a small randomized trial evaluating the use of uridine, alone or in combination with pravastatin in patients with lipoatrophy that have discontinued the use of thymidine analogs. They were unable to demonstrate a consistent effect of uridine, pravastatin or both in subcutaneous fat in this particular population. The final answer to the utility of uridine, if any, for lipoatrophy will come from a large, ongoing ACTG study (ACTG A5229, clinical trials.gov # NCT00307164), that I hope will be presented soon. Dr. Rao and Mulligan form San Francisco are also conducting a smaller study evaluating escalating doses of uridine (clinical trials.gov #NCT00471614), that might also provide some light on this issue.

I just want to end stating that this was a great conference, perfectly organized, with some ground breaking presentations that made the trip to this beautiful country well worthwhile from the scientific perspective.

Bibliography

1.   Daniel Fitzgerald et al. When to start ART in developing countries . Program and abstracts of the 5th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention; July 19-22, 2009; Cape Town, South Africa. Abstract WESY201

2.   Shapiro R et al. A randomized trial comparing highly active antiretroviral therapy regimens for virologic efficacy and the prevention of mother-to-child transmission among breastfeeding women in Botswana (The Mma Bana Study). Program and abstracts of the 5th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention; July 19-22, 2009; Cape Town, South Africa. Abstract WeLLB101

3.   Chasela C, Hudgens M, Jamieson D, et al. Both maternal HAART and daily infant nevirapine (NVP) are effective in reducing HIV-1 transmission during breastfeeding in a randomized trial in Malawi: 28 week results of the Breastfeeding, Antiretroviral and Nutrition (BAN) study. Program and abstracts of the 5th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention; July 19-22, 2009; Cape Town, South Africa. Abstract WELBC103.

4.   Dominique Costagliola. The current debate on abacavir; risks and relationship between HIV viremia and cardiovascular events. Program and abstracts of the 5th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention; July 19-22, 2009; Cape Town, South Africa. Presentation MOAB201

5.   Bedimo R et al. Abacavir use and risk of acute myocardial infarction and cerebrovascular disease in the HAART era. Program and abstracts of the 5th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention; July 19-22, 2009; Cape Town, South Africa. Abstract MoAb202.

6.   Durand M, Sheehy O, Baril JG, Lelorier J, Tremblay C. Relation between use of nucleosidic reverse transcriptase inhibitors (NRTI) and risk of myocardial infarction (MI): a nested case control study using Quebec’s public health insurance database (QPHID). Program and abstracts of the 5th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention; July 19-22, 2009; Cape Town, South Africa. Abstract TUPEB175.

7.   Martinez E et al. No evidence for recent abacavir/lamivudine use in promoting inflammation, endothelial dysfunction, hypercoagulability, or insulin resistance in virologically suppressed HIV-infected patients: a substudy of the BICOMBO randomized clinical trial (ISRCTN61891868). Program and abstracts of the 5th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention; July 19-22, 2009; Cape Town, South Africa. Abstract MoAb203.

8.   Welz T, Childs K, Ibrahim F, Poulton M, Post F. Efavirenz use is associated with severe vitamin D deficiency in a large, ethnically diverse urban UK cohort. Program and abstracts of the 5th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention; July 19-22, 2009; Cape Town, South Africa. Abstract TUPEB186.

9.   Bone mineral density (BMD) in a population of healthy HIV-negative young African adults enrolling in a pre-exposure prophylaxis (PrEP) trial in Botswana. Program and abstracts of the 5th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention; July 19-22, 2009; Cape Town, South Africa. Abstract WECA103.

10.                 Walker UA, Venhoff N. Uridine in the prevention and treatment of NRTI-related mitochondrial toxicity. Antivir Ther. 2005;10 Suppl 2:M117-23. Review.

11.                 Walker UA, Langmann P, Miehle N, Zilly M, Klinker H, Petschner F. Beneficial effects of oral uridine in mitochondrial toxicity. AIDS. 2004 Apr 30;18(7):1085-6.

12.                 A. Calmy, M. Bloch, H. Wand et al. No effect of uridine or pravastatin for HIV lipoatrophy in men who have ceased thymidine nucleoside analogue therapy: a randomized trial. Program and abstracts of the 5th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention; July 19-22, 2009; Cape Town, South Africa. Abstract TUPEB169

_______________________________________________
NATAP nataphcvhiv mailing list -- nataphcvhiv@...

This is an annoucement-only mailing list. Do not reply.

To unsubscribe: send a blank email to nataphcvhiv-request@... with a subject of unsubscribe.

For more information, see http://seven.pairlist.net/mailman/listinfo/nataphcvhiv

_______________________________________________

#30031

From: "gamsfo94108" <gamsfo94108@...>
Date: Wed Jul 29, 2009 4:33 pm
Subject: M.D.'s in the San Diego, CA area

gamsfo94108

Offline

Thank you and much appreciation to all of you who offered your advise regarding
the above.

Reply | Forward | Messages in this Topic (2)

#30030

From: PoWeRTX@...
Date: Wed Jul 29, 2009 10:56 am
Subject: Fwd: NATAP: FDA WARNS-Body Building Products Marketed as Containing Steroids/...

nelsonvergel

Offline

NATAP http://natap.org/
_______________________________________________

FDA Warns Consumers Not to Use Body Building Products Marketed as Containing Steroids or Steroid-Like Substances

FDA NEWS RELEASE

For Immediate Release: July 28, 2009

Media Inquiries: Christopher Kelly, 301-796-4676, christopher.kelly@...
Consumer Inquiries: 888-INFO-FDA

Agency issues Warning Letter to American Cellular Laboratories for marketing and distributing potentially harmful steroid-containing products

The U.S. Food and Drug Administration today issued a Public Health Advisory (PHA) warning consumers to stop using body building products that are represented as containing steroids or steroid-like substances. Many of these products are marketed as dietary supplements.

The agency also issued a Warning Letter to American Cellular Laboratories Inc. for marketing and distributing body building products containing synthetic steroid substances. Although these products are marketed as dietary supplements, they are not dietary supplements, but instead are unapproved and misbranded drugs.

The PHA notifies consumers and health care professionals that the FDA has received reports of serious adverse events associated with the use of body building products that claim to contain steroids or steroid-like substances. Those adverse events include cases of serious liver injury, stroke, kidney failure and pulmonary embolism (artery blockage in the lung). The PHA also advises consumers to stop taking body building products from any manufacturer that claim to contain steroid-like substances or to enhance or diminish androgen-, estrogen-, or progestin-like effects in the body.

The FDA has received five adverse event reports, including serious liver injury, in men taking products marketed as dietary supplements by American Cellular Laboratories including TREN-Xtreme and MASS Xtreme. Acute liver injury is generally known to be a possible side effect of using products that contain anabolic steroids. Some of the cases resulted in hospitalization, but there were no reports of death or acute liver failure.

�Products marketed for body building and claiming to contain steroids or steroid-like substances are illegal and potentially quite dangerous,� said Commissioner of Food and Drugs Margaret A. Hamburg, M.D. �The FDA is taking enforcement action today to protect the public.�

The products listed in the Warning Letter to American Cellular Laboratories Inc., include �TREN-Xtreme,� �MASS Xtreme,� �ESTRO Xtreme,� �AH-89-Xtreme,� �HMG Xtreme,� �MMA-3 Xtreme,� �VNS-9 Xtreme,� and �TT-40-Xtreme,� and are sold on the Internet and in some stores. These products, which claim to contain steroid-like ingredients but in fact contain synthetic steroid substances, are unapproved new drugs because they are not generally recognized as safe and effective. In addition, the products are misbranded because the label is misleading and does not provide adequate directions for use.

Consumers taking body building supplements that claim to contain steroids or steroid-like substances should stop taking them immediately. Consumers should also consult a health care professional if they suspect they are experiencing problems associated with the products. Health care professionals and consumers are encouraged to report adverse events that may be related to the use of these types of products to the FDA's MedWatch Program by phone at 1-800-FDA-1088 or by fax at 1-800-FDA-0178 or by mail at MedWatch, HF-2, FDA, 5600 Fishers Lane, Rockville, MD 20852-9787.

To view the Public Health Advisory:
http://www.fda.gov/Drugs/DrugSafety/PublicHealthAdvisories/ucm173935.htm

To view the July 27, 2009 Warning Letter to American Cellular Laboratories Inc., and the FDA consumer article on body building products marketed as containing steroids or steroid-like substances:
http://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/ucm173965.htm

_______________________________________________
NATAP nataphcvhiv mailing list -- nataphcvhiv@...

This is an annoucement-only mailing list. Do not reply.

To unsubscribe: send a blank email to nataphcvhiv-request@... with a subject of unsubscribe.

For more information, see http://seven.pairlist.net/mailman/listinfo/nataphcvhiv

_______________________________________________

#30029

From: Roger Ramjet <roger92103@...>
Date: Wed Jul 29, 2009 1:10 pm
Subject: Re: Re: Fw: M.D.'s in the San Diego, CA area

roger92103

Offline

From: hoppefaith@... <hoppefaith@...>
Subject: [PozHealth] Re: Fw: M.D.'s in the San Diego, CA area
To: PozHealth@yahoogroups.com
Date: Tuesday, July 28, 2009, 10:25 AM

I use Houghton,.. I don;t know if he has the hiv ID specialty, but my vl has been unded for years and my care is easy.. For a complex case with treatment resistance,, etc.. I don;t know if I;d use him.. I used to use shamblaw and found him to be always running very late and he was rude.. I;ve been to Caperna for the anal paps and the wait can be long in the clinic.. If you have good insurance (and a complex case.)the VA hospital in san diego does take some patients,, I used to see Douglas Richman, one of the best in the US. Susan Little is also there,.. Mind you.. you do get your blood drawn in a military hospital ,where people might be training and mistakes might happen at the blood draw center, , but at the VA they cover all stuff in the labs like your creatinine clearance levels.. etc.. And those two docs are very good and the setting there is easy and relaxed and on time.. Both those docs are researchers also,, good if your case is complex. Email me if you need more info.. good luck

An Excellent Credit Score is 750. See Yours in Just 2 Easy Steps!