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What Causes Sarcoidosis?
 Moderated by: Prof Trevor Marshall Page:  First Page Previous Page  1  2  3   
 

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Prof Trevor Marshall
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Joined: Fri Jul 9th, 2004
Location: Thousand Oaks, California USA
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 Posted: Sat Nov 5th, 2011 17:55

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:)

be-well
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 Posted: Fri Mar 30th, 2012 07:45

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Chen and Moller's most recent paper on Sarcoidosis seems to summarise its findings with a message that says, well yes there is great progressive strides in understanding pathogenesis, but actually its not worth writing home about so lets leave it at that until the answers we seek knock on our door and say 'boo'.

Their first paper can be interpreted as a solid watertight basis to recommend immunostimulation as the most logical next step, particularly for those who are not in the latter stages of progressive th1 disease and therefore in a position to make faster progress, thus validating the pathway to recovery for others to consider.  The second then kills that off with its clinical directive to continue prescribing steroids as the only safe, sensible intervention even though they add, their role "remains uncertain".

What is it they are just not 'getting' if they are familiar with a MP intervention structure. I assume they have articulated their reservation at some point.  Is it partly due to the long years of universal reliance on steroids which feed into a faster disease progression and conceal  inflammatory data,  that has encouraged a lack of 'fire in the belly' for doctors to say hey, this really looks promising, let's give it a whirl, let's discuss it with our patients ?

Last edited on Fri Mar 30th, 2012 08:04 by be-well



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mcs,chronic fatigue,hiatus hernia,osteopenia, polycystic liver,grains intolerance,tinnitus,photosensitivity.
|25-D-3.3.-1,25D-58. 25-D-3.3.- 1,25D-70.Dec 2014.
Prof Trevor Marshall
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Joined: Fri Jul 9th, 2004
Location: Thousand Oaks, California USA
Posts: 15733
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 Posted: Fri Mar 30th, 2012 08:00

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The 'fire in the belly' is an issue, as Dr Om Sharma, from USC, effectively controls publication of any paper with 'sarcoidosis' in the title. Dr Sharma is the universally recognized peer-reviewer for sarcoidosis papers, and is on the editorial board of just about every pulmonology journal. Anger him, and you lose your path to publishing, your path to success.

But the problem runs deeper than that. Most pulmonologists have tried everything (their words). For example, Moller and Chen were trialling a minocycline /doxycycline therapy at one point. It didn't work. Therefore, microbes can't possibly be the cause of the disease (do you understand their logic in drawing that conclusion?). Similarly, the MP can't possibly work, either (by the same logic).

There is a simplicity in 20th Century clinical medicine which many physicians seem to hold dear. They need to release this, if they are to be successful in the 21st Century, but most seem to think that maintaining the status-quo should be their career goal.

Neither Moller or Chen have ever bothered to email or phone me, or contact any of my colleagues :X

..trevor..
 

wrotek
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 Posted: Sat Mar 31st, 2012 04:13

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It is amazing how they define success.

I once got letter from pulmunologist, asking for informations, who does biopsies for sarc patients and was himself diagnosed with sarc.



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Freddie Ash
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Joined: Fri Apr 8th, 2005
Location: LeSage, West Virginia USA
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 Posted: Sat Mar 31st, 2012 08:05

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HI ALL

This is Fred in  WV.  My family doctor once (since I have been on the MP) to tell him how to diagnose another doctor patient of his with sarcoidosis.

Remember, we are all in this together and I am pulling for us.

Your friend in Sarcoidosis
Freddie



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be-well
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 Posted: Mon Apr 2nd, 2012 10:46

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" there are no clinically useful biomarkers that can assist the clinician in diagnosis, prognosis or assessment of treatment effects" (chen/moller). 

To claim stagnation at such close quarters for a promising way forward in treatment defies logic, particularly because both doctors will no doubt be familiar with the sum total of universal mortality and suffering from the  standard palliation.

Sarcoidosis does not belong exclusively to men of medicine.  Everyone whose life has been touched by it, has a vested interest.

I am familiar with the godlike aura of some 'status quo' clinicians over the years.  But what I have noticed more recently here in UK is a definate confusion about the subject of 'vitamin' D and more care in the benefit to risk equation before prescribing steroids.   A caution has been nurtured which is here to stay and more docs are delving deeper.  Things are moving!

I think pure Olmesartan will bring a closer more careful scrutiny to a wider audience in the very near future.











Last edited on Mon Apr 2nd, 2012 10:53 by be-well



____________________
mcs,chronic fatigue,hiatus hernia,osteopenia, polycystic liver,grains intolerance,tinnitus,photosensitivity.
|25-D-3.3.-1,25D-58. 25-D-3.3.- 1,25D-70.Dec 2014.

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