Unnecessary carotid surgery for asymptomatic atheroma

"Pending the completion of CREST-2, we think that it would be desirable for interventionists and surgeons to forgo stenting and endarterectomy in low-risk asymptomatic patients outside that trial. This restraint would not only spare patients from procedures that may be unnecessary, but it should also facilitate early completion of the trial (and so avoid the fate of SPACE-2), so that it may be possible to identify which patients will benefit from an intervention rather than medical therapy alone in an evidence-based rather than an eminence-based manner."

http://www.ncbi.nlm.nih.gov/pubmed/26890473

The only advice is: take a second advice!

"Evidence now suggests that the annual rate of ipsilateral stroke may be as low as 0.5 to 1%8 — a rate that is very similar to that observed in ACT I and CREST after successful stenting or endarterectomy."

The other issue about carotid plaque is to assess the status of the plaque surface. For instance in ACS a small trial is testing DAPT instead of stents:
http://www.medscape.com/viewarticle/868367?src=wnl_tp10n_161007_mscpedit_ous&uac=7267HX&impID=1210486

https://clinicaltrials.gov/show/NCT02041650?link_type=CLINTRIALGOV&access_num=NCT02041650

The declining death rate of breast cancer: stop the lies about conventional treatment inefficiency

Breast cancer

Ecouter d'abord ce que dit Philippot. Ensuite se faire une idée de ce qui est possible.

https://youtu.be/nHR5ALf3Xls

Skullcap and the OR

http://www.medpagetoday.com/HospitalBasedMedicine/GeneralHospitalPractice/59872?xid=NL_breakingnews_2016-08-26&eun=g432148d0r

Live medicine in a country impoverished by socialism

http://www.nytimes.com/2016/05/16/world/americas/dying-infants-and-no-medicine-inside-venezuelas-failing-hospitals.html?hp&action=click&pgtype=Homepage&clickSource=story-heading&module=first-column-region&region=top-news&WT.nav=top-news&_r=1

Innovation and telemedicine

http://www.caretakermedical.net/caretaker/

CRISPR

http://www.fiercebiotech.com/research/guide-to-crispr-cas9-gene-activation-could-lead-to-new-therapies

http://www.nytimes.com/2016/05/14/science/synthetic-human-genome.html?hp&action=click&pgtype=Homepage&clickSource=story-heading&module=first-column-region&region=top-news&WT.nav=top-news&_r=1

https://www.newscientist.com/article/2088703-why-would-scientists-want-to-build-human-genomes-from-scratch/

Good sense: secure France and our borders before going abroad!

https://www.facebook.com/sniper.overland/videos/1402237066459518/

It is so obvious that the choices of our ruling class are particularly suspect 

Find it by tracking it!

https://buy.thetrackr.co/gu/special-offers/06/?utm_source=2420&utm_medium=cpa&utm_term=35516197&utm_content=321&utm_campaign=GU&aff_id=2420&camp_id=11606&clk_id=35516197&sub_id=cpa

Glyphosate: un article dénué de toute valeur ajoutée car pollué par l'idéologie verte et rouge

Le glyphosate à nouveau autorisé en Europe pour dix-huit mois. La Commission européenne a renouvelé l'agrément de l'herbicide controversé, faute d'accord entre les Etats membres


C'est la conclusion de quinze mois de bataille. La Commission européenne a annoncé, mercredi 29 juin, le renouvellement de l'autorisation en Europe du glyphosate, principe actif controversé du célèbre Roundup et d'un grand nombre d'herbicides, pour une période de dix-huit mois au maximum. Les commissaires ont pris cette décision malgré la résistance de certains Etats membres.


Après plusieurs reports, les Etats n'avaient toujours pas réussi à se mettre d'accord lors d'une dernière réunion d'experts le 24 juin. Dix-neuf pays avaient voté en faveur de la proposition de la Commission de renouveler provisoirement le glyphosate. Mais l'abstention de sept Etats (Allemagne, Italie, Portugal, Grèce, Autriche, Bulgarie, Luxembourg) et le vote contre de la France – qui fait évoluer sa position de l'abstention vers un vote négatif – et de Malte ont bloqué toute décision, empêchant de trouver une majorité qualifiée. Celle-ci est atteinte lorsque 55 % des Etats membres, représentant 65 % de la population européenne, votent une proposition.


Mercredi, l'exécutif européen a expliqué, dans un communiqué, avoir " décidé de prolonger l'autorisation du glyphosate pour une période limitée, jusqu'à ce que l'Agence européenne des produits chimiques publie son avis, au plus tard à la fin de 2017 ", rendant responsables de cette décision les Etats membres qui n'ont pas été capables de " prendre leurs responsabilités ".


" Cancérogène probable "


Le commissaire européen à la santé, Vytenis Andriukaitis, avait annoncé cette décision dès mardi, à l'occasion d'un sommet des ministres de l'agriculture. L'autorisation du produit arrivant à échéance jeudi, la Commission devait trancher, au risque de voir cet herbicide, le plus utilisé dans les champs européens, interdit de fait dans l'Union européenne.


Les commissaires ont toutefois proposé des restrictions sur l'usage de cette substance, notamment dans les jardins publics et les parcs, et comme traitement préalable à la récolte pratiqué sur des cultures destinées à la consommation. Un adjuvant utilisé avec le glyphosate, le PŒ-tallowamine, a été interdit.


Ces restrictions ne donnent que plus de poids à ceux qui dénoncent la dangerosité de ce produit, considéré comme " cancérogène probable " par le Centre international de recherche sur le cancer de l'Organisation mondiale de la santé, l'Autorité européenne de sécurité des aliments ayant quant à elle estimé " improbable que cette substance soit cancérogène ".


Dès la décision européenne confirmée, les protestations se sont multipliées. " La Commission aurait dû interdire cette substance (…) et ainsi faire prévaloir la santé des Européens sur les préoccupations strictement pécuniaires de l'industrie chimique ", a déclaré Michèle Rivasi, la vice-présidente écologiste du Parlement européen. La ministre de l'environnement française, Ségolène Royal, rappelle de son côté que " le travail a été fait, la France a voté -contre ". " Le glyphosate a quand même du plomb dans l'aile, et son autorisation n'est plus que de dix-huit mois, au lieu de quinze ans - comme le prévoyait à l'origine la Commission - ", a ajouté la ministre. Cette réduction de la durée d'autorisation irrite d'ailleurs les professionnels regroupés dans le Groupe de travail sur le glyphosate, qui dénonce des " considérations politiques ".


Rémi Barroux

© Le Monde

Article publié avec l'aimable autorisation du Monde et de Rémi Barroux

http://www.lemonde.fr/idees/article/2016/06/23/glyphosate-et-si-tout-n-etait-qu-un-theatre-d-ombre_4956640_3232.html
Intéressant mais non sourcé sur le plan scientifique.


Voir aussi http://www.lemonde.fr/pollution/article/2016/06/29/la-commission-europeenne-autorise-le-glyphosate-a-repartir-pour-dix-huit-mois_4960635_1652666.html

https://www.geneticliteracyproject.org/2016/05/17/contradicting-iarc-world-health-organization-says-glyphosate-unlikely-to-cause-cancer/

https://www.anses.fr/fr/system/files/SUBCHIM2015sa0093.pdf

http://www.glyphosateeu.fr/histoire-du-glyphosate

Sex (XX and XY genomes) and brain differences

http://journal.frontiersin.org/article/10.3389/fneur.2016.00087/full

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3969295/

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2711771/

Genrism is just a trend to get funding from tax payer money with the PC stamp!

No it is not a choice you are genetically brain wired!

Taxation is not a solution to the vices of citizens

Tax an individual or a company, is to force him to pay an amount proportional to general income or assets. All political systems have recourse to taxation.
"I will give you seed, and you shall sow your fields, so you can collect grains. Ye shall give the fifth part to the king; and I give you the four others to sow the land and to feed your families and your children "(Genesis 47: 24), the Bible says.

If taxation is old, the use of taxes varies by political systems. In France, in 2014, those resources (44.7% of gross domestic product - GDP) are used to finance the sovereign functions of the state and the welfare state (31.9% of GDP).

Moreover, the notion of vice is closely linked to moral and refers to religious prohibitions. It was called vice in view of the evil temptation was requalified by science "addiction". Addiction to substances, such as nicotine, or practices such as gambling, or behaviors such as compulsive overeating.

Nicotine is a psycho-stimulant present in tobacco leaves whose effects are, as for the coca leaf, long known. From the industrial age, smoked tobacco consumption has grown, pyrolysis for taking more nicotine you inhale. Vice to addiction, the transition is not neutral. In the first, the individual is responsible for his choices in life; in addiction, the individual's responsibility can be reduced on the grounds that we are not equal before the addiction.

Prohibition encourages smuggling

The particular penchant for addictions or morally reprehensible behaviors are subject to a ban (prohibition) or taxation. History shows that the prohibition does not eliminate the vice. In France, cannabis is prohibited, but it is consumed by many French people, including teenagers. Like heroin, cocaine is banned, but consumption has never been removed, and if it has fallen, it is due to the appearance on the market of other synthetic drugs equally prohibited.

It is therefore surprising that some doctors call for ban of tobacco. This generous formal opinion, in addition to seriously interfere with individual freedom, in practice leads to worst. Prohibition encourages smuggling, poor quality of consumed products and other criminal activities. Moreover, it paradoxically increases consumption.

If the prohibition can not overcome human vices, it is often argued that taxation could. The intentions of the States here perfectly readable. Taxation appears to be a compromise between powerful interests and prevention of display. However, advocates of behavioral taxes respond with the argument of the level of taxation. If it is very high, they say, lower consumption. This is already a concession, since no one ventures to predict the disappearance of smoked tobacco ...

Nevertheless, these lawyers have serious arguments, especially the Australian experience. A continent isolated by the sea and Anglo-Saxon culture has managed to seriously curb consumption, increasing taxes to make it very expensive pack of cigarettes. But this is not the situation in France. So that in Europe, it is clear that taxes can not overcome vices.

Stop-gaps in social budgets

In economic theory, the additional taxation of addictive substances is a perfectly legitimate basis: the externalities. Tobacco use has effects that the market does not internalize in the price. Medicine known diseases induced by tobacco accurately. The cost of care due to complications tobacco is paid by others, as part of the pooling of Sécurité Sociale (Medicare/ Medicaid) or taxes.

These negative externalities are only partly offset by lower life expectancy which means that pensions are no longer paid. Grace completeness of care data and its accuracy, we can actually calculate the equation of externalities. Therefore  "Pigouvian" taxation (named after the British economist Arthur Cecil Pigou - 1877-1959) who described in his 1920 book, The Economics of Welfare (Macmillan) is rational. It combines individual freedom and economic consequences.

The door opened to the vice of State

But in this area, and assuming that the additional tobacco tax becomes Pigouvian (that is to say, calculated based on the cost of externalities), there is, in France, an exceptional situation. Tobacco taxation is indeed far from being in favor of treatment or prevention. It has served and still serves as stop-gaps in unfunded social budgets that invents State at the discretion of election often necessities. As it is to grant "rights" without having the necessary funding.

In 2000, the reform of social security contributions Financing Fund received favors from the state, however much evil to find the necessary funding. This fund is rated as 85.5% of the product of the "right of use" on tobacco. In 2012, no less than 11 recipients shared the 11.13 billion euros of this product, for fractions ranging from 53.52% for the National Fund for health insurance, 0.31% for the Fund of early retirement of asbestos workers.

If the tax is not a solution to citizen services, we see that it can be an open door to the vice of the state, which diverts money collected on the basis of well-intentioned motives for doing fiscal resources to finance its policies.

Biofuels are worse than gas: an example of environmental assumption failure?

http://www.freep.com/story/news/local/michigan/2016/08/25/u-m-study-biofuels-worse-climate-change-than-gasoline/89265358/

https://drive.google.com/file/d/0B7ZwDXl-m2O9TFFiZXdRLUtsWlU/view

http://www.carsclimate.com/2015/08/bringing-biofuels-back-to-earth.html

Ipsos 2016

Pour 87% des Français, le nombre d’immigrés est en augmentation constante depuis cinq ans; 11% seulement considèrent que l’impact de l’immigration est positif ; 57% jugent qu’il y a maintenant trop d’immigrés dans le pays.

Transplantation: is it time to pay french donors?

http://www.france-adot.org/images/pj/Chiffres-Greffes-prelevements.pdf

http://www.wsj.com/articles/pay-bone-marrow-donors-save-lives-1471992096

23 à 25 euros. Vous croyez à ce simulacre de convention?

Apparemment certains doutent de cette nouvelle convention "inéluctable"... L'UNION COLLEGIALE LE GROUPE DES REBELLES LE MILLION, LE MILLION, LE MILLION… ! Et les pseudos rebelles signent en 1er Ça y est : ils vont l’avoir leur million d’euros tous les ans.Et peu leur importe au passage de massacrer encore un peu plus la médecine libérale et de piétiner l’honneur des médecins libéraux. Vous y avez cru ? Vous pensiez qu’ils étaient rebelles ? Vous avez voté pour eux aux URPS ? Tant pis pour vous, tant pis pour nous : vous leur avez donné la légitimité de décider de votre avenir, de notre avenir, mais surtout de l’avenir de la médecine libérale. Nous vous l’annoncions, sans être devins : ils vont finir par signer !L’UNION COLLEGIALE aurait vraiment aimé se tromper. Et maintenant ? Les Caisses, les syndicats signataires et la presse médicale s’empressent de clamer partout que l’application de la Convention est devenue inexorable : c’est faux ! Les syndicats SML & CSMF représentant plus de 50 % des voix des special! istes aux élections aux URPS ML peuvent s'y opposer ; L’UNION COLLEGIALE y apportera symboliquement ses voix. S’IL VOUS PLAIT : OPPOSEZ VOUS A CETTE CONVENTION DE MERDE Dr Meyer SABBAH, Président de L’UNION COLLEGIALE

Depression: news for intractable ones

http://ajp.psychiatryonline.org/doi/abs/10.1176/appi.ajp.2016.15111500?journalCode=ajp

http://www.post-gazette.com/news/health/2016/08/22/Pittsburgh-researchers-may-have-found-cure-for-some-untreatable-depression/stories/201608220015

a Folinic acid (5-formyl-THF) enters the pathway without the action of DHFR and contributes active metabolites. 5-Methyl-THF is a distal metabolite. DHFR=dihydrofolate reductase; DHF=dihydrofolate; dTMP=deoxy-thymidine phosphate; dUMP=deoxy-uridine phosphate; NAD=nicotinamide adenine dinucleotide; NADP=nicotinamide adenine dinucleotide phosphate; NADPH=nicotinamide adenine dinucleotide phosphate, reduced; THF=tetrahydrofolate.

Hollande et le bol : quand la providence ne choisit pas l'économie

À y réfléchir quelques secondes on peut estimer que le président Hollande a parfaitement décrit la situation du point de vue du chômage.
Selon lui il n'aurait pas eu de bol. C'est effectivement une constatation factuelle.
Pour le président Hollande, l'action politique est superficielle, elle vise à créer un théâtre d'ombres qui épuise les problèmes et rend inutiles les solutions. sa préférence pour la citation de Queuille n'est qu'une confirmation de ce soubassement politique.

C'est pourquoi il considère que les événements obéissent à la providence. Dans cette perspective force est de constater que sur le plan du terrorisme, l'autre sujet majeur de la France dans le quinquennat Hollande, la providence a beaucoup aidé l'exécutif et le président actuel.

Il a eu du bol.
Jamais le seuil fatidique de 500 ou 1000 morts n'a été atteint. Ils auraient pu l'être lors de l'attentat du Thalys mais de braves et courageux citoyens ont évité le pire.

Il y aurait pu y avoir une guerre civile, elle a été évité grâce aux exercices de compassion collective organisée par le pouvoir sur la forme de marches extrêmement dangereuses mais qui ont créé l'illusion d'une unité nationale.
Il aurait pu y avoir une victime au gouvernement mais tout a été fait pour les protéger et cela a réussi.

C'est pourquoi oui il a eu du bol sur le terrorisme alors même qu'il n'a rien fait de bien décisif comme d'habitude. La providence ayant une sacrée habitude d'équilibrer les probabilités, ce bol a disparu dans l'action économique ou là aussi il a été d'une médiocrité flagrante, Croyant que grâce a sa baraka l'empilement fiscal serait annihilé par la reprise européenne il a laissé le bateau ivre de la dépense publique aller à vau l'eau. Le bol a disparu et ce sont les chômeurs qui se sont empilés.
Au final Hollande est marqué par le signe de la providence. Qui aurait cru en ses chances? Personne et surtout pas au PS. Cette confiance née de sa victoire contre toute attente et grace à une très grande inefficacité du président précédent a provoqué l'euphorie. Le désarroi est grand si bien qu'il l'avoue lui même, la politique dans une démocratie captive d'une classe politique installée à vie est une question de bol.
Voilà ou nous en sommes arrivés et ce n'est pas fini.

Histoire de la Secu

http://www.lefigaro.fr/histoire/archives/2015/10/03/26010-20151003ARTFIG00109-la-securite-sociale-en-1948-une-administration-colossale.php

Crony socialism

http://www.nationalreview.com/corner/439237/massachusetts-uber-lyft-shakedown

They did so and the country sinks

But is the FN able to change anything?

Betablockers after PCI for stable angina

In stable angina which is treated by PCI, BB bring no benefit. The side effects are sometimes severe especially in young patients. So it is smart to stick to Statins/ACE inhibitors/anti platelet treatment.

http://interventions.onlinejacc.org/article.aspx?articleid=2544548

http://interventions.onlinejacc.org/article.aspx?articleid=2544559

Is there a future for France?

https://www.gatestoneinstitute.org/8657/france-islam

Useful in EU

https://www.trustbag.com/products/trustbagblue?variant=24843466695

A warning to all my young med colleagues

Why Many Doctors Aren't Wealthy?

Traditionally, much of the cachet associated with being a physician had to do with the perception that the profession was equated with affluence. To the average individual today, one might make the same assumption upon hearing or reading about a physician's income. But, as noted in a recent article on TheWhiteCoatInvestor.com, many doctors lack high net worth because they are:

1. Late to the game. Some students may not finish residency or fellowship until they're 40 or older. Losing 10 years' worth of investing, capital appreciation, and compounding can mean thousands of dollars less for retirement. In this setting France is in the back of the wagon with too long med studies and a trend to practice later than in other countries.

2. Saddled with debt. It isn't unusual for physicians to start out owing a few hundred thousand dollars in medical school loan debt—in addition to the debt that can build up in residency on car loans and credit cards, and for other expenses. Over time, the interest paid on all this debt can double or triple the original debt amount. in this setting it could be useful to use financial tools and to favour an entrepreneurship approach.

3. Saving too little. Although setting aside money for retirement may be the last thing on a newly graduated physician's mind, it's those early years that could be most instrumental in maximizing one's savings. The later you start, the more you'll need to save up. The take home message is save early even a little.

4. Not disaster-proofing their finances. There is no substitute for insurance against disaster—fires, accidents, unexpected illness or death, and liability. As exorbitant as the premiums can be, they are worth every penny when a possible tragedy becomes a reality. That said, there are ways to trim premiums, especially in the case of auto and home insurance, by increasing deductibles and eliminating nonessential coverage.

5. Mistaking their expertise in one area for expertise in another. Many doctors look for shortcuts to wealth by investing in what they believe to be the next hot stock or chasing last year's top funds. But often, that works against them. The THM is that your are a physician and investment is not based on science. Investment is based on value.

6. Losing sight of the bottom line. You can't just look at an investment's earnings without factoring in the costs. A healthy profit could well be diminished by taxes, inflation, or sales commissions. A financial advisor isn't worth his or her salt if the advice costs more than the earnings. Before going in practice look at the planet. If your business is to be losing money over time change your practice or your country. By chance there is a shortage of physicians.
Remember that if you cannot thrive you will no longer care.

Over-diagnosis of thyroid cancer and a blow to "increasing thyroid cancer due to Fukushima"!

10.1056/NEJMp1604412

"Finally, the enormous increase in thyroid-cancer incidence in South Korea subsequent to opportunistic ultrasonography-based screening sends a strong warning about data interpretation in the context of large-scale screening of the thyroid gland after radiation exposure from exceptional events like the nuclear accident in Fukushima."

Papillary cancer is not a mandatory indication for agressive treatment. People diagnosed with papillary cancer of the thyroid should ask for a second advice before deciding an agressive approach.