Talk:Myocardial infarction/Archive 1

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Can anyone take a closer look to ouabain. strange claims there without valid references. Jeff


Excuse me, but at the end of the ouabain site there is a link to an article, which has 264 references !!! Many with direct links to pubmed and additional informations (location of the university). Where do you find this service anywhere else ? The most of the clinical references are unfortunately only published in german language, but there are also studies published in english and partly at pubmed. Regarding the pathogenesis of myocardial infarction there is a host of references from pubmed. My book about ouabain has 1380 references and a preface from Prof. Dr. med. Hans Schaefer / Heidelberg, who was a leading physiologist for several decades and international renowned. Why is there this sharp opposition against a medication that has surpassing positive effects in myocardial infarction and angina pectoris ? For more text see below. I will add more information on the ouabain site when I´ll find the time... regarding the topics "oral absortion" and "ouabain as a newfound hormone" please see the discussion of the ouabain site. I have worked on the topic ouabain meticulously for several years. Every little detail is supported by references. --RJ Petry 23:23, 4 September 2005 (UTC)


Contents

Quintiliano H. de Mesquita

Dear Dr. Wolff

I have sent to you last monday the reasons why Dr. Quintiliano H. de Mesquita is notable. However my message disappeared by magic.

Do you want I send it again?

Hoping you are not a watchdog for the interests of the medical establishment, I send

My best regards

Carlos Monteiro

Infarct Combat Project

secretary@infarctcombat.org

Do you have any evidence at all supporting his theory? --WS 14:24, 17 August 2005 (UTC)

Dear WS

Do you have any evidence at all supporting the Thrombogenic Theory???

I strongly suggest you to see Dr. Mesquita's article "Myogenic Theory Explains or The Thrombogenic Theory Tumbled Down and the Orthodox Cardiology Didn't Noticed" at http://www.infarctcombat.org/MyogenicTheoryExplains.html and also his book about the Myogenic Theory of Myocardial Infarction with a Summary in English at http://www.infarctcombat.org/LivroTM/parte8.htm

Carlos Monteiro

Infarct Combat Project

Carlos, you are making a mistake. Dr Mesquita may be correct, but the fact that he is a lone voice in a desert full of misguided cardiologists does not make him notable. Honestly. Only if the field recognises him as a dissenter (of which you have provided no evidence) or a significant minority of the field aknowledges his views is there any hope of including him.
The thrombogenic theory is supported by angiographic studies, the effectiveness of thrombolysis, postmortem studies, animal models and many other avenues of research. I know that you will be able to answer every single assertion with some obscure study, so I will not endeavour to continue the discussion. JFW | T@lk 18:15, 17 August 2005 (UTC)

Please help -- a request

I have noticed that this article contains no list of symptoms or reasons for immediate action in cases of heart attack. I understand that pain radiating into the left arm is not universal, but I also understand that some other common symptoms are not either. While WP is not intended to be a medical (or emergency treatment) resource, at least something along this line should be here. Many readers will, now that WP has become the astonishing resource that it is, refer to it for some information when they think there might be a problem. Wording should, of course, contain the necessary disclaimers and warnings so as to diffuse the possibility of WP being sued for 'malpractice', but nevertheless something like this is needed here.

I invite the medical folk who contribute to WP to add something responsible along these lines.

Thanks.

The most relevant symptoms are all there. There is no need for a disclaimer - the Wikipedia:General disclaimer specifically disclaims medical information. You don't need to be a doctor to edit this article! JFW | T@lk 07:20, 1 September 2005 (UTC)

I agree it could have a more detailed features or symptoms section, will look into it later... --WS 10:56, 1 September 2005 (UTC)

Added symptoms section. --WS 15:23, 5 September 2005 (UTC)

Prof. DeMesquita and others and the effects of ouabain in acute myocardial infarction

There has to be made a differentiation: 1) the alternative view of the pathogenesis of myocardial infarction, 2) the surpassing positive effetcs of ouabain in this indication (and angina pectoris !). Regarding point 1) we can debate for a long time. There are astonishing facts (with many references) supporting an alternative view. But I don´t like a war against the orthodox position. Perhaps the “truth“ is a complementary one. The German advocates of the ouabain therapy, especially Dr.med. Berthold Kern, the explorer of the oral ouabain therapy, and the International Society of Infarct Prevention (in the 1960ies up to the 1980ies) always closely associated the topic “ouabain“ with the “new cardiac infarction hypothesis“ and presented the latter often in a sometimes too unilateral manner, and so the resistance of the official medicine regarding new aspects in the pathogenesis of cardiac infarction was perhaps carried over to the topic of ouabain. For an interesting reading see http://ouabain.twoday.net/ and look for Part II: Mostly unknown aspects of myocardial infarction (many references). The advance in science is dependent on (good) hypotheses !!!

The pathogenesis of infarction is interesting, but not as important as the concrete clinical experiences with ouabain. Here some facts - not all (without references, for them please see http://ouabain.twoday.net/.

In acute mayocardial infarction (AMI) 1975-1987 Prof.R.Dohrmann from Berlin (West), the leader of a public hospital, used a new therapy with 1) i.v. cortison to stabilize the lysosomal membranes and 2) from 1975 -1976 oral ouabain (lingual absorption, capsule to break with the teeth, 6 mg) and then from 1976-1987 i.v. k-strophanthin (0,25 mg every 24 h). The quota of nonsurvivors (30 days) after myocardial infarction previously was very high (38,8 %) because in Berlin (West) have been much more elderly people than in the rest of Germany. With this therapy Prof. Dohrmann reached the worldwide best rate of survival of that time - in the first year with oral ouabain 17,6 % nonsurvivors (3), and 1987, after 12 years, 15,1 % with experiences with 1056 patients (4). A multicenter study of northern Germany reported a quota of 26 % mortality in a comparable period (5). Prof. Dohrmann was outnumbered only by Prof.DeMesquita from a clinic in Sao Paolo (6) who used ouabain i.v. from 1972 -1979 in 1037 cases (until ouabain lost the license in Brasilia): they reached 9,6 % mortality during the stay in hospital, which could be reduced to 5-7 days with the ouabain therapy.

Another example is a coal mine in Gelsenkirchen/Germany (7) where the average number of workers dying because of acute myocardial infarction (AMI) in the mine, under the surface of the earth, was 3 every year; the way to the doctor lasted more than half an hour. After the doctors of the mine began with oral ouabain therapy directly in the mine in 1974 - given only when there was an acute heart attack, not prophylactically given -, the mortality concearning AMI was reduced to zero in the following 10 years with this therapy. In two cases there was no possibility to give oral ouabain (accidents) and the workers died. The cases concearning severe angina pectoris attacks and non-mortal cardiac infarctions that forced to drive the workers out of the mine were reduced by 80 % with oral ouabain in 1974-1984.

The best example for the indeed excellent therapeutic results of oral ouabain in angina pectoris and myocardial infarction is a study of Prof. Dohrmann starting 1975 with this therapy. 1984 Dohrmann & Dohrmann published a study (1) dealing with oral ouabain therapy in unstable angina pectoris. 148 patients with severe stenosis visable in coronary angiography, who received for years all the medicaments modern medicine offers and who are dissatisfied because of continous heart attacks and in part unpleasant side effects, have been switched over (with their agreement after an information discourse) to the therapy with oral ouabain from one day to the other, i.e. the other medicaments including the ß-blockers (!) were discontinued immediately. After one week 122 of 148 patients were completely free from angina pectoris, and after two weeks this success could be seen with 146 patients. They were also free from the side effects of the former medication.

An study in english language supporting the numerous studies in german is Sharma B, P.A.Majid, M.K.Meeran; W.Whitaker & S.H.Taylor (Leeds / GB): Clinical, electrocardiographic, and haemodynamic effects of digitalis (ouabain) in angina pectoris. Br Heart J 34: 631-637, 1972

For all aspects of this complex topic please see my article. --RJ Petry 00:03, 5 September 2005 (UTC)

How many adherents does this theory have? And outside Germany? Please note that Wikipedia only mentions significant minority views. JFW | T@lk 06:34, 5 September 2005 (UTC)

At first I have to beg your pardon for my probably bad english. I have read many studies, but to write in english is not my strongest discipline / ability.

Outside Germany at least Mr. Monteiro (former Mr. DeMesquita) with experiences in his clinic in Sao Paulo since 1972 is an adherent. I think the workgroup of Mr. Baroldi in Milan / Italy have great sympathy. I will contact soon... In Germany 2000-3000 doctors are using orally administered ouabain in the prophylaxis and treatment of angina pectoris and heart infarction. There are dozens of clinical and pharmyco-dynamical studies (in part double-blind) !

I think, that in this point the number of adherents is not important. This is a quantitative aspect. In this topic the quality of data content is so extraordinary (see above, my first text), that the formal aspect of the number of adherents or citations is only of secondary importance.

Really, it´s an inherent attribute of a new hypothesis / paradigm shift, that in the beginning there are only few adherents. Excuse the overconfident comparison, but the heliocentric world view also had only very few adherents in the beginning.

Don´t victimise the really optimal solution of the problem of myocardial infarction that is unsolved for many decades on the altar of the financial fundament of medical business, which is dominated by the interests of the big combines. No big company will spend the immense sum for a substance like ouabain that has lost its patent rights for long and that could displace most of the actual medicaments in a cost-saving way.

Please read my article on http://ouabain.twoday.net/ and think about it. The ordinary formal aspects had to step back, I think. I have worked for some years intensively on my book about ouabain and have documented every detail by references meticulously. --RJ Petry 09:22, 5 September 2005 (UTC)

You appear to be misunderstanding Wikipedia. It is not a scientific review. It does therefore not need to mention scientifically relevant opinions unless they are widely held or notorious (or both).
If you have been writing a book advocating the use of ouabain you may actually not be the ideal person to judge the notability of this treatment. You should not be turning to Wikipedia to popularise your view, but recruit patients for randomised trials and presenting the results at cardiology conferences. Perhaps that will lead to the paradigm shift you're hoping for. I find "some doctors in Germany, Brazil and Italy" not a significant representation of the cardiological field. JFW | T@lk 12:10, 5 September 2005 (UTC)
I agree with JFW for the most part. I wouldn't object to a neutral mention that some practitioners use ouabain for treatment purposes, but that such use has neither been thoroughly tested nor peer reviewed. There have been few research efforts in this area, and their statistical validity is thus questionable; peer review depends on repeatability of the research and its findings in order for a claim to become accepted, or at least to pass the stage of testable hypothesis.
The link to your website certainly doesn't belong here. Also, how many references you cite is irrelevant; what's important is how many authors cite the studies you mention in their own work. Keep in mind that Wikipedia requires both neutrality and verifiability, and rejects original research. Mindmatrix 20:21, 5 September 2005 (UTC)


There are always persons that are defending the orthodox positions and keep them clean from all facts that don´t fit in the dominant theory. Is it really harmful to Wikipedia that in this article there is one link to an article with many indices for a really outstanding therapy in a situation where we have this problem of myocardial infarction unsolved for decades ? I want to accent that I don´t work for the producer of the ouabain medication.

You (JFW) write: "You should ... recruit patients for randomised trials and presenting the results at cardiology conferences. Perhaps that will lead to the paradigm shift you're hoping for." Oh, I whish it could be so simple. Ähem: A randomized trial does cost a lot of money, especially if it is a big one. This money no company will spend on a substance without patent rights, as I wrote above. AND: No big company will spend the immense sum for a substance like ouabain that has lost its patent rights for long and that could displace most of the actual medicaments in a cost-saving way.

In this situation I see no general way for the undoubtly optimal therapy for myocardial infarction and angina pectoris. A real tragedy. But this information has to be preserved for better times in the future...

But there is already a randomized placebo-controlled clinical trial, even if it is including only 30 patients and is published only in german language: Salz & Schneider 1985 (8, for the full text with references please see http://ouabain.twoday.net) carried out a placebo controlled doeble-blind study with 30 patients with coronary heart disease. They found after 14 days of prophylactic application of oral ouabain (3 x 6 mg Strodival mr® daily) a highly significant effect on the ECG (elevation of the lowered S-T-segment), the angina pectoris attacks and the subjective state of health in comparison of the verum and the placebo group and also an amelioretion of hypertension. With placebo there was seen a deterioration of all parameters, see table below:

Salz & Schneider 1985, double-blind study

the effect of Strodival® in 16 patients

...........patients without change ...moderate improvement..essential improvement

exercise-ECG..............0........................5...........................11

angina pectoris-attacks..1......................2...........................13

subjective condition......0........................1...........................15


the effext of the placebo in 14 patients

...............................patients with deterioration

exercise-ECG...........................12

angina pectoris-attacks.............10

subjective condition...................10


Saradeth & Ernst 1991 (47) made a randomized, double-blind and placebo-controlled crossover-study with healthy volunteers and found a reduced rise of diastolic blood pressure in exercise after lingually administered ouabain (6 mg).

The double-blind experiment of Kubicek and Reisner 1973 (69) with angina pectoris-patients under hypoxia showed in 19 of 22 patients a marked improvement of the electrocardiogram (S-T-alterations) - in 7 cases a total normalization - after 6 mg oral Strophoral® (90 % ouabain, 10 % k-strophanthin) in comparison to a control group, and the result of subjective state of health is as follows: control: 18 patients with pain or giddiness and only 4 without trouble. After oral ouabain: Only 4 patients with pain or giddiness and 18 patients are without trouble. A placebo showed no effect. Digitalis had a negative effect, so that some experiments had to stop before the regular end (several drugs in differentiated dosis: Digoxin i.v. 0,4 mg, 0,8 mg, ß-Methyl-Digoxin oral 0,05 mg, 0,2 mg, 0,8 mg). Also Sharma et al. 1972 (70) had similar good results with 0,7 mg i.v. ouabain. After ouabain the patients had much less angina pectoris pain using bicycle exercise. The ECG didn´t change, perhaps because of the very high dosage. This is the corroboration of the therapeutical results reported by Prof. Dohrmann and others.

Belz et al 1984 (71) made a placebo-controlled double-blind crossover-study, which shows that lingually administered ouabain (12 mg) has a constant and significant (in part highly significant) effect on the heart contractility of healthy volunteers that is different from the effect of ouabain i.v. and similar to that of nitroglycerine, that is a negative inotropic effect. The double-blind experiment of Kubicek and Reisner 1973 (69) with angina pectoris-patients under hypoxia showed in 19 of 22 patients a marked improvement of the electrocardiogram (S-T-alterations) - in 7 cases a total normalization - after 6 mg oral Strophoral® (90 % ouabain, 10 % k-strophanthin) in comparison to a control group, and the result of subjective state of health is as follows: control: 18 patients with pain or giddiness and only 4 without trouble. After oral ouabain: Only 4 patients with pain or giddiness and 18 patients are without trouble. A placebo showed no effect. Digitalis had a negative effect, so that some experiments had to stop before the regular end (several drugs in differentiated dosis: Digoxin i.v. 0,4 mg, 0,8 mg, ß-Methyl-Digoxin oral 0,05 mg, 0,2 mg, 0,8 mg). Also Sharma et al. 1972 (70) had similar good results with 0,7 mg i.v. ouabain. After ouabain the patients had much less angina pectoris pain using bicycle exercise. The ECG didn´t change, perhaps because of the very high dosage. This is the corroboration of the therapeutical results reported by Prof. Dohrmann and others, see above.

Belz et al 1984 (71) made a placebo-controlled double-blind crossover-study, which shows that lingually administered ouabain (12 mg) has a constant and significant (in part highly significant) effect on the heart contractility of healthy volunteers that is different from the effect of ouabain i.v. and similar to that of nitroglycerine, that is a negative inotropic effect. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=6428911&query_hl=4 Dohrmann & Schlief-Pflug 1986 (72) repeated the above mentioned study with patients which had severe coronary heart disease and instable angina pectoris.

I know that the documentation of the orally administered ouabain therapy has formal weakness regarding the contemporary pretensions of a "evidence based madicine" which are unaffordable for every little or medium-sized pharmaceutical company. But the content is extraordinary and sensationally positive, and everyone who reads the multitude of all the studies has no doubt that ouabain could be the solution of the problem of myocardial infarction. The severity of this problem and the quality of the data pro ouabain outweighs the formal aspects that you are emphasising.

Mindmatrix: Naturally I know what you adress, but in this case the conventional formal criteria are failing. There is a strange opposition against ouabain: The deceased doctor of the coal mine in Gelsenkirchen / Germany in which ouabain had sensationally therapeutical success over 10 years (see above), Dr. Brembach, told me that after the appearance of an article about the ouabain therapy in the factory there has been a meeting of managers of the german pharmaceutic industry with the employer, who thereupon has forbidden the continuation of the ouabain therapy in the factory, which had prevented 30 statistically probable deaths by cardiac infarction. (!) Prof. Belz, who made the randomized placebo-controlled crossover study with ouabain (see pubmed-link above) got problems after the publication of his study - the threat that he would not receive orders any more if he would continue his research. Ouabain seems to be something like a taboo - also here at Wikipedia ?

I know that it is a problem to ask for reading literature, but I do so: Did you read my article ? Please don´t sabotage very important informations that are solving many lives and could solve much more of them and are demanding only a place at the end of the site at "external links". --RJ Petry 21:29, 5 September 2005 (UTC)

RJ, please give briefer responses. I have little care for your page and the 267 references. Ouabain is not a taboo - it is too poorly supported by evidence. Wikipedia is not going to be your forum in recruiting adherents to your theory. I wish you stopped your attempts at using it for that purpose. Even if ouabain was a miracle cure, it would be denied a place in Wikipedia unless it was recognised as such by the relevant professionals. Unless you can indicate this is indeed the case, I will not accept your external link.
Please write a grant proposal to a large cardiovascular charity, recruit investigators and start including patients into large randomised, double-blind placebo-controlled trials. You will be saving more lives than by writing on Wikipedia. JFW | T@lk 22:14, 5 September 2005 (UTC)
I'd also prefer if you kept your responses brief. To answer one question, Wikipedia does not consider ouabain taboo, otherwise that article wouldn't exist at all (I note you've already edited that article). You say: which had prevented 30 statistically probable deaths by cardiac infarction; probable and definite are two different things. There is no certainty that infarction would have occurred. Irrespective of that, I re-iterate that this simply needs more peer review. If it costs too much for small pharma companies, then either cardio charities (as mentioned by JFW) or governments may fund such research. The peer review system exists for a reason.
Case in point: how do you know that the study you mention didn't lie outside of the statistical confidence interval? This can only be determined by successive experimentation and research. The more research exists, the more likely it will trend towards an accurate representation of that which it studies. We're not preventing you from adding neutral comments into these articles - feel free to mention ouabain, that some alternative medicine practitioners use it to treat patients etc. But the fact that most cardiologists do not believe in its potency will also be noted in the article; so too for potential risks etc. Wikipedia will maintain neutrality in this matter, but will present facts as they exist. We're not trying to be difficult, just well-grounded in realism with a small dose of scepticism. Mindmatrix 02:23, 6 September 2005 (UTC)

Briefer responses

Okay, this time only a brief response (not having time and not willing to be impertinent) and only to the topic of the sequence ot the sub-topics. I have clicked on every "see also" links", none of them has all three sub-topics. Only "Dresslers Disease": 1) see also, 2) references. At "Bypass" I found 1) references 2) see also 3) external links. So the statement: "all Wikipedia articles follow this sequence" is much more invalid as the results of the ouabain studies (...smile...). I think, at least the references have to had their place before "see also". Regarrding the other points I will add a notice later... --RJ Petry 08:03, 6 September 2005 (UTC)

I've fixed the article at Coronary artery bypass surgery - I think that's the one you mentioned. Thanks for pointing it out. Note that at one time, Wikipedia did not have standards about this, but to ensure that articles have some consistency, this policy was eventually chosen by consensus. There are still many articles that have not been modified to match this new standard, but they will be eventually. Mindmatrix 17:21, 6 September 2005 (UTC)

Thrombogenic Theory (Herrick, 1912) X Myogenic Theory (Mesquita, 1972): Almost the same therapeutic conduct

Dear JFW

For your better clarification follows the (hidden or forgotten, due contradiction) part of the classic text "Clinical features of sudden obstruction of the coronary arteries, JAMA, 59: 2015-2020, 1912 by James B. Herrick. There was presented, besides the proposition of a mechanism, his therapeutical experience using digitalis and strophanthin in front of angina pectoris and coronary thrombosis:

“”...................................................................................................................................... If these cases are recognized, the importance of absolute rest in bed for several days is clear. It would seem to be far wiser to use Digitalis, Strophantus or their congeners than to follow the routine practice of giving Nitroglycerin or allied drugs. The hope for the damaged Myocardium lies in the direction of securing a supply of blood through friendly neighboring vessels, so as to restore so far as possible its functional integrity. Digitalis or Strophantus by increasing the force of the heart’s beat, would tend to help in the direction more than the Nitrites. The prejudice against Digitalis in cases in which the Myocardium is weak is only partially grounded in fact. Clinical experience shows this remedy of great value in Angina, and especially in cases of angina with low blood pressure, and these obstructive cases come under this head. The timely use this remedy may occasionaly in such cases save life. Quick results should also be sought by using it hypodermically or intravenously. Other quickly acting heart remedies would also be of service."”

This little disagreement about the pathophysiological mechanism and the therapeutic conduct in Herrick’s paper is not told or discussed at medical schools or in scientific papers. So, nearly all doctors still in total medical ignorance about the subject until today. The Herrick’s Thrombogenic Teory was adopted and his therapeutical conduct was forgotten.

The Myogenic Theory of myocardial infarction, by the way, is entirely compatible with the therapeutic conduct by digitalis and strophanthin.

Sincerely yours

Carlos Monteiro

Infarct Combat Project

Carlos, you're starting to get repetitive. The Herrick paradigm, as I said above, has been confirmed endlessly by literally 1000s of studies, from post-mortem to angiographic to interventional studies. The use of cardiac glycosides, which Herrick may have supported, has now been abandoned by most practicioners. The number of cardiologists that adheres to the thrombogenic paradigm is many, many times the number of adherents to your Mosquito therapy. I have asked yourself and RJ Petry to cite clear evidence that a substantive minority of cardiologists supports the theory. So far all you have done is quote your master and insist that cardiac glycosides will mean the end of all heart disease. Start conducting studies, and we will talk again. JFW | T@lk 17:23, 7 September 2005 (UTC)

Dear JFW (jfdwollf)

As you requested I am sending you a link to the last paper by Mesquita and Baptista. In this paper published at Ars Cvrandi Magazine in 2002 presented the follow-up of 28 years (1972-2000) using digitalis in daily doses to prevent acute coronary syndromes in nearly 1200 patients with coronary-myocardial disease. As a result it had a very low mortality of 14.2% in cases without previous myocardial infarction (0.5% per year) and of 41% in cases with previous myocardial infarction (1.4% per year). This paper was republished at Internet in 2005: The link is http://www.infarctcombat.org/28anos/digitalicos.html

This article by Mesquita and Baptista is the most complete and definitive proof that the medical therapy by digitalis or strophanthin in prevention or treatment of acute coronary syndromes can save many lives as occurred in the past in Germany (Ex: Ernst Edens; Berthold Kern; R. Dohrmann, and many others), In US (Ex: James Bryan Herrick 1912; Louis Hamman, 1926; Ferdinand R. Schemm, 1950; John Martin Askey, 1951; Norman H. Boyer,1955 - see at http://www.infarctcombat.org/heartnews-02.html) and in Brazil (Quintiliano H. de Mesquita, Cláudio Baptista et al, since 1972 - See at http://www.infarctcombat.org/MyogenicTheory.html ).

Let’s talk now about the convenient and heroic procedures like bypass surgery, angioplasty, stents and drugs like clot-busters, statins, and beta blockers that you and the substantive majority of cardiologists support. Do you KNOW how many million lives are being SAVED with these modern approaches?

Regards

Carlos Monteiro

Infarct Combat Project

These modern approaches save a lot of lives, to the point that the most spendthrift health authorities are advocating the routine use of statins in many cardiovascular diseases. But you have not been listening. The fact that there is evidence is not the determining factor for inclusion on Wikipedia. Notability is. Unless you can quote evidence that many cardiologists support the Mosquito theory, it will not be mentioned here. I will not respond to your postings anymore unless you can produce this evidence, as you have not been responding to my repeated enquiries on this matter. JFW | T@lk 17:04, 8 September 2005 (UTC)

Dear JFW (jfdwollf)

Please remember that our initial intention was just to place the existence of another theory (Myogenic) opposing the dogmatic coronary thrombosis theory (thrombogenic) to explain the triggering mechanism of the myocardial infarction.

Unfortunately our request was denied by professionals that apparently have a large investment in the status quo.

You as a doctor and presumable as a scientist must accept that your version of reality will be overturned in the fullness of time. If you can’t accept that you are not a true doctor or scientist.

Sincerely, taking in account your responses, I do not see sufficient scientific honestly or expertise from you to administrate this important subject at Wikipidia. Moreover looking to hide your real identity as a protection from this kind of censorship attitudes you are taking. In fact I do not like to discuss science with anonymous.

For your information we don’t want to transform the myocardial infarction section at Wikipidia in a permanent tribunal to accuse or to judge the inefficacy of modern medical approaches dealing with coronary artery disease and/or to open a page at our website denouncing that Wikipidia is making censorship in this theme.

However, we are prepared to do so

Regards

Carlos Monteiro

Infarct Combat Project

While your comments were directed at JFW, I'll add my reply too.
First, you state that "our request was denied by professionals that apparently have a large investment in the status quo". This is not so; outside of Wikipedia, I am a programmer and systems administrator - I am not involved in medicine in any way, nor do I have a vested interest in it.
Secondly, "a scientist must accept that your version of reality will be overturned in the fullness of time. If you can’t accept that you are not a true doctor or scientist." This is false. A scientist accepts that in the future, competing hypotheses will be presented, but that they must withstand the peer review process before becoming a theory and displacing entrenched beliefs.
Thirdly, "I do not see sufficient scientific honestly or expertise from you to administrate this important subject at Wikipidia". Nobody that participates in Wikipedia administers a subject or article; all articles are written by consensus by any authors that wish to contribute to it. Contentious items will require discussion, as is the case here, and anything which is not resolved to your satisfaction with the authors can be brought to arbitration, or raised for discussion elsewhere in Wikipedia, to be analyzed by parties with no vested interest in the topic. See dispute resolution for more details.
Finally, "looking to hide your real identity as a protection from this kind of censorship attitudes you are taking. In fact I do not like to discuss science with anonymous." An individual's identity or anonymity does not change the facts of the situation. Furthermore, if you feel there is censorship, bring it to the attention of other Wikipedia authors. To me, it appears that you don't understand how Wikipedia works, nor any of its policies. Mindmatrix 21:39, 8 September 2005 (UTC)

Filed for RfC

Note that I have raised this issue at Wikipedia:Requests for comment/Maths, natural science, and technology. Mindmatrix 22:08, 8 September 2005 (UTC)

It's suddenly very quiet here. A myocardial infraction? JFW | T@lk 05:19, 17 October 2005 (UTC)
As a secondary character in a B-rate horror movie might reply: "Too quiet." Mindmatrix 18:27, 17 October 2005 (UTC)

Taking in view you want some noise follows the current myths on human coronary atherosclerotic plaque* according the great and notable, recognized internationally, Professor Giorgio Baroldi, cardiovascular pathologist from Italy, which we totally agree:

1. Experimental hypercholesterol model and correspondent human conditions do not represent the natural history of atherosclerosis in coronary arteries in the general population. 2. Physiological intimal thickening can not be interpreted as starting point of the atherosclerotic process. 3. Fatty streak does not represent the early atherosclerotic lesion. 4. Calcification is not synonymous of severe stenosis. 5. Hemorrhage is not consequent to endothelial fissuration. 6. Prevention of macrophage “inflammation” as source of substances able to disrupt the fibrous cap allowing rupture and thrombosis as well as identification of the thickness of fibrous cap to diagnose a vulnerable plaque may have little, if any, sense. Rupture and thrombosis may be secondary phenomena and not the cause of an acute coronary syndrome. 7. Degree and number of severe coronary plaques do not predict onset, course, complications and death in CHD.

Unfortunately the maintenance of these myths is very convenient to many and many doctors, hospitals and pharmaceutical industry. The reason is that many current treatments are dependable of these myths.

Carlos Monteiro

secretary@infarctcombat.org

Oh yeah, sure. Everything we believe in is wrong. Listen buddy, I worked for a large trial that looked into people with LDL receptor mutations. High LDL cholesterol, otherwise healthy. Their medical records were rather scary: young women dead at 26 with heart attacks. The kids with homozygous disease have heart attacks when they're toddlers.
Just spare us your spin and attempts to rewrite medical science. I have absolutely no idea why you, with a site called "infarct combat", should subscribe to all that sort of bizarre ideas. You are not doing the world any favours. They will carry on smoking and eating rubbish, firmly believing that those doctors are lying anyway. JFW | T@lk 02:21, 23 October 2005 (UTC)

Here is a typical example of conservative reaction exposed by a professional when he receives new information that defies his beliefs, mainly when his pocket is affected.

About the cholesterol myths and regarding the very few benefits (by pleitrotropic effects) and many risks from statins to the health, you can instruct yourself at The International Network of Cholesterol Skeptics (http://www.thincs.org)

Anyway, I would like to know in what large cholesterol trial you have worked and also if your name was reported as author.

Infarct Combat Project publishes scientific medical matters based in scientific evidence, not rubbish.

Moreover the Infarct Combat Project doesn’t receive any funding support in donations, advertisements or else, from pharmaceutical companies or through its representatives.

So we do not have conflicts of interest in medical matters published at ICP

Carlos Monteiro

Infarct Combat Project

secretary@infarctcombat.org

I have only two words for you, Carlos: Go Away. JFW | T@lk 02:45, 28 October 2005 (UTC)

Mindmatrix,it is hard to believe in Wikepedia when we see your response of September 8, and now your colleague tells that he has just two words for me as above:

"Nobody (????) that participates in Wikipedia administers a subject or article; all articles are written by consensus by any authors that wish to contribute to it. Contentious items will require discussion, as is the case here, and anything which is not resolved to your satisfaction with the authors can be brought to arbitration, or raised for discussion elsewhere in Wikipedia, to be analyzed by parties with no vested interest in the topic".

I regret to know the preference from Wikipedia about marketing over Science.

I still waiting the response about my claim regarding censorship you raised at Wikipedia:Requests for comment/Maths, natural science, and technology. Mindmatrix on 22:08, 8 September 2005 (UTC)

Carlos Monteiro

secretary@infarctcombat.org

Ah, it's marketing now, eh? Nobody has actually been censoring you. You've just been making nonsensical claims about an unsupported fringe theory. Just because you think something is notable is fairly poor grounds for inclusion. I suggest you start conducting serious trials and presenting the results at international cardiology conferences. This will have more of an impact than complaining on this page that you're not being listened to. JFW | T@lk 01:53, 30 October 2005 (UTC)
Yes, maybe by narrow-mindedness or ignoring the science but still marketing. A good example of “marketing” you are doing is for statins. The data from the Heart Protection Study tells the truth. HPS involved 20.536 patients aged 40-80 years with coronary disease, other vascular diseases or diabetes, representing high-risk individuals. The patients in the HPS study were randomly allocated to receive 40 mg Simvastatin daily or matching placebo during a scheduled 5 year treatment period, aiming to verify mortality and fatal and non-fatal events. Follows the findings of HPS Study (1):

1) Simvastatin, mortality in 5 years: Total = 12.9% (2.58% year); Cardiac mortality = 5.7% (1.14% year); Cancer mortality = 3.5% (0,7% year) 2) Placebo, mortality in 5 years: Total = 14.7% (2.94% year); Cardiac mortality = 6.9% (1.38% year); Cancer mortality = 3.4% (0,68% year)

As you can see, at the end of the 5 years of continuous treatment with Simvastatin less than 2% of patients will be benefited in the reduction of cardiac mortality or in total mortality and 98% will not. Unfortunately the patients are misinformed about the correct data, receiving instead, through a massive marketing, just the relative risk reduction numbers which cause an inappropriate spin.

Please compare the HPS numbers with those got by Mesquita and Baptista in a follow-up of 28 years (1972-2000) using digitalis in daily doses to prevent acute coronary syndromes in nearly 1200 patients with coronary-myocardial disease (Informed here on September 7). The result was a very low mortality of 14.2% in cases without previous myocardial infarction (0.5% per year) and of 41% in cases with previous myocardial infarction (1.4% per year).

1.The effects of cholesterol lowering with simvastatin on cause-specific mortality and on cancer incidence in 20,536 high-risk people: a randomised placebo-controlled trial, Heart Protection Study Collaborative Group. BMC Medicine 2005, 3:6 http://www.biomedcentral.com/1741-7015/3/6 (Table 2)

Do you need more examples??

Carlos Monteiro

Infarct Combat Project

Regarding the subject please see the article “Two Heart Disease Theories, Same Therapeutic Treatment”, published this month in Dr. Thomas Cowan’s newsletter with comments at http://www.fourfoldhealing.com/NL%20NovDec%202005.htm
Regards
Carlos Monteiro
Infarct Combat Project

Carlos, we don't need more of your preaching. What we need is evidence that the Mesquita theory has a significant following in the international field of cardiology. I'm fully aware of the Heart Protection Study, but am unconvinced we should be treating all our MIs with foxglove instead of alteplase. Have a nice day. JFW | T@lk 12:56, 6 December 2005 (UTC)

Dr Cowan has a website about nutrition, therapeutics, movement and medication. Very traditional indeed. He actually kills off your whole effort here: "I would venture that there are not five western trained physicians on the planet who are not completely convinced that the cause of heart attacks are the blockages in the coronary arteries. In fact, a common synonym for a heart attack is to say the patient has had a coronary, meaning he has an illness of his coronary arteries." In other words, Cowan admits that the Mesquita theorem has no adherents! How on earth are we supposed to cover this! There are well over 5 people who believe that heart attacks are caused by mothers-in-law. So is that going to go into the article? Nope. JFW | T@lk 13:01, 6 December 2005 (UTC)

Doctors living in illusion: “People, doctors included, have a tendency to see what they expect to see. It's the premise of every sleight-of-hand game. If it makes sense that a treatment will work -- or if one stands to make money if a treatment works -- then a doctor will, with alarming and disheartening reliability, perceive that it does in fact work. What is surprising is that a profession that dresses itself up in the garb of science has taken so long to acknowledge a principle that every small-town carny understands”. (1)
If you are not totally convinced to treat all your MIs with foxglove instead of alteplase I think you need to read a little more before any final decision. The proof of efficacy of thrombolysis for AMI depends on 9 randomized placebo-controlled trials totalling 58,511 patients. The meta-analysis of these trials showed an overall survival advantage of about only 2% (11.5% vs 9.6 %) in favor of thrombolysis – meaning that 2% of patients will be benefited by thrombolysis and 98% will not. Please take into account that the use of thrombolytics comes also with an additional clinical price besides potentially fatal bleeding complications. (2)
Our article published at Dr. Cowan’s Newsletter breaks the silence imposed to the subject by the medical establishment. So, we have now the opportunity to convince others (perhaps you) that are in search of the medical truth.
1. What Doctors Don't Know (Almost Everything) By Kevin Patterson, May 5, 2002, New York Times Magazine
2. Thrombolysis for Acute Myocardial Infarction: Drug Review, David K. Cundiff, Medscape General Medicine, January 2, 2002. http://www.medscape.com/viewarticle/414942 (excellent review!!)
Regards
Carlos Monteiro
Infarct Combat Project

You are not to use Wikipedia to popularise your theories. Your bleating about the "medical establishment" is getting particularly tiresome. I will stop replying to your posts, because you have consistently failed to show that anyone believes in the digitalis theory. This is after many weeks of repeated messages from you that we should enlighten ourselves. In fact, I will remove your posts without comment if they do not contain the information I asked for, because your criticism of the medical establishment has no direct bearing on the content of this Wikipedia article. JFW | T@lk 22:12, 7 December 2005 (UTC)