Wednesday,
September 16, 1998
|
|
Dissenting
Research Opinion When a breast lump is
detected
|
| H |
AIDS neither infectious nor STD THERE are many scientific facts which show that the so-called human immunodeficiency virus (HIV) does not fulfil the epidemiological and biological requirements, nor the common ‘sense’ requirements, to be the cause of the human immunodeficiency syndrome (AIDS). HIV is neither necessary nor sufficient to cause AIDS, and antibody positivity does not always precede the development of the syndrome. This is demonstrated by thousands of AIDS cases that are HIV negative and a host of people that are absolutely healthy and have never developed AIDS, even though they are diagnosed HIV positive. HIV is not a pathogenic agent, and for this reason it cannot explain the immunological alterations, nor the pathogenesis, nor the natural history, nor the different clinical forms within the groups of people that develop AIDS. What is called HIV has never been isolated as an independent, free viral entity. There are facts that question the existence of HIV as a real virus. Since it has never been proven that HIV is the cause of AIDS investigators who enthusiastically defend HIV as the cause of the syndrome have proposed a vast variety of agents as helpers or “cofactors” of HIV in the genesis of AIDS. However, these “cofactors” are by themselves casual agents of immunodeficiency and may generate AIDS with or without the diagnosis of HIV. I prefer to call the “co-factors” immunological stressor agents. The new real circumstance that surrounds all the groups of people that develop AIDS with the greatest frequency is the exaggerated exposure in the last decades to a variety of stressor agents against the immune system, that can have a chemical, physical, biological, mental or nutritional origin. Coincidentally, AIDS appears in various and distant groups of people in the second half of the twentieth century, at the time when the immune system of human beings is already saturated and has seriously deteriorated, due to involuntary exposure (and many times voluntary) to immunological stressors. The capabilities and functions of the immune system are neither infallible nor infinite. They have limits. The increment of stressors in the human ecosystem is putting in serious danger the preservation of our own species. AIDS is an alarm sounding. The distribution of these stressors varies within the groups of people that develop the syndrome and this fact is the explanation for the different clinical forms of AIDS that occur in these groups. The immunological stressor agents create immunotoxic or immunogenic effects, or both, which generate a state of oxidative stress on immunocompetent cells and metabolic reactions of the immune system. Stressor agents also generate oxidative stress on other body systems. Progressive and continuous deterioration of the immune system causes a deficit of the defence, surveillance and homeostasis immunological functions, with the subsequent development of infections, neoplasias, and metabolic alterations. The severe weakening of the immune system and of the entire body eventually causes death. By contrast, all the definitions for AIDS created by the Centres for Disease Control and Prevention (CDC), U.S.A. are subjective, arbitrary, and include other less severe immunodeficiencies that are not AIDS at all. This conception of toxic pathogenesis and of the natural history of AIDS allows new forms of treatment and prevention that have positive repercussions on individual and community health.. Drug treatments like AZT, the protease inhibitors and other similar antiretrovirals, must be eliminated from the treatment and prevention of AIDS, because they are immunotoxic agents and rather than producing wellness, they can generate AIDS. The prevention, control, and eradication of AIDS are easily possible and they depend on avoiding exposures to immunological stressors. The current programmes for preventing AIDS, based mostly on what is called “safe sex”, with generalised and indiscriminate distribution of condoms, rather than achieving any benefit promote the risks of promiscuity, a potentially toxic lifestyle that helps undermine the immune system. In the same way, the programmes of providing free “clean syringes” (“without HIV”) to drug addicts stimulate addiction to drugs and indirectly promote the traffic of drugs. All the psychoactive drugs that are introduced to the body are potent immunotoxic agents. This toxic hypothesis of AIDS solves the problems that the infectious hypothesis (HIV/AIDS) has not yet solved, not to mention the millions of dollars invested in research, prevention, and patient care within the infectious conception of the syndrome. The so-called “AIDS test” is neither sensible nor specific for detecting past or present infection with an HIV. Without reason it is used for diagnosis, or to decide the medications to treat or prevent this syndrome. “HIV antibody” positivity may act as a marker for immunodeficiency, but is not generative of AIDS. HIV, on the contrary, could be an effect of the pathogenesis of this syndrome. There is scientific evidence that suggests that stressors of the cells of all species can work as inductor agents of viruses and virus-like particles. The error over the etiology of AIDS was committed in part due to microbiologic prejudice in the mind of researchers, health professionals, journalists, and the public at large. This prejudice comes from the exaggeration of the germ theory of disease promulgated by Pasteur and Koch, which brought many benefits to the medical field at the time. Unfortunately, today they continue to think as at the end of the last century — that all is infectious, that all is contagious, and that it should be a microbe that causes everything. The world was prepared by a century of panic over microbes to mistake the etiology of AIDS. It was not possible to avoid it. Another contribution to the error about the cause of AIDS is the failure in research methodology to fulfil epidemiological requirements. None of the postulates on which the infectious hypothesis of AIDS is based fulfil the requirements of the research method. None of the bases of the HIV-AIDS hypothesis has been demonstrated at an objective level. They are theoretical assumptions, created by the minds of those who generate and defend that hypothesis. Practically, the entire world has become accustomed to believe all that we are told by the so-called men of science. Currently, the critical and questioning capabilities of “the people” are null. They do not ask for the necessary proofs for the affirmations that can look objective. The worst epidemic that the contemporary world suffers is an epidemic of crises in the scientific method. It is more extensive than the AIDS epidemic. There will be more consequences unless we take a pathway paved with an authentic objective research methodology. The scientific community has been wrong many times in this century — by considering as infectious diseases that are not — pellagra, scurvy and beriberi. The error currently made with AIDS has a larger magnitude due to the catastrophic repercussions on thousands of people that suffer from this toxic syndrome. The guilt for the error made with AIDS falls on a few resear-chers and health institutions of the US government. The majority of people in the world simply believed the so-called men of science. Analysis, understanding and solution of the error will force international medical authorities to rediscuss their tactics and strategies in the health care of people. This will lead to questions, investigations and solutions to the unfair forms by which men socially relate amongst themselves in modern society, which in the end are the reason for the existence of AIDS. Let us go back to Hippocratic medicine. Let us divulge and stimulate the discussion about the cause of AIDS. Roberto
Giraldo is a specialist in Internal Medicine from the
University of Antioquia, Colombia. He currently works in
the clinical immuno-logy section of the Department of
Microbiology, University Hospital, New York City. He has
been an independent researcher into AIDS for the past 15
years. |
| H |
Our fine gold dust RECENT reports regarding suspensions, transfers and resignations of medical teachers (The Tribune — September 11 & 12) indicate that something is seriously wrong with medical education in the state of Punjab. Medical education is a continuous process from the time the student enters a Medical College to the time of retirement. A doctor today requires more technical ability and greater breadth of knowledge, while the essential skills remain the same. No education system, least of all the medical education system, can afford to ignore the role of the teachers. It must be remembered that medical teachers are engaged in training and teaching of doctors who are going to be responsible for looking after the health of the nation in the years to come. Medicine differs from many other professions in the huge amount of teaching expected from all of its practitioners, for whom teaching is an important professional activity. The Hippocratic oath enshrines these words: “I swear by Apollo the physician..... that by precept, lecture, and every other mode of instruction, I will impart the knowledge of the Art to my own sons, and those of my teachers, and to disciples bound by a stipulation and oath according to the laws of medicine........”. Almost all doctors are teachers to some extent, but medical teachers have traditionally been accorded a lower status in the medical world. Even full time medical teachers find that service requirements, management responsibilities, audit and research, all compete with teaching for staff time. Finding a proper balance between the needs of medical education, service profession and a satisfactory career structure for medical teachers is the need of the hour. It is high time the approach to medical education and medical teachers underwent a sea change. Medical teachers should be given better service conditions, including higher emoluments, than their counterparts in state health services. They should be given a mandatory time off every five years for a full-time approved programme in assignments to update their medical knowledge and skills. The carrot and stick of reward and reappraisal should be introduced more widely in medical education, with proper financial rewards going to those medical teachers who excel in this important task. High quality medical teachers are like gold dust, and they should be handled with kid gloves! I sincerely hope our governments would not be found lacking in this regard. Prof
Kak is the Director-Principal, Government Medical
College, and Secretary, Medical Education and Research,
Chandigarh Administration. |
When a breast
lump is detected THE detection of a breast lump is common occurrence and a source of great anxiety to a patient until its nature is determined. To diminish the psychological stress caused by diagnostic uncertainty, the work-up of a breast lump should be completed as rapidly as possible, using a minimum of procedures. Having lumpy breasts can be perfectly normal for some women and can occur anytime in life. Often it varies with the menstrual cycle, being worst before a period. This type of nodularity without any single outstanding lump does not predispose a patient to any greater risk of cancer. A range of benign conditions may be responsible — notable being fibroadenoma (over-development of fibrous tissue). Some women may have multiple lumps which are harmless. If they get larger they are removed to allay anxiety. A painful lump can be an early cancer but is more likely to be a cyst. If the pain affects both breasts and the pain occurs before periods, or if both breasts feel lumpy, cancer is very unlikely. If the pain is one-sided, and you have a lump, see your doctor. In case of a single lump different in texture from the rest of the breast, the doctor inserts a fine needle into the lump and the tissue that is drawn off is sent to the laboratory for examination. At times if the report is suspicious, the lump is removed — a small operation is done and there is very little scaring or alteration in the breast afterwards. The area of breast tissue which has been removed is sent off for examination under the microscope. Whether further surgery is required or not depends upon the results of the microscopic examination of the breast tissue. Abnormalities on X-ray of the breast (mammography) which cannot be felt — the only way to accurately define is for the radiologist to insert a guidewire into this abnormality under X-ray control and remove the abnormal area. The area of breast tissue which has been removed is sent off for examination under the microscope. This reduces the need for surgical biopsy. What is breast biopsy? A cut is made in the skin over or near the affected area of the breast in a place that will be included in case any further operation is required. The affected area of the breast is removed in one piece. This can be done as an outpatient procedure. After various tests, if you have a malignant lump (cancer), a number of options are available. Breast-conserving surgery refers to removal of the tumour along with a cuff of normal tissue, while preserving the cosmetic appearance of the breast. Breast conserving surgery is referred to as segmentectomy (removal of a wedge of the breast tissue), wide local excision and axillary clearance (removal of some or all of the glands under the armpit — done through two separate incisions — one just below the hair bearing area in the armpit, and the other on the breast over the abnormal area). Mastectomy refers to the removal of the entire breast tissue. Please do not hesitate to ask any questions about the merits of each operation. No question is ever unimportant. The surgeon must make a full and balanced presentation to the patient concerning the pros and cons of these procedures. The patient should be given time to digest the information provided and return for a follow-up discussion if she wishes. Taking one or two weeks to arrive at a decision does not compromise the chance of cure. Whether or not you will need any other form of treatment afterwards will depend upon the microscopic findings of the tissues removed. Most people will require radiotherapy to the breast itself, some will require tablets in addition to radiotherapy, and some may require injection treatment. This is discussed with the patient at an appropriate time. Examine your breasts regularly: once a month is often enough. The best time is just after a period, when breasts are probably at their softest. It is important to continue regular checks. There is an urgent need for offering help, information and support to women with breast cancer or other breast-related problems. This will provide opportunity to a woman to talk freely to someone who has had a similar experience and has since resumed her normal everyday life. Full and sympathetic explanation at every step, with time for and encouragement of questions, are an important component of care. Early diagnosis should enable early treatment with the expectation of an improved outcome. The concept of early diagnosis is particularly pertinent for a malignant lump. Efforts to speed the diagnosis of breast cancer have focused on regular mammographic screening and periodic breast self-examinations. Such techniques aim at detecting tumoursat an early stage when treatment can be expected to lead to a better outcome. An early diagnosis of the disease of the breast is an established tenet of medicine and the patient should be kept fully informed. Understanding a patient’s expectation of therapy is essential to making optimal therapeutic decisions. Some may opt for a less aggressive therapy. A regular follow-up is extremely important. Dr
Wig is a renowned surgeon and an eminent teacher at the
PGI, Chandigarh. |
. |
 |
| | Nation | Punjab | Haryana | Himachal Pradesh | Jammu
& Kashmir | Chandigarh | | Editorial | Business | Stocks | Sports | | Mailbag | Spotlight | World | 50 years of Independence | Weather | | Search | Subscribe | Archive | Suggestion | Home | E-mail | |
