Podcasts about truvada

Pop some popcorn and loosen your belts because this week's episode of Butt Honestly! Dr. Carlton and Dangilo are back with their unfiltered thoughts on the popper ban (because how dare they), and they're setting the record straight on U=U—what it means and how it works. Plus, we're diving headfirst into some juicy drama with a vengeful update in the saga of Trampage and acsteamy Butt Dial from a listener fresh off their first Atlantis Cruise. Let's just say it's wetter than the open seas!Since March is Colorectal Cancer Awareness Month (and yes, we're rocking that blue!), the guys are dropping some knowledge to help you keep your backdoor in check.And because you can't get enough, our Hit It and Quit It segment is BACK with five scorching questions:What are the signs of colon cancer? A listener's feeling backed up and wondering if it's more than just a bad burrito.I'm a top, but I can't finish while topping—what gives? One frustrated listener is desperate to bust a nut without the help of his hands.Anal Botox for fissures—is it brilliant or a one-way ticket to Shartsville? Someone's worried about accidentally turning their ass into a Slip ‘N Slide, and Dr. Carlton's here to ease the fear.Truvada and kidney function—is every other day dosing a good idea? A listener's doc recommended it, but does that even make sense?I want TRT, but my T levels are just above the low range—how do I convince my doc? We're talking low energy, no sex drive, and gaining weight. The guys give out tips on making your case.Plus, we've got a listener question that takes a hard look at the realities of hookups that might involve BB—how do you assess risk when you're not entirely sure how compliant someone is with their meds? Dr. Carlton and Dangilo tackle the tricky topic with their signature blend of honesty and humor.And just when you think it can't get steamier, we've got an Atlantis Cruise story that's as hot as it is scandalous. To top it all off, the guys wrap things up with their Love Lounge of the Week—a little sweetness to balance out the spice.Hit play and hold on tight—this episode's gonna leave you breathless!Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Dr. Gary Null provides a commentary on "Universal  Healthcare"       Universal Healthcare is the Solution to a Broken Medical System Gary Null, PhD Progressive Radio Network, March 3, 2025 For over 50 years, there has been no concerted or successful effort to bring down medical costs in the American healthcare system. Nor are the federal health agencies making disease prevention a priority. Regardless whether the political left or right sponsors proposals for reform, such measures are repeatedly defeated by both parties in Congress. As a result, the nation's healthcare system remains one of the most expensive and least efficient in the developed world. For the past 30 years, medical bills contributing to personal debt regularly rank among the top three causes of personal bankruptcy. This is a reality that reflects not only the financial strain on ordinary Americans but the systemic failure of the healthcare system itself. The urgent question is: If President Trump and his administration are truly seeking to reduce the nation's $36 trillion deficit, why is there no serious effort to reform the most bloated and corrupt sector of the economy? A key obstacle is the widespread misinformation campaign that falsely claims universal health care would cost an additional $2 trillion annually and further balloon the national debt. However, a more honest assessment reveals the opposite. If the US adopted a universal single-payer system, the nation could actually save up to $20 trillion over the next 10 years rather than add to the deficit. Even with the most ambitious efforts by people like Elon Musk to rein in federal spending or optimize government efficiency, the estimated savings would only amount to $500 billion. This is only a fraction of what could be achieved through comprehensive healthcare reform alone. Healthcare is the largest single expenditure of the federal budget. A careful examination of where the $5 trillion spent annually on healthcare actually goes reveals massive systemic fraud and inefficiency. Aside from emergency medicine, which accounts for only 10-12 percent of total healthcare expenditures, the bulk of this spending does not deliver better health outcomes nor reduce trends in physical and mental illness. Applying Ockham's Razor, the principle that the simplest solution is often the best, the obvious conclusion is that America's astronomical healthcare costs are the direct result of price gouging on an unimaginable scale. For example, in most small businesses, profit margins range between 1.6 and 2.5 percent, such as in grocery retail. Yet the pharmaceutical industrial complex routinely operates on markup rates as high as 150,000 percent for many prescription drugs. The chart below highlights the astronomical gap between the retail price of some top-selling patented pharmaceutical medications and their generic equivalents. Drug Condition Patent Price (per unit) Generic Price Estimated Manufacture Cost Markup Source Insulin (Humalog) Diabetes $300 $30 $3 10,000% Rand (2021) EpiPen Allergic reactions $600 $30 $10 6,000% BMJ (2022) Daraprim Toxoplasmosis $750/pill $2 $0.50 150,000% JAMA (2019) Harvoni Hepatitis C $94,500 (12 weeks) $30,000 $200 47,000% WHO Report (2018) Lipitor Cholesterol $150 $10 $0.50 29,900% Health Affairs (2020) Xarelto Blood Thinner $450 $25 $1.50 30,000% NEJM (2020) Abilify Schizophrenia $800 (30 tablets) $15 $2 39,900% AJMC (2019) Revlimid Cancer $16,000/mo $450 $150 10,500% Kaiser Health News (2021) Humira Arthritis $2,984/dose $400 $50 5,868% Rand (2021) Sovaldi Hepatitis C $1,000/pill $10 $2 49,900% JAMA (2021) Xolair Asthma $2,400/dose $300 $50 4,800% NEJM (2020) Gleevec Leukemia $10,000/mo $350 $200 4,900% Harvard Public Health Review (2020) OxyContin Pain Relief $600 (30 tablets) $15 $0.50 119,900% BMJ (2022) Remdesivir Covid-19 $3,120 (5 doses) N/A $10 31,100% The Lancet (2020) The corruption extends far beyond price gouging. Many pharmaceutical companies convince federal health agencies to fund their basic research and drug development with taxpayer dollars. Yet when these companies bring successful products to market, the profits are kept entirely by the corporations or shared with the agencies or groups of government scientists. On the other hand, the public, who funded the research, receives no financial return. This amounts to a systemic betrayal of the public trust on a scale of hundreds of billions of dollars annually. Another significant contributor to rising healthcare costs is the widespread practice of defensive medicine that is driven by the constant threat of litigation. Over the past 40 years, defensive medicine has become a cottage industry. Physicians order excessive diagnostic tests and unnecessary treatments simply to protect themselves from lawsuits. Study after study has shown that these over-performed procedures not only inflate costs but lead to iatrogenesis or medical injury and death caused by the medical  system and practices itself. The solution is simple: adopting no-fault healthcare coverage for everyone where patients receive care without needing to sue and thereby freeing doctors from the burden of excessive malpractice insurance. A single-payer universal healthcare system could fundamentally transform the entire industry by capping profits at every level — from drug manufacturers to hospitals to medical equipment suppliers. The Department of Health and Human Services would have the authority to set profit margins for medical procedures. This would ensure that healthcare is determined by outcomes, not profits. Additionally, the growing influence of private equity firms and vulture capitalists buying up hospitals and medical clinics across America must be reined in. These equity firms prioritize profit extraction over improving the quality of care. They often slash staff, raise prices, and dictate medical procedures based on what will yield the highest returns. Another vital reform would be to provide free medical education for doctors and nurses in exchange for five years of service under the universal system. Medical professionals would earn a realistic salary cap to prevent them from being lured into equity partnerships or charging exorbitant rates. The biggest single expense in the current system, however, is the private health insurance industry, which consumes 33 percent of the $5 trillion healthcare budget. Health insurance CEOs consistently rank among the highest-paid executives in the country. Their companies, who are nothing more than bean counters, decide what procedures and drugs will be covered, partially covered, or denied altogether. This entire industry is designed to place profits above patients' lives. If the US dismantled its existing insurance-based system and replaced it with a fully reformed national healthcare model, the country could save $2.7 trillion annually while simultaneously improving health outcomes. Over the course of 10 years, those savings would amount to $27 trillion. This could wipe out nearly the entire national debt in a short time. This solution has been available for decades but has been systematically blocked by corporate lobbying and bipartisan corruption in Washington. The path forward is clear but only if American citizens demand a system where healthcare is valued as a public service and not a commodity. The national healthcare crisis is not just a fiscal issue. It is a crucial moral failure of the highest order. With the right reforms, the nation could simultaneously restore its financial health and deliver the kind of healthcare system its citizens have long deserved. American Healthcare: Corrupt, Broken and Lethal Richard Gale and Gary Null Progressive Radio Network, March 3, 2025 For a nation that prides itself on being the world's wealthiest, most innovative and technologically advanced, the US' healthcare system is nothing less than a disaster and disgrace. Not only are Americans the least healthy among the most developed nations, but the US' health system ranks dead last among high-income countries. Despite rising costs and our unshakeable faith in American medical exceptionalism, average life expectancy in the US has remained lower than other OECD nations for many years and continues to decline. The United Nations recognizes healthcare as a human right. In 2018, former UN Secretary General Ban Ki-moon denounced the American healthcare system as "politically and morally wrong." During the pandemic it is estimated that two to three years was lost on average life expectancy. On the other hand, before the Covid-19 pandemic, countries with universal healthcare coverage found their average life expectancy stable or slowly increasing. The fundamental problem in the U.S. is that politics have been far too beholden to the pharmaceutical, HMO and private insurance industries. Neither party has made any concerted effort to reign in the corruption of corporate campaign funding and do what is sensible, financially feasible and morally correct to improve Americans' quality of health and well-being.   The fact that our healthcare system is horribly broken is proof that moneyed interests have become so powerful to keep single-payer debate out of the media spotlight and censored. Poll after poll shows that the American public favors the expansion of public health coverage. Other incremental proposals, including Medicare and Medicaid buy-in plans, are also widely preferred to the Affordable Care Act or Obamacare mess we are currently stuck with.   It is not difficult to understand how the dismal state of American medicine is the result of a system that has been sold out to the free-market and the bottom line interests of drug makers and an inflated private insurance industry. How advanced and ethically sound can a healthcare system be if tens of millions of people have no access to medical care because it is financially out of their reach?  The figures speak for themselves. The U.S. is burdened with a $41 trillion Medicare liability. The number of uninsured has declined during the past several years but still lingers around 25 million. An additional 30-35 million are underinsured. There are currently 65 million Medicare enrollees and 89 million Medicaid recipients. This is an extremely unhealthy snapshot of the country's ability to provide affordable healthcare and it is certainly unsustainable. The system is a public economic failure, benefiting no one except the large and increasingly consolidated insurance and pharmaceutical firms at the top that supervise the racket.   Our political parties have wrestled with single-payer or universal healthcare for decades. Obama ran his first 2008 presidential campaign on a single-payer platform. Since 1985, his campaign health adviser, the late Dr. Quentin Young from the University of Illinois Medical School, was one of the nation's leading voices calling for universal health coverage.  During a private conversation with Dr. Young shortly before his passing in 2016, he conveyed his sense of betrayal at the hands of the Obama administration. Dr. Young was in his 80s when he joined the Obama campaign team to help lead the young Senator to victory on a promise that America would finally catch up with other nations. The doctor sounded defeated. He shared how he was manipulated, and that Obama held no sincere intention to make universal healthcare a part of his administration's agenda. During the closed-door negotiations, which spawned the weak and compromised Affordable Care Act, Dr. Young was neither consulted nor invited to participate. In fact, he told us that he never heard from Obama again after his White House victory.   Past efforts to even raise the issue have been viciously attacked. A huge army of private interests is determined to keep the public enslaved to private insurers and high medical costs. The failure of our healthcare is in no small measure due to it being a fully for-profit operation. Last year, private health insurance accounted for 65 percent of coverage. Consider that there are over 900 private insurance companies in the US. National Health Expenditures (NHE) grew to $4.5 trillion in 2022, which was 17.3 percent of GDP. Older corporate rank-and-file Democrats and Republicans argue that a single-payer or socialized medical program is unaffordable. However, not only is single-payer affordable, it will end bankruptcies due to unpayable medical debt. In addition, universal healthcare, structured on a preventative model, will reduce disease rates at the outset.    Corporate Democrats argue that Obama's Affordable Care Act (ACA) was a positive step inching the country towards complete public coverage. However, aside from providing coverage to the poorest of Americans, Obamacare turned into another financial anchor around the necks of millions more. According to the health policy research group KFF, the average annual health insurance premium for single coverage is $8,400 and almost $24,000 for a family. In addition, patient out-of-pocket costs continue to increase, a 6.6% increase to $471 billion in 2022. Rather than healthcare spending falling, it has exploded, and the Trump and Biden administrations made matters worse.    Clearly, a universal healthcare program will require flipping the script on the entire private insurance industry, which employed over half a million people last year.  Obviously, the most volatile debate concerning a national universal healthcare system concerns cost. Although there is already a socialized healthcare system in place -- every federal legislator, bureaucrat, government employee and veteran benefits from it -- fiscal Republican conservatives and groups such as the Koch Brothers network are single-mindedly dedicated to preventing the expansion of Medicare and Medicaid. A Koch-funded Mercatus analysis made the outrageous claim that a single-payer system would increase federal health spending by $32 trillion in ten years. However, analyses and reviews by the Congressional Budget Office in the early 1990s concluded that such a system would only increase spending at the start; enormous savings would quickly offset it as the years pass. In one analysis, "the savings in administrative costs [10 percent of health spending] would be more than enough to offset the expense of universal coverage."    Defenders of those advocating for funding a National Health Program argue this can primarily be accomplished by raising taxes to levels comparable to other developed nations. This was a platform Senator Bernie Sanders and some of the younger progressive Democrats in the House campaigned on. The strategy was to tax the highest multimillion-dollar earners 60-70 percent. Despite the outrage of its critics, including old rank-and-file multi-millionaire Democrats like Nancy Pelosi and Chuck Schumer, this is still far less than in the past. During the Korean War, the top tax rate was 91 percent; it declined to 70 percent in the late 1960s. Throughout most of the 1970s, those in the lowest income bracket were taxed at 14 percent. We are not advocating for this strategy because it ignores where the funding is going, and the corruption in the system that is contributing to exorbitant waste.    But Democratic supporters of the ACA who oppose a universal healthcare plan ignore the additional taxes Obama levied to pay for the program. These included surtaxes on investment income, Medicare taxes from those earning over $200,000, taxes on tanning services, an excise tax on medical equipment, and a 40 percent tax on health coverage for costs over the designated cap that applied to flexible savings and health savings accounts. The entire ACA was reckless, sloppy and unnecessarily complicated from the start.    The fact that Obamacare further strengthened the distinctions between two parallel systems -- federal and private -- with entirely different economic structures created a labyrinth of red tape, rules, and wasteful bureaucracy. Since the ACA went into effect, over 150 new boards, agencies and programs have had to be established to monitor its 2,700 pages of gibberish. A federal single-payer system would easily eliminate this bureaucracy and waste.    A medical New Deal to establish universal healthcare coverage is a decisive step in the correct direction. But we must look at the crisis holistically and in a systematic way. Simply shuffling private insurance into a federal Medicare-for-all or buy-in program, funded by taxing the wealthiest of citizens, would only temporarily reduce costs. It will neither curtail nor slash escalating disease rates e. Any effective healthcare reform must also tackle the underlying reasons for Americans' poor state of health. We cannot shy away from examining the social illnesses infecting our entire free-market capitalist culture and its addiction to deregulation. A viable healthcare model would have to structurally transform how the medical economy operates. Finally, a successful medical New Deal must honestly evaluate the best and most reliable scientific evidence in order to effectively redirect public health spending.    For example, Dr. Ezekiel Emanuel, a former Obama healthcare adviser, observed that AIDS-HIV measures consume the most public health spending, even though the disease "ranked 75th on the list of diseases by personal health expenditures." On the other hand, according to the American Medical Association, a large percentage of the nation's $3.4 trillion healthcare spending goes towards treating preventable diseases, notably diabetes, common forms of heart disease, and back and neck pain conditions. In 2016, these three conditions were the most costly and accounted for approximately $277 billion in spending. Last year, the CDC announced the autism rate is now 1 in 36 children compared to 1 in 44 two years ago. A retracted study by Mark Blaxill, an autism activist at the Holland Center and a friend of the authors, estimates that ASD costs will reach $589 billion annually by 2030. There are no signs that this alarming trend will reverse and decline; and yet, our entire federal health system has failed to conscientiously investigate the underlying causes of this epidemic. All explanations that might interfere with the pharmaceutical industry's unchecked growth, such as over-vaccination, are ignored and viciously discredited without any sound scientific evidence. Therefore, a proper medical New Deal will require a systemic overhaul and reform of our federal health agencies, especially the HHS, CDC and FDA. Only the Robert Kennedy Jr presidential campaign is even addressing the crisis and has an inexpensive and comprehensive plan to deal with it. For any medical revolution to succeed in advancing universal healthcare, the plan must prioritize spending in a manner that serves public health and not private interests. It will also require reshuffling private corporate interests and their lobbyists to the sidelines, away from any strategic planning, in order to break up the private interests' control over federal agencies and its revolving door policies. Aside from those who benefit from this medical corruption, the overwhelming majority of Americans would agree with this criticism. However, there is a complete lack of national trust that our legislators, including the so-called progressives, would be willing to undertake such actions.    In addition, America's healthcare system ignores the single most critical initiative to reduce costs - that is, preventative efforts and programs instead of deregulation and closing loopholes designed to protect the drug and insurance industries' bottom line. Prevention can begin with banning toxic chemicals that are proven health hazards associated with current disease epidemics, and it can begin by removing a 1,000-plus toxins already banned in Europe. This should be a no-brainer for any legislator who cares for public health. For example, Stacy Malkan, co-founder of the Campaign for Safe Cosmetics, notes that "the policy approach in the US and Europe is dramatically different" when it comes to chemical allowances in cosmetic products. Whereas the EU has banned 1,328 toxic substances from the cosmetic industry alone, the US has banned only 11. The US continues to allow carcinogenic formaldehyde, petroleum, forever chemicals, many parabens (an estrogen mimicker and endocrine hormone destroyer), the highly allergenic p-phenylenediamine or PBD, triclosan, which has been associated with the rise in antibiotic resistant bacteria, avobenzone, and many others to be used in cosmetics, sunscreens, shampoo and hair dyes.   Next, the food Americans consume can be reevaluated for its health benefits. There should be no hesitation to tax the unhealthiest foods, such as commercial junk food, sodas and candy relying on high fructose corn syrup, products that contain ingredients proven to be toxic, and meat products laden with dangerous chemicals including growth hormones and antibiotics. The scientific evidence that the average American diet is contributing to rising disease trends is indisputable. We could also implement additional taxes on the public advertising of these demonstrably unhealthy products. All such tax revenue would accrue to a national universal health program to offset medical expenditures associated with the very illnesses linked to these products. Although such tax measures would help pay for a new medical New Deal, it may be combined with programs to educate the public about healthy nutrition if it is to produce a reduction in the most common preventable diseases. In fact, comprehensive nutrition courses in medical schools should be mandatory because the average physician receives no education in this crucial subject.  In addition, preventative health education should be mandatory throughout public school systems.   Private insurers force hospitals, clinics and private physicians into financial corners, and this is contributing to prodigious waste in money and resources. Annually, healthcare spending towards medical liability insurance costs tens of billions of dollars. In particular, this economic burden has taxed small clinics and physicians. It is well past the time that physician liability insurance is replaced with no-fault options. Today's doctors are spending an inordinate amount of money to protect themselves. Legions of liability and trial lawyers seek big paydays for themselves stemming from physician error. This has created a culture of fear among doctors and hospitals, resulting in the overly cautious practice of defensive medicine, driving up costs and insurance premiums just to avoid lawsuits. Doctors are forced to order unnecessary tests and prescribe more medications and medical procedures just to cover their backsides. No-fault insurance is a common-sense plan that enables physicians to pursue their profession in a manner that will reduce iatrogenic injuries and costs. Individual cases requiring additional medical intervention and loss of income would still be compensated. This would generate huge savings.    No other nation suffers from the scourge of excessive drug price gouging like the US. After many years of haggling to lower prices and increase access to generic drugs, only a minute amount of progress has been made in recent years. A 60 Minutes feature about the Affordable Care Act reported an "orgy of lobbying and backroom deals in which just about everyone with a stake in the $3-trillion-a-year health industry came out ahead—except the taxpayers.” For example, Life Extension magazine reported that an antiviral cream (acyclovir), which had lost its patent protection, "was being sold to pharmacies for 7,500% over the active ingredient cost. The active ingredient (acyclovir) costs only 8 pennies, yet pharmacies are paying a generic maker $600 for this drug and selling it to consumers for around $700." Other examples include the antibiotic Doxycycline. The price per pill averages 7 cents to $3.36 but has a 5,300 percent markup when it reaches the consumer. The antidepressant Clomipramine is marked up 3,780 percent, and the anti-hypertensive drug Captopril's mark-up is 2,850 percent. And these are generic drugs!    Medication costs need to be dramatically cut to allow drug manufacturers a reasonable but not obscene profit margin. By capping profits approximately 100 percent above all costs, we would save our system hundreds of billions of dollars. Such a measure would also extirpate the growing corporate misdemeanors of pricing fraud, which forces patients to pay out-of-pocket in order to make up for the costs insurers are unwilling to pay.    Finally, we can acknowledge that our healthcare is fundamentally a despotic rationing system based upon high insurance costs vis-a-vis a toss of the dice to determine where a person sits on the economic ladder. For the past three decades it has contributed to inequality. The present insurance-based economic metrics cast millions of Americans out of coverage because private insurance costs are beyond their means. Uwe Reinhardt, a Princeton University political economist, has called our system "brutal" because it "rations [people] out of the system." He defined rationing as "withholding something from someone that is beneficial." Discriminatory healthcare rationing now affects upwards to 60 million people who have been either priced out of the system or under insured. They make too much to qualify for Medicare under Obamacare, yet earn far too little to afford private insurance costs and premiums. In the final analysis, the entire system is discriminatory and predatory.    However, we must be realistic. Almost every member of Congress has benefited from Big Pharma and private insurance lobbyists. The only way to begin to bring our healthcare program up to the level of a truly developed nation is to remove the drug industry's rampant and unnecessary profiteering from the equation.     How did Fauci memory-hole a cure for AIDS and get away with it?   By Helen Buyniski   Over 700,000 Americans have died of AIDS since 1981, with the disease claiming some 42.3 million victims worldwide. While an HIV diagnosis is no longer considered a certain death sentence, the disease looms large in the public imagination and in public health funding, with contemporary treatments running into thousands of dollars per patient annually.   But was there a cure for AIDS all this time - an affordable and safe treatment that was ruthlessly suppressed and attacked by the US public health bureaucracy and its agents? Could this have saved millions of lives and billions of dollars spent on AZT, ddI and failed HIV vaccine trials? What could possibly justify the decision to disappear a safe and effective approach down the memory hole?   The inventor of the cure, Gary Null, already had several decades of experience creating healing protocols for physicians to help patients not responding well to conventional treatments by the time AIDS was officially defined in 1981. Null, a registered dietitian and board-certified nutritionist with a PhD in human nutrition and public health science, was a senior research fellow and Director of Anti-Aging Medicine at the Institute of Applied Biology for 36 years and has published over 950 papers, conducting groundbreaking experiments in reversing biological aging as confirmed with DNA methylation testing. Additionally, Null is a multi-award-winning documentary filmmaker, bestselling author, and investigative journalist whose work exposing crimes against humanity over the last 50 years has highlighted abuses by Big Pharma, the military-industrial complex, the financial industry, and the permanent government stay-behind networks that have come to be known as the Deep State.   Null was contacted in 1974 by Dr. Stephen Caiazza, a physician working with a subculture of gay men in New York living the so-called “fast track” lifestyle, an extreme manifestation of the gay liberation movement that began with the Stonewall riots. Defined by rampant sexual promiscuity and copious use of illegal and prescription drugs, including heavy antibiotic use for a cornucopia of sexually-transmitted diseases, the fast-track never included more than about two percent of gay men, though these dominated many of the bathhouses and clubs that defined gay nightlife in the era. These patients had become seriously ill as a result of their indulgence, generally arriving at the clinic with multiple STDs including cytomegalovirus and several types of herpes and hepatitis, along with candida overgrowth, nutritional deficiencies, gut issues, and recurring pneumonia. Every week for the next 10 years, Null would counsel two or three of these men - a total of 800 patients - on how to detoxify their bodies and de-stress their lives, tracking their progress with Caiazza and the other providers at weekly feedback meetings that he credits with allowing the team to quickly evaluate which treatments were most effective. He observed that it only took about two years on the “fast track” for a healthy young person to begin seeing muscle loss and the recurrent, lingering opportunistic infections that would later come to be associated with AIDS - while those willing to commit to a healthier lifestyle could regain their health in about a year.    It was with this background that Null established the Tri-State Healing Center in Manhattan in 1980, staffing the facility with what would eventually run to 22 certified health professionals to offer safe, natural, and effective low- and no-cost treatments to thousands of patients with HIV and AIDS-defining conditions. Null and his staff used variations of the protocols he had perfected with Caiazza's patients, a multifactorial patient-tailored approach that included high-dose vitamin C drips, intravenous ozone therapy, juicing and nutritional improvements and supplementation, aspects of homeopathy and naturopathy with some Traditional Chinese Medicine and Ayurvedic practices. Additional services offered on-site included acupuncture and holistic dentistry, while peer support groups were also held at the facility so that patients could find community and a positive environment, healing their minds and spirits while they healed their bodies.   “Instead of trying to kill the virus with antiretroviral pharmaceuticals designed to stop viral replication before it kills patients, we focused on what benefits could be gained by building up the patients' natural immunity and restoring biochemical integrity so the body could fight for itself,” Null wrote in a 2014 article describing the philosophy behind the Center's approach, which was wholly at odds with the pharmaceutical model.1   Patients were comprehensively tested every week, with any “recovery” defined solely by the labs, which documented AIDS patient after patient - 1,200 of them - returning to good health and reversing their debilitating conditions. Null claims to have never lost an AIDS patient in the Center's care, even as the death toll for the disease - and its pharmaceutical standard of care AZT - reached an all-time high in the early 1990s. Eight patients who had opted for a more intensive course of treatment - visiting the Center six days a week rather than one - actually sero-deconverted, with repeated subsequent testing showing no trace of HIV in their bodies.   As an experienced clinical researcher himself, Null recognized that any claims made by the Center would be massively scrutinized, challenging as they did the prevailing scientific consensus that AIDS was an incurable, terminal illness. He freely gave his protocols to any medical practitioner who asked, understanding that his own work could be considered scientifically valid only if others could replicate it under the same conditions. After weeks of daily observational visits to the Center, Dr. Robert Cathcart took the protocols back to San Francisco, where he excitedly reported that patients were no longer dying in his care.    Null's own colleague at the Institute of Applied Biology, senior research fellow Elana Avram, set up IV drip rooms at the Institute and used his intensive protocols to sero-deconvert 10 patients over a two-year period. While the experiment had been conducted in secret, as the Institute had been funded by Big Pharma since its inception half a century earlier, Avram had hoped she would be able to publish a journal article to further publicize Null's protocols and potentially help AIDS patients, who were still dying at incredibly high rates thanks to Burroughs Wellcome's noxious but profitable AZT. But as she would later explain in a 2019 letter to Null, their groundbreaking research never made it into print - despite meticulous documentation of their successes - because the Institute's director and board feared their pharmaceutical benefactors would withdraw the funding on which they depended, given that Null's protocols did not involve any patentable or otherwise profitable drugs. When Avram approached them about publication, the board vetoed the idea, arguing that it would “draw negative attention because [the work] was contrary to standard drug treatments.” With no real point in continuing experiments along those lines without institutional support and no hope of obtaining funding from elsewhere, the department she had created specifically for these experiments shut down after a two-year followup with her test subjects - all of whom remained alive and healthy - was completed.2   While the Center was receiving regular visits by this time from medical professionals and, increasingly, black celebrities like Stokely Carmichael and Isaac Hayes, who would occasionally perform for the patients, the news was spreading by word of mouth alone - not a single media outlet had dared to document the clinic that was curing AIDS patients for free. Instead, they gave airtime to Anthony Fauci, director of the National Institute of Allergies and Infectious Diseases, who had for years been spreading baseless, hysteria-fueling claims about HIV and AIDS to any news outlet that would put him on. His claim that children could contract the virus from “ordinary household conduct” with an infected relative proved so outrageous he had to walk it back,3 and he never really stopped insisting the deadly plague associated with gays and drug users was about to explode like a nuclear bomb among the law-abiding heterosexual population. Fauci by this time controlled all government science funding through NIAID, and his zero-tolerance approach to dissent on the HIV/AIDS front had already seen prominent scientists like virologist Peter Duesberg stripped of the resources they needed for their work because they had dared to question his commandment: There is no cause of AIDS but HIV, and AZT is its treatment. Even the AIDS activist groups, which by then had been coopted by Big Pharma and essentially reduced to astroturfing for the toxic failed chemotherapy drug AZT backed by the institutional might of Fauci's NIAID,4 didn't seem to want to hear that there was a cure. Unconcerned with the irrationality of denouncing the man touting his free AIDS cure as an  “AIDS denier,” they warned journalists that platforming Null or anyone else rejecting the mainstream medical line would be met with organized demands for their firing.    Determined to breach the institutional iron curtain and get his message to the masses, Null and his team staged a press conference in New York, inviting scientists and doctors from around the world to share their research on alternative approaches to HIV and AIDS in 1993. To emphasize the sound scientific basis of the Center's protocols and encourage guests to adopt them into their own practices, Null printed out thousands of abstracts in support of each nutrient and treatment being used. However, despite over 7,000 invitations sent three times to major media, government figures, scientists, and activists, almost none of the intended audience members showed up. Over 100 AIDS patients and their doctors, whose charts exhaustively documented their improvements using natural and nontoxic modalities over the preceding 12 months, gave filmed testimonials, declaring that the feared disease was no longer a death sentence, but the conference had effectively been silenced. Bill Tatum, publisher of the Amsterdam News, suggested Null and his patients would find a more welcoming audience in his home neighborhood of Harlem - specifically, its iconic Apollo Theatre. For three nights, the theater was packed to capacity. Hit especially hard by the epidemic and distrustful of a medical system that had only recently stopped being openly racist (the Tuskegee syphilis experiment only ended in 1972), black Americans, at least, did not seem to care what Anthony Fauci would do if he found out they were investigating alternatives to AZT and death.    PBS journalist Tony Brown, having obtained a copy of the video of patient testimonials from the failed press conference, was among a handful of black journalists who began visiting the Center to investigate the legitimacy of Null's claims. Satisfied they had something significant to offer his audience, Brown invited eight patients - along with Null himself - onto his program over the course of several episodes to discuss the work. It was the first time these protocols had received any attention in the media, despite Null having released nearly two dozen articles and multiple documentaries on the subject by that time. A typical patient on one program, Al, a recovered IV drug user who was diagnosed with AIDS at age 32, described how he “panicked,” saw a doctor and started taking AZT despite his misgivings - only to be forced to discontinue the drug after just a few weeks due to his condition deteriorating rapidly. Researching alternatives brought him to Null, and after six months of “detoxing [his] lifestyle,” he observed his initial symptoms - swollen lymph nodes and weight loss - begin to reverse, culminating with sero-deconversion. On Bill McCreary's Channel 5 program, a married couple diagnosed with HIV described how they watched their T-cell counts increase as they cut out sugar, caffeine, smoking, and drinking and began eating a healthy diet. They also saw the virus leave their bodies.   For HIV-positive viewers surrounded by fear and negativity, watching healthy-looking, cheerful “AIDS patients” detail their recovery while Null backed up their claims with charts must have been balm for the soul. But the TV programs were also a form of outreach to the medical community, with patients' charts always on hand to convince skeptics the cure was scientifically valid. Null brought patients' charts to every program, urging them to keep an open mind: “Other physicians and public health officials should know that there's good science in the alternative perspective. It may not be a therapy that they're familiar with, because they're just not trained in it, but if the results are positive, and you can document them…” He challenged doubters to send in charts from their own sero-deconverted patients on AZT, and volunteered to debate proponents of the orthodox treatment paradigm - though the NIH and WHO both refused to participate in such a debate on Tony Brown's Journal, following Fauci's directive prohibiting engagement with forbidden ideas.    Aside from those few TV programs and Null's own films, suppression of Null's AIDS cure beyond word of mouth was total. The 2021 documentary The Cost of Denial, produced by the Society for Independent Journalists, tells the story of the Tri-State Healing Center and the medical paradigm that sought to destroy it, lamenting the loss of the lives that might have been saved in a more enlightened society. Nurse practitioner Luanne Pennesi, who treated many of the AIDS patients at the Center, speculated in the film that the refusal by the scientific establishment and AIDS activists to accept their successes was financially motivated. “It was as if they didn't want this information to get out. Understand that our healthcare system as we know it is a corporation, it's a corporate model, and it's about generating revenue. My concern was that maybe they couldn't generate enough revenue from these natural approaches.”5   Funding was certainly the main disciplinary tool Fauci's NIAID used to keep the scientific community in line. Despite the massive community interest in the work being done at the Center, no foundation or institution would defy Fauci and risk getting itself blacklisted, leaving Null to continue funding the operation out of his pocket with the profits from book sales. After 15 years, he left the Center in 1995, convinced the mainstream model had so thoroughly been institutionalized that there was no chance of overthrowing it. He has continued to counsel patients and advocate for a reappraisal of the HIV=AIDS hypothesis and its pharmaceutical treatments, highlighting the deeply flawed science underpinning the model of the disease espoused by the scientific establishment in 39 articles, six documentaries and a 700-page textbook on AIDS, but the Center's achievements have been effectively memory-holed by Fauci's multi-billion-dollar propaganda apparatus.     FRUIT OF THE POISONOUS TREE   To understand just how much of a threat Null's work was to the HIV/AIDS establishment, it is instructive to revisit the 1984 paper, published by Dr. Robert Gallo of the National Cancer Institute, that established HIV as the sole cause of AIDS. The CDC's official recognition of AIDS in 1981 had done little to quell the mounting public panic over the mysterious illness afflicting gay men in the US, as the agency had effectively admitted it had no idea what was causing them to sicken and die. As years passed with no progress determining the causative agent of the plague, activist groups like Gay Men's Health Crisis disrupted public events and threatened further mass civil disobedience as they excoriated the NIH for its sluggish allocation of government science funding to uncovering the cause of the “gay cancer.”6 When Gallo published his paper declaring that the retrovirus we now know as HIV was the sole “probable” cause of AIDS, its simple, single-factor hypothesis was the answer to the scientific establishment's prayers. This was particularly true for Fauci, as the NIAID chief was able to claim the hot new disease as his agency's own domain in what has been described as a “dramatic confrontation” with his rival Sam Broder at the National Cancer Institute. After all, Fauci pointed out, Gallo's findings - presented by Health and Human Services Secretary Margaret Heckler as if they were gospel truth before any other scientists had had a chance to inspect them, never mind conduct a full peer review - clearly classified AIDS as an infectious disease, and not a cancer like the Kaposi's sarcoma which was at the time its most visible manifestation. Money and media attention began pouring in, even as funding for the investigation of other potential causes of AIDS dried up. Having already patented a diagnostic test for “his” retrovirus before introducing it to the world, Gallo was poised for a financial windfall, while Fauci was busily leveraging the discovery into full bureaucratic empire of the US scientific apparatus.   While it would serve as the sole basis for all US government-backed AIDS research to follow - quickly turning Gallo into the most-cited scientist in the world during the 1980s,7 Gallo's “discovery” of HIV was deeply problematic. The sample that yielded the momentous discovery actually belonged to Prof. Luc Montagnier of the French Institut Pasteur, a fact Gallo finally admitted in 1991, four years after a lawsuit from the French government challenged his patent on the HIV antibody test, forcing the US government to negotiate a hasty profit-sharing agreement between Gallo's and Montagnier's labs. That lawsuit triggered a cascade of official investigations into scientific misconduct by Gallo, and evidence submitted during one of these probes, unearthed in 2008 by journalist Janine Roberts, revealed a much deeper problem with the seminal “discovery.” While Gallo's co-author, Mikulas Popovic, had concluded after numerous experiments with the French samples that the virus they contained was not the cause of AIDS, Gallo had drastically altered the paper's conclusion, scribbling his notes in the margins, and submitted it for publication to the journal Science without informing his co-author.   After Roberts shared her discovery with contacts in the scientific community, 37 scientific experts wrote to the journal demanding that Gallo's career-defining HIV paper be retracted from Science for lacking scientific integrity.8 Their call, backed by an endorsement from the 2,600-member scientific organization Rethinking AIDS, was ignored by the publication and by the rest of mainstream science despite - or perhaps because of - its profound implications.   That 2008 letter, addressed to Science editor-in-chief Bruce Alberts and copied to American Association for the Advancement of Science CEO Alan Leshner, is worth reproducing here in its entirety, as it utterly dismantles Gallo's hypothesis - and with them the entire HIV is the sole cause of AIDS dogma upon which the contemporary medical model of the disease rests:   On May 4, 1984 your journal published four papers by a group led by Dr. Robert Gallo. We are writing to express our serious concerns with regard to the integrity and veracity of the lead paper among these four of which Dr. Mikulas Popovic is the lead author.[1] The other three are also of concern because they rely upon the conclusions of the lead paper .[2][3][4]  In the early 1990s, several highly critical reports on the research underlying these papers were produced as a result of governmental inquiries working under the supervision of scientists nominated by the National Academy of Sciences and the Institute of Medicine. The Office of Research Integrity of the US Department of Health and Human Services concluded that the lead paper was “fraught with false and erroneous statements,” and that the “ORI believes that the careless and unacceptable keeping of research records...reflects irresponsible laboratory management that has permanently impaired the ability to retrace the important steps taken.”[5] Further, a Congressional Subcommittee on Oversight and Investigations led by US Representative John D. Dingell of Michigan produced a staff report on the papers which contains scathing criticisms of their integrity.[6]  Despite the publically available record of challenges to their veracity, these papers have remained uncorrected and continue to be part of the scientific record.  What prompts our communication today is the recent revelation of an astonishing number of previously unreported deletions and unjustified alterations made by Gallo to the lead paper. There are several documents originating from Gallo's laboratory that, while available for some time, have only recently been fully analyzed. These include a draft of the lead paper typewritten by Popovic which contains handwritten changes made to it by Gallo.[7] This draft was the key evidence used in the above described inquiries to establish that Gallo had concealed his laboratory's use of a cell culture sample (known as LAV) which it received from the Institut Pasteur.  These earlier inquiries verified that the typed manuscript draft was produced by Popovic who had carried out the recorded experiment while his laboratory chief, Gallo, was in Europe and that, upon his return, Gallo changed the document by hand a few days before it was submitted to Science on March 30, 1984. According to the ORI investigation, “Dr. Gallo systematically rewrote the manuscript for what would become a renowned LTCB [Gallo's laboratory at the National Cancer Institute] paper.”[5]  This document provided the important evidence that established the basis for awarding Dr. Luc Montagnier and Dr. Francoise Barré-Sinoussi the 2008 Nobel Prize in Medicine for the discovery of the AIDS virus by proving it was their samples of LAV that Popovic used in his key experiment. The draft reveals that Popovic had forthrightly admitted using the French samples of LAV renamed as Gallo's virus, HTLV-III, and that Gallo had deleted this admission, concealing their use of LAV.  However, it has not been previously reported that on page three of this same document Gallo had also deleted Popovic's unambiguous statement that, "Despite intensive research efforts, the causative agent of AIDS has not yet been identified,” replacing it in the published paper with a statement that said practically the opposite, namely, “That a retrovirus of the HTLV family might be an etiologic agent of AIDS was suggested by the findings.”  It is clear that the rest of Popovic's typed paper is entirely consistent with his statement that the cause of AIDS had not been found, despite his use of the French LAV. Popovic's final conclusion was that the culture he produced “provides the possibility” for detailed studies. He claimed to have achieved nothing more. At no point in his paper did Popovic attempt to prove that any virus caused AIDS, and it is evident that Gallo concealed these key elements in Popovic's experimental findings.  It is astonishing now to discover these unreported changes to such a seminal document. We can only assume that Gallo's alterations of Popovic's conclusions were not highlighted by earlier inquiries because the focus at the time was on establishing that the sample used by Gallo's lab came from Montagnier and was not independently collected by Gallo. In fact, the only attention paid to the deletions made by Gallo pertains to his effort to hide the identity of the sample. The questions of whether Gallo and Popovic's research proved that LAV or any other virus was the cause of AIDS were clearly not considered.  Related to these questions are other long overlooked documents that merit your attention. One of these is a letter from Dr. Matthew A. Gonda, then Head of the Electron Microscopy Laboratory at the National Cancer Institute, which is addressed to Popovic, copied to Gallo and dated just four days prior to Gallo's submission to Science.[8] In this letter, Gonda remarks on samples he had been sent for imaging because “Dr Gallo wanted these micrographs for publication because they contain HTLV.” He states, “I do not believe any of the particles photographed are of HTLV-I, II or III.” According to Gonda, one sample contained cellular debris, while another had no particles near the size of a retrovirus. Despite Gonda's clearly worded statement, Science published on May 4, 1984 papers attributed to Gallo et al with micrographs attributed to Gonda and described unequivocally as HTLV-III.  In another letter by Gallo, dated one day before he submitted his papers to Science, Gallo states, “It's extremely rare to find fresh cells [from AIDS patients] expressing the virus... cell culture seems to be necessary to induce virus,” a statement which raises the possibility he was working with a laboratory artifact. [9]  Included here are copies of these documents and links to the same. The very serious flaws they reveal in the preparation of the lead paper published in your journal in 1984 prompts our request that this paper be withdrawn. It appears that key experimental findings have been concealed. We further request that the three associated papers published on the same date also be withdrawn as they depend on the accuracy of this paper.  For the scientific record to be reliable, it is vital that papers shown to be flawed, or falsified be retracted. Because a very public record now exists showing that the Gallo papers drew unjustified conclusions, their withdrawal from Science is all the more important to maintain integrity. Future researchers must also understand they cannot rely on the 1984 Gallo papers for statements about HIV and AIDS, and all authors of papers that previously relied on this set of four papers should have the opportunity to consider whether their own conclusions are weakened by these revelations.      Gallo's handwritten revision, submitted without his colleague's knowledge despite multiple experiments that failed to support the new conclusion, was the sole foundation for the HIV=AIDS hypothesis. Had Science published the manuscript the way Popovic had typed it, there would be no AIDS “pandemic” - merely small clusters of people with AIDS. Without a viral hypothesis backing the development of expensive and deadly pharmaceuticals, would Fauci have allowed these patients to learn about the cure that existed all along?   Faced with a potential rebellion, Fauci marshaled the full resources under his control to squelch the publication of the investigations into Gallo and restrict any discussion of competing hypotheses in the scientific and mainstream press, which had been running virus-scare stories full-time since 1984. The effect was total, according to biochemist Dr. Kary Mullis, inventor of the polymerase chain reaction (PCR) procedure. In a 2009 interview, Mullis recalled his own shock when he attempted to unearth the experimental basis for the HIV=AIDS hypothesis. Despite his extensive inquiry into the literature, “there wasn't a scientific reference…[that] said ‘here's how come we know that HIV is the probable cause of AIDS.' There was nothing out there like that.”9 This yawning void at the core of HIV/AIDS “science" turned him into a strident critic of AIDS dogma - and those views made him persona non grata where the scientific press was concerned, suddenly unable to publish a single paper despite having won the Nobel Prize for his invention of the PCR test just weeks before.  10   DISSENT BECOMES “DENIAL”   While many of those who dissent from the orthodox HIV=AIDS view believe HIV plays a role in the development of AIDS, they point to lifestyle and other co-factors as being equally if not more important. Individuals who test positive for HIV can live for decades in perfect health - so long as they don't take AZT or the other toxic antivirals fast-tracked by Fauci's NIAID - but those who developed full-blown AIDS generally engaged in highly risky behaviors like extreme promiscuity and prodigious drug abuse, contracting STDs they took large quantities of antibiotics to treat, further running down their immune systems. While AIDS was largely portrayed as a “gay disease,” it was only the “fast track” gays, hooking up with dozens of partners nightly in sex marathons fueled by “poppers” (nitrate inhalants notorious for their own devastating effects on the immune system), who became sick. Kaposi's sarcoma, one of the original AIDS-defining conditions, was widespread among poppers-using gay men, but never appeared among IV drug users or hemophiliacs, the other two main risk groups during the early years of the epidemic. Even Robert Gallo himself, at a 1994 conference on poppers held by the National Institute on Drug Abuse, would admit that the previously-rare form of skin cancer surging among gay men was not primarily caused by HIV - and that it was immune stimulation, rather than suppression, that was likely responsible.11 Similarly, IV drug users are often riddled with opportunistic infections as their habit depresses the immune system and their focus on maintaining their addiction means that healthier habits - like good nutrition and even basic hygiene - fall by the wayside.    Supporting the call for revising the HIV=AIDS hypothesis to include co-factors is the fact that the mass heterosexual outbreaks long predicted by Fauci and his ilk in seemingly every country on Earth have failed to materialize, except - supposedly - in Africa, where the diagnostic standard for AIDS differs dramatically from those of the West. Given the prohibitively high cost of HIV testing for poor African nations, the WHO in 1985 crafted a diagnostic loophole that became known as the “Bangui definition,” allowing medical professionals to diagnose AIDS in the absence of a test using just clinical symptoms: high fever, persistent cough, at least 30 days of diarrhea, and the loss of 10% of one's body weight within two months. Often suffering from malnutrition and without access to clean drinking water, many of the inhabitants of sub-Saharan Africa fit the bill, especially when the WHO added tuberculosis to the list of AIDS-defining illnesses in 1993 - a move which may be responsible for as many as one half of African “AIDS” cases, according to journalist Christine Johnson. The WHO's former Chief of Global HIV Surveillance, James Chin, acknowledged their manipulation of statistics, but stressed that it was the entire AIDS industry - not just his organization - perpetrating the fraud. “There's the saying that, if you knew what sausages are made of, most people would hesitate to sort of eat them, because they wouldn't like what's in it. And if you knew how HIV/AIDS numbers are cooked, or made up, you would use them with extreme caution,” Chin told an interviewer in 2009.12   With infected numbers stubbornly remaining constant in the US despite Fauci's fearmongering projections of the looming heterosexually-transmitted plague, the CDC in 1993 broadened its definition of AIDS to include asymptomatic (that is, healthy) HIV-positive people with low T-cell counts - an absurd criteria given that an individual's T-cell count can fluctuate by hundreds within a single day. As a result, the number of “AIDS cases” in the US immediately doubled. Supervised by Fauci, the NIAID had been quietly piling on diseases into the “AIDS-related” category for years, bloating the list from just two conditions - pneumocystis carinii pneumonia and Kaposi's sarcoma - to 30 so fast it raised eyebrows among some of science's leading lights. Deeming the entire process “bizarre” and unprecedented, Kary Mullis wondered aloud why no one had called the AIDS establishment out: “There's something wrong here. And it's got to be financial.”13   Indeed, an early CDC public relations campaign was exposed by the Wall Street Journal in 1987 as having deliberately mischaracterized AIDS as a threat to the entire population so as to garner increased public and private funding for what was very much a niche issue, with the risk to average heterosexuals from a single act of sex “smaller than the risk of ever getting hit by lightning.” Ironically, the ads, which sought to humanize AIDS patients in an era when few Americans knew anyone with the disease and more than half the adult population thought infected people should be forced to carry cards warning of their status, could be seen as a reaction to the fear tactics deployed by Fauci early on.14   It's hard to tell where fraud ends and incompetence begins with Gallo's HIV antibody test. Much like Covid-19 would become a “pandemic of testing,” with murder victims and motorcycle crashes lumped into “Covid deaths” thanks to over-sensitized PCR tests that yielded as many as 90% false positives,15 HIV testing is fraught with false positives - and unlike with Covid-19, most people who hear they are HIV-positive still believe they are receiving a death sentence. Due to the difficulty of isolating HIV itself from human samples, the most common diagnostic tests, ELISA and the Western Blot, are designed to detect not the virus but antibodies to it, upending the traditional medical understanding that the presence of antibodies indicates only exposure - and often that the body has actually vanquished the pathogen. Patients are known to test positive for HIV antibodies in the absence of the virus due to at least 70 other conditions, including hepatitis, lupus, rheumatoid arthritis, syphilis, recent vaccination or even pregnancy. (https://www.chcfl.org/diseases-that-can-cause-a-false-positive-hiv-test/) Positive results are often followed up with a PCR “viral load” test, even though the inventor of the PCR technique Kary Mullis famously condemned its misuse as a tool for diagnosing infection. Packaging inserts for all three tests warn the user that they cannot be reliably used to diagnose HIV.16 The ELISA HIV antibody test explicitly states: “At present there is no recognized standard for establishing the presence and absence of HIV antibody in human blood.”17   That the public remains largely unaware of these and other massive holes in the supposedly airtight HIV=AIDS=DEATH paradigm is a testament to Fauci's multi-layered control of the press. Like the writers of the Great Barrington Declaration and other Covid-19 dissidents, scientists who question HIV/AIDS dogma have been brutally punished for their heresy, no matter how prestigious their prior standing in the field and no matter how much evidence they have for their own claims. In 1987, the year the FDA's approval of AZT made AIDS the most profitable epidemic yet (a dubious designation Covid-19 has since surpassed), Fauci made it clearer than ever that scientific inquiry and debate - the basis of the scientific method - would no longer be welcome in the American public health sector, eliminating retrovirologist Peter Duesberg, then one of the most prominent opponents of the HIV=AIDS hypothesis, from the scientific conversation with a professional disemboweling that would make a cartel hitman blush. Duesberg had just eviscerated Gallo's 1984 HIV paper with an article of his own in the journal Cancer Research, pointing out that retroviruses had never before been found to cause a single disease in humans - let alone 30 AIDS-defining diseases. Rather than allow Gallo or any of the other scientists in his camp to respond to the challenge, Fauci waged a scorched-earth campaign against Duesberg, who had until then been one of the most highly regarded researchers in his field. Every research grant he requested was denied; every media appearance was canceled or preempted. The University of California at Berkeley, unable to fully fire him due to tenure, took away his lab, his graduate students, and the rest of his funding. The few colleagues who dared speak up for him in public were also attacked, while enemies and opportunists were encouraged to slander Duesberg at the conferences he was barred from attending and in the journals that would no longer publish his replies. When Duesberg was summoned to the White House later that year by then-President Ronald Reagan to debate Fauci on the origins of AIDS, Fauci convinced the president to cancel, allegedly pulling rank on the Commander-in-Chief with an accusation that the “White House was interfering in scientific matters that belonged to the NIH and the Office of Science and Technology Assessment.” After seven years of this treatment, Duesberg was contacted by NIH official Stephen O'Brien and offered an escape from professional purgatory. He could have “everything back,” he was told, and shown a manuscript of a scientific paper - apparently commissioned by the editor of the journal Nature - “HIV Causes AIDS: Koch's Postulates Fulfilled” with his own name listed alongside O'Brien's as an author.18 His refusal to take the bribe effectively guaranteed the epithet “AIDS denier” will appear on his tombstone. The character assassination of Duesberg became a template that would be deployed to great effectiveness wherever Fauci encountered dissent - never debate, only demonize, deplatform and destroy.    Even Luc Montagnier, the real discoverer of HIV, soon found himself on the wrong side of the Fauci machine. With his 1990 declaration that “the HIV virus [by itself] is harmless and passive, a benign virus,” Montagnier began distancing himself from Gallo's fraud, effectively placing a target on his own back. In a 1995 interview, he elaborated: “four factors that have come together to account for the sudden epidemic [of AIDS]: HIV presence, immune hyper-activation, increased sexually transmitted disease incidence, sexual behavior changes and other behavioral changes” such as drug use, poor nutrition and stress - all of which he said had to occur “essentially simultaneously” for HIV to be transmitted, creating the modern epidemic. Like the professionals at the Tri-State Healing Center, Montagnier advocated for the use of antioxidants like vitamin C and N-acetyl cysteine, naming oxidative stress as a critical factor in the progression from HIV to AIDS.19 When Montagnier died in 2022, Fauci's media mouthpieces sneered that the scientist (who was awarded the Nobel Prize in 2008 for his discovery of HIV, despite his flagging faith in that discovery's significance) “started espousing views devoid of a scientific basis” in the late 2000s, leading him to be “shunned by the scientific community.”20 In a particularly egregious jab, the Washington Post's obit sings the praises of Robert Gallo, implying it was the American scientist who really should have won the Nobel for HIV, while dismissing as “

Hold onto your butts, because Dr. Carlton and Dangilo are back with an episode that's as wild as it is informative! This week, Dr. C gives us the full scoop on his trip to Dallas for the fisting conference—yes, you read that right—the infamous Rose Bowl, where he gave a speaking engagement... and made a pit stop at the warehouse party! Dangilo shares the dirty deets from DirtyBear AfterDark, and things get downright juicy.In the mix, the guys dive into a hilarious THEM article, “Straight Men Are Posting About Locktober. Who's Gonna Tell Them It's a Chastity Kink?"—and it's everything you'd expect and more. You'll laugh, you'll learn, and you'll probably be shaking your head at what straight dudes are up to this time.Next, it's time for another round of "HIT IT & QUIT IT" where they tackle listener questions like, "Do men really enjoy bearded cunnilingus?" and "What should I be mindful of if I'm using Truvada long-term?"Then, during Butt Dials, the questions get personal. A colorectal cancer survivor is ready to bottom again—is he in the clear? One listener asks, “Can I still have sex after hemorrhoids?” Another's struggling with stubborn anal fissures—what's the future of their elasticity down there? And a coupled-up 60-year-old writes in, seeking advice on getting over the mental and physical hurdles of breeding.Packed with humor, heart, and some risqué revelations, this episode is a wild ride from start to finish. So grab a drink, sit back, and enjoy—Butt Honestly has never been this raw!THEM ARTICLE: https://www.them.us/story/straight-men-fitness-bros-tiktok-locktober-trend-chastity-kink-fetish-challengeTRUVADA LAWSUIT INFORMATION: https://www.shouselaw.com/torts/truvada/Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Dr Rebecca Culshaw is a mathematician who questioned the official science to support the HIV virus and AIDS narrative.  Earlier, Rebecca taught at the University of Texas at Tyler as an assistant professor. She received her doctorate in mathematics from Dalhousie University in Canada, her dissertation focusing on immune response to HIV infection and AIDS treatments. She has written for several peer-review journals about mathematical modeling of HIV-related immunology and served on the editorial board of the Journal of Biological Systems. Dr Culshaw is the author of  "The Real AIDS Epidemic: How the Tragic HIV Mistake Threatens Us All" -- which presents the mistakes and corruption in the so-called War Against AIDS. Her most recent book is "The Truvada and PrEP Disaster" as a Kindle release and provides the history and details of anti-HIV drug toxicities and lawsuits against their manufacturers.   Neenyah Ostrom was the first American investigative journalist to report on myalgic encephalomyelitis and Chronic fatigue syndrome in the 1980s and 90s. Her writings have been recognized by Project Censored as among the most important censored stories.  Neenyah is the author of four books addressing the chronic fatigue syndrome epidemic including "What Really Killed Gilda Radner" and "America's Biggest Coverup: Fifty More Things Everyone Should Know about the Chronic Fatigue Syndrome Epidemic and its Links to AIDS."  Her latest book is "Ampligen: the Battle for a Promising ME/CFS Drug." Robert Kennedy Jr relies on Neenyah's work extensively in his best seller "The Real Anthony Fauci." She has also worked as an editor and ghostwriter on popular science books, including "Total Breast Health", which was chosen "Best Book of 1998" by Publishers Weekly.         REBECCA CULSHAW BOOKS:    "The Truvada and PrEP Disaster".   &.  "The Real AIDS Epidemic How the Tragic HIV Mistake Threatens Us All"  NEENYAH OSTROM'S BOOKS:  "America's Biggest Coverup: Fifty More Things Everyone Should Know about the Chronic Fatigue Syndrome Epidemic and its Links to AIDS."    AND   "Ampligen: the Battle for a Promising ME/CFS Drug."

A woman is starting up a new relationship. Her previous boyfriend was a dom who introduced her to kink. She loved it but found it all too contrived. How can she take the parts of Dom/sub dynamics she likes and leave the scripted parts behind? It used to take her soooooo long to come. But then she discovered suction toys, and blam! Her husband learned how to get her off orally, but then they divorced. Now she's back to square one and worries it will take another 6 years to train new lovers to get her off. How can she give them a crash course in how her body works?  On the Magnum, a severe strain of Mpox is on the rise in Africa. Dan brings back the wise and calm Dr. Carlton to discuss this and other anal health issues. Dr. Carlton shares his handy, (if sacriligious) technique to open up for anal sex without poppers. And they spell out use of Truvada, Doxy Pep and other meds on the scene. If you use your butt for sex, you'll want to tune in. A single mother and breast cancer survivor needs a little cash. She would like to set up an OnlyFans account, but worries that the scars from her mastectomy will hinder her chances or attract unwanted fetishists. Should she do this?  206-302-2064     Q@Savage.Love Find Dr. Carlton: Instagram, Threads and Tik Tok @DoctorCarlton X: @Doctor_Carlton Podcast: Butt Honestly with all social handles @butthonestlypod This episode is brought to you by Squarespace. They make it easy to build a website or blog. Give it a whirl at Squarespace.com/Savage and if you want to buy it, use the code Savage for a 10% off your first purchase. We're partnering with NOCD to raise awareness about OCD. Imagine having unwanted thoughts about your relationship stuck in your head all day no matter how hard you try to make them go away. That's OCD. Breaking the OCD cycle takes effective treatment. Go to NOCD.com/savage to learn more.

I am thrilled to connect with Dr. Tyna Moore today. She is a naturopathic physician and chiropractor, host of the Dr. Tyna podcast, a best-selling author, and an international speaker who offers a unique perspective for those seeking a stronger foundation for their health and well-being.  Recent statistics indicate that approximately 13% of Americans have used GLP-1 agonists, a class of drugs primarily prescribed for weight loss or metabolic health issues. According to a KFF health tracking poll, over 15 million people were prescribed GLP-1 drugs as of May 2024, and a Truvada report revealed that more than a million patients used those medications between January 2018 and September 2023.  Dr. Tyna thinks outside of the traditional media narrative regarding GLP-1 drugs and has been very successful in using them with her patients. In our discussion today, we explore the underlying reasons for the metabolic health crisis in our country, looking at sarcopenic obesity, why we are malnourished yet over-fed, and the impact of a sedentary lifestyle. We also dive into GLP-1 drugs, discussing their origin and their neurologic benefits, debunking the myths surrounding them, and examining their use during perimenopause and menopause.  Stay tuned for today's enlightening discussion with Dr. Tyna Moore on these incredible new weight-loss drugs and their application. IN THIS EPISODE YOU WILL LEARN: Why are we so sick as a country? The limitations of traditional allopathic medicine regarding lifestyle-related diseases Why weightlifting is essential for optimal health The benefits of peptides for cognition, pain reduction, and preventing brain fog The advantages of using GLP-1 agonists for treating depression and metabolic dysfunction  The potential risks of using GLP-1 drugs Debunking the myths surrounding the use of GLP-1 drugs Why women in perimenopause and menopause face unique challenges with metabolic health Why middle-aged women are the most stressed group of people, and how stress can exacerbate insulin resistance The merits of using GLP-1 peptides for treating middle-aged women with metabolic issues Why proactive lifestyle changes are essential for the neurocognitive health of menopausal women Connect with Cynthia Thurlow   Follow on Twitter Instagram LinkedIn Check out Cynthia's website Submit your questions to support@cynthiathurlow.com Connect with Dr. Tyna Moore On her website Instagram Facebook YouTube  Ozempic Uncovered Course  Podcast

Amazon.com: The Truvada and PrEP Disaster eBook : Culshaw Smith, Rebecca: Kindle Store

"The Truvada and PrEP Disaster" available on Amazon July 16, 2024 (substack.com)

Amazon.com: The Truvada and PrEP Disaster eBook : Culshaw Smith, Rebecca: Kindle Store

Amazon.com: The Truvada and PrEP Disaster eBook : Culshaw Smith, Rebecca: Kindle Store

Amazon.com: The Truvada and PrEP Disaster eBook : Culshaw Smith, Rebecca: Kindle Store

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Seeking Personal Truvada Stories - by Rebecca Culshaw Smith (substack.com)

If there's one person you'd want to talk to about immunology, the immune system and Covid, holes in our knowledge base about the complex immune system, and where the field is headed, it would be Professor Iwasaki. And add to that the topic of Women in Science. Here's our wide-ranging conversation.A snippet of the video, Full length Ground Truths videos are posted here and you can subscribe. Ground Truths is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.Transcript with many external link and links to the audio, recorded 30 April 2024 Eric Topol (00:06):Hello, it's Eric Topol and I'm really thrilled to have my friend Akiko Iwasaki from Yale, and before I start talking with Akiko, I just want to mention there aren't too many silver linings of the pandemic, but one for me was getting to know Professor Iwasaki. She is my go-to immunologist. I've learned so much from her over the last four years and she's amazing. She just, as you may know, she was just recently named one of the most influential people in the world by TIME100. [and also recognized this week in TIME 100 Health]. And besides that, she's been elected to the National Academy of Medicine, National Academy of Sciences. She's the president of the American Association of Immunologists and she's a Howard Hughes principal investigator. So Akiko, it's wonderful to have you to join into an extended discussion of things that we have of mutual interest.Akiko Iwasaki (01:04):Thank you so much, Eric, for having me. I equally appreciate all of what you do, and I follow your blog and tweets and everything. So thank you Eric.Eric Topol (01:14):Well, you are a phenom. I mean just, that's all I can say because I think it was so appropriate that TIME recognize your contributions, not just over the pandemic, but of course throughout your career, a brilliant career in immunology. I thought we'd start out with our topic of great interest on Long Covid. You've done seminal work here and this is an evolving topic obviously. I wonder what your latest thoughts are on the pathogenesis and where things are headed.Long CovidAkiko Iwasaki (01:55):Yeah, so as I have been saying throughout the pandemic, I think that Long Covid is not one disease. It's a collection of multiple diseases and that are sort of ending up in similar sets of symptoms. Obviously, there are over 200 symptoms and not everyone has the same set of symptoms, but what we are going for is trying to understand the disease drivers, so persistent viral infection is one of them. There are overwhelming evidence for that theory now, all the way from autopsy and biopsy studies to looking at peripheral blood RNA signatures as well as circulating spike protein and nucleocapsid proteins that are detected in people with Long Covid. Now whether that persistent virus or remnants of virus is driving the disease itself is unclear still. And that's why trials like the one that we are engaging with Harlan Krumholz on Paxlovid should tell us what percentage of the people are suffering from that type of driver and whether antivirals like Paxlovid might be able to mitigate those. If I may, I'd like to talk about three other hypotheses.Eric Topol (03:15):Yeah, I'd love for you to do that.Akiko Iwasaki (03:18):Okay, great. So the second hypothesis that we've been working on is autoimmune disease. And so, this is clearly happening in a subset of people, again, it's a heterogeneous disease, but we can actually not only look at reactogenicity of antibodies from people with Long Covid where we can transfer IgG from patients with Long Covid into an animal, a healthy animal, and really measure outcomes of a pathogenesis. So that's a functional evidence that antibodies in some people with Long Covid is really actually causing some of the damages that are occurring in vivo. And the third hypothesis is the reactivation of herpes viruses. So many of us adults have multiple latent herpes virus family members that are just dormant and are not really causing any pathologies. But in people with Long Covid, we're seeing elevated reactivation of viruses like Epstein-Barr virus (EBV) or Varicella-zoster virus (VZV) and that may again be just a signature of Long Covid, but it may also be driving some of the symptoms that people are suffering from.(04:32):So that's again, we see the signature over and over, not just our group, but multiple other groups, Michael Peluso's group, Jim Heath, and many others. So that's also an emerging evidence from multiple groups showing that. And finally, we think that inflammation that occurs during the acute phase can sort of chronically change some tissue tone. For instance, in the brain with Michelle Monje's team, we developed a sort of localized mild Covid model of infection and showed that changes in microglia can be seen seven weeks post infection even though the virus is completely gone. So that means that inflammation that's established as a result of this initial infection can have prolonged sequence and sequela within the person and that may also be driving disease. And Eric, the reason we need to understand these diseases separately is because not only for diagnostic purposes, but for therapeutic purposes because to target a persistent virus is very different approach from targeting autoantibodies, for example.Eric Topol (05:49):Well, that's great. There's a lot to unpack there as you laid out four distinct paths that could result in the clinical syndrome and sequelae. I think you know I had the chance to have a really fun conversation with Michelle about their joint work that you've done, and she reminded me how she made a cold call to you to start as a collaboration, which I thought was fantastic. Look what that yielded. But yeah, this is fascinating because as I think you're getting at is that it may not be the same pathogenesis in any given individual so that all these, and even others might be operative. I guess maybe I first delve into the antibody story as you're well aware, we see after people get Covid a higher rate of autoimmune diseases crop up, which is really interesting because it seems to rev up self-directed immune response. And this I think many people haven't really noted yet, although obviously you're well aware of this, it's across all the different autoimmune diseases, connective tissue disease, not just one in particular. And it's, as you say, the idea that you could take the blood from a person suffering from Long Covid and give it to an experimental animal model and be able to recapitulate some of the abnormalities, it's really pretty striking. So the question I guess is if you were to do plasmapheresis and try to basically expunge these autoantibodies, wouldn't you expect people to have some symptomatic benefit pretty rapidly or is it just that the process is already far from the initiating step?Akiko Iwasaki (07:54):That's a great question. Plasmapheresis may be able to transiently improve the person if they're suffering from these autoantibody mediated diseases. People have reported, for example, IVIG treatment has dramatically improved their symptoms, but not in everybody. So it's really critical to understand who's suffering from this particular driver and appropriately treat those people. And there are many other very effective therapies in autoimmune disease field that can be repurposed for treating these patients as well.Eric Topol (08:34):The only clinical trial that has clicked so far, interestingly, came out of Hong Kong with different types of ways to manipulate the gut microbiome, which again, you know better than me is a major modulator of our immune system response. What are your thoughts about taking advantage of that way to somehow modulate this untoward immune response in people with this condition?Akiko Iwasaki (09:07):Yeah, so that is an exciting sort of development, and I don't mean to discount the importance of microbiome at all. It's just the drivers that are mentioning are something that can be directly linked to disease, but certainly dysbiosis and translocation of metabolites and microbiome itself could trigger Long Covid as well. So it's something that we're definitely keeping our eyes on. And as you say, Eric, the immune system is in intimate contact with the gut microbiome and also the gut is intimate contact with the brain. So there's a lot of connections that we really need to be paying attention to. So yeah, absolutely. This is a very exciting development.Eric Topol (09:57):And it is intriguing of course, the reactivation of viruses. I mean, we've learned in recent years how important EBV is in multiple sclerosis (MS). The question I have for you on that pathway, is this just an epiphenomena or do you actually think that could be a driving force in some people?Akiko Iwasaki (10:19):Yeah, so that's really hard to untangle in people. I mean, David Putrino and my team we're planning a clinical trial using Truvada. Truvada obviously is an HIV drug, but it has reported antiviral activity to Epstein-Barr virus (EBV) and others. So potentially we can try to interrogate that in people, but we're also developing mouse models that can sort of recapitulate EBV like viral reactivation and to see whether there's any sort of causal link between the reactivation and disease process.Eric Topol (10:57):Right now, recently there's been a bunch of anecdotes of people who get the glucagon-like peptide one (GLP-1) drugs which have a potent anti-inflammatory, both systemic and in the brain. I'd love to test these drugs, but of course these companies that make them or have other interests outside of Long Covid, do you think there's potential for a drug like that?Akiko Iwasaki (11:23):Yeah, so those drugs seem to have a lot of miraculous effects on every disease. So obviously it has to be used carefully because many people with Long Covid have issues with liver functions and other existing conditions that may or may not be conducive to taking those types of GLP-1 agonists. But in subset of people, maybe this can be tried, especially due to the anti-inflammatory properties, it may benefit again, a subset of people. I don't expect a single drug to cure everyone. That would be pretty amazing, but unlikely.Eric Topol (12:09):Absolutely. And it's unfortunate we are not further along in this whole story of clinical trials, testing treatments and applauding your efforts with my friend Harlan there to get into the testing which we had hoped RECOVER was going to do with their more than billion dollars or allocation, which didn't get us too far in that. Now before we leave Long Covid, which we could speak about for hours, I mean it's so darn important because so many people are really out there disabled or suffering on a daily basis or periodically they get better and then get worse again. There's been this whole idea that, oh, it's going away and that reinfections don't pose a threat. Maybe you could straighten that story out because I think there seems to be some miscues about the risk of Long Covid even as we go along with the continued circulating virus.Akiko Iwasaki (13:11):Right, so when you look at the epidemiological evidence of Long Covid, clearly in the beginning when we had no vaccines, no antivirals, no real good measure against Covid, the incident of developing Long Covid per infection was higher than a current date where we do have vaccines and Omicron may have changed its property significantly. So if you compare, let's say the Delta period versus Omicron period, there seems to be a reduced risk per infection of Long Covid. However, Omicron is super infectious. It's infected millions of people, and if you look at the total number of people suffering from Long Covid, we're not seeing a huge decline there at all because of the transmissibility of Omicron. So I think it's too early for us to say, okay, the rates are declining, we don't need to worry about it. Not at all, I think we still have to be vigilant.(14:14):We need to be up to date on vaccines and boosters because those seem to reduce the risk for Long Covid and whether Paxlovid can reduce the rate of Long Covid at the acute phase for the high risk individual, it seems to be yes, but for people who are not at high risk may or may not be very effective. So again, we just need to be very cautious. It's difficult obviously, to be completely avoiding virus at this time point, but I think masking and anything you can do, vaccination boosters is going to be helpful. And a reinfection does carry risk for developing Long Covid. So that prior infection is not going to prevent Long Covid altogether, even though the risk may be slightly reduced in the first infection. So when you think about these risks, again we need to be cognizant that reinfection and some people have multiple infections and then eventually get Long Covid, so we're just not safe from Long Covid yet.Nasal Vaccines and Mucosal ImmunityEric Topol (15:24):Right. No, I think that's the problem is that people have not acknowledged that there's an ongoing risk and that we should continue to keep our guard up. I want to applaud you and your colleagues. You recently put out [Yale School of Public Health] this multi-panel about Covid, which we'll post with this podcast that gave a lot of the facts straight and simple diagrams, and I think this is what you need is this is kind of like all your threads on Twitter. . They're always such great educational ways to get across important information. So now let's go onto a second topic of great mutual interest where you've also been a leader and that's in the mucosal nasal vaccine story. I had the privilege of writing with you a nice article in Science Immunology back in 2022 about Operation Nasal Vaccine, and unfortunately we don't have a nasal vaccine. We need a nasal vaccine against Covid. Where do we stand with this now?Akiko Iwasaki (16:31):Yeah, so you're right. I mean nasal vaccines, I don't really know what the barrier is because I think the preclinical models all support the effectiveness against transmission and infection and obviously disease. And there is a White House initiative to support rapid development of next generation vaccine, which includes mucosal vaccine, so perhaps that's sort of pushing some of these vaccine candidates forward. You're probably more familiar than me about those kinds of events that are happening. But yeah, it's unfortunate that we don't have an approved mucosal booster vaccine yet, and our research has shown that as simple as a spray of recombinant spike protein without any adjuvants are able to restimulate immune response and then establish mucosal immunity in the nasal cavity, which goes a long way in preventing infection as well as transmission. So yeah, I mean I'm equally frustrated that things like that don't exist yet.The Neomycin and Neosporin SurpriseEric Topol (17:52):Well, I mean the work that you and many other groups around the world have published on this is so compelling and this is the main thing that we don't have now, which is a way to prevent infection. And I think most of us would be very happy to have a spray that every three or four months and gave us much higher levels of protection than we're ever going to get from shots. And your whole concept of prime and spike, I mean this is something that we could have had years ago if there was a priority, and unfortunately there never has been. Now, the other day you came with a surprise in a paper on Neomycin as an alternate or Neosporin ointment. Can you tell us about that? Because that one wasn't expected. This was to use an antibiotic in a way to reduce Covid and other respiratory virus.Akiko Iwasaki (18:50):Right. So yeah, that's a little known fact. I mean, of course widespread use of antibiotics has caused some significant issues with resistance and so on. However, when you look at the literature of different types of antibiotics, we have reported in 2018 that certain types of antibiotics known as aminoglycoside, which includes Neosporin or neomycin, has this sort of unintended antiviral property by triggering Toll-like receptor 3 in specialized cell types known as conventional dendritic cell type 1. And we published that for a genital herpes model that we were working on at the time. But because it's acting on the host, the Toll-like receptor 3 on the host cell to induce interferon and interferon stimulated genes to prevent the replication of the virus, we knew that it could be pan-viral. It doesn't really matter what the virus is. So we basically leverage that discovery that was made by a postdoc Smita Gopinath when she was in the lab to see if we can use that in the nasal cavity.(20:07):And that's what Tianyang Mao, a former graduate student did, in fact. And yeah, little spray of neomycin in the nose of the mice reduce this infection as well as disease and can even be used to treat shortly after the infection disease progress and using hamster models we also showed that hamsters that are pretreated with neomycin when they were caged with infected hamsters, the transmission rate was much reduced. And we also did with Dr. Charles Dela Cruz, a small clinical trial, randomized though into placebo and Neosporin arms of healthy volunteers. We asked them to put in a pea size amount of Neosporin on a cotton swab into the nose, and they were doing that twice a day for seven days. We measured the RNA from the nose of these people and indeed see that more than half the participants in the Neosporin group had elevated interferon stimulated genes, whereas the control group, which were given Vaseline had no response. So this sort of shows the promise of using something as generic and cheap as Neosporin to trigger antiviral state in the nose. Now it does require a much larger trial making sure that the safety profiles there and effectiveness against viral infection, but it's just a beginning of a story that could develop into something useful.New Frontiers in Immunology and Tx CellsEric Topol (21:51):Yeah, I thought it was fascinating, and it does bring up, which I think has also been underdeveloped, is our approaches for interferon a frontline defense where augmenting that, just getting that exploiting the nasal mucosa, the entry site, whether it be through that means or of course through even more potent a nasal vaccine, it's like a missing, it's a hole in our whole defense of against this virus that's led to millions of people not just dying, but of course also sick and also with Long Covid around the world. So I hope that we'll see some progress, but I thought that was a really fascinating hint of something to come that could be very helpful in the meantime while we're waiting for specific nasal vaccines. Now added to all these things recently, like last week you published a paper in Cell with your husband who's in the same department, I think at Yale. Is that right? Can you tell us about that and this paper about the whole new perspectives in immunology?Akiko Iwasaki (23:05):Yeah, so my husband Ruslan Medzhitov is a very famous immunologist who's in the same department, and we've written four or five review and opinion pieces together over the years. This new one is in Cell and it's really exploring new perspectives in immunology. We were asked by the editors to celebrate the 50th anniversary of the Cell journal with a perspective on the immune system. And the immune response is just a beautiful system that is triggered in response to specific pathogens and can really provide long-term or even sometimes lifelong immunity and resistance against pathogens and it really saves our lives. Much has been learned throughout the last 20, 30 years about the innate and adaptive immune system and how they're linked. In this new perspective, we are trying to raise some issues that the current paradigm cannot explain properly, some of the mysteries that are still remaining in the immune system.(24:22):And we try to come up with new concepts about even the role of the immune system in general. For instance, is the immune system only good for fighting pathogens or can it be repurposed for conducting normal physiology in the host? And we came up with a new subset of T-cells known as, or we call it Tx cells, which basically is an interoceptive type of T-cells that monitor homeostasis in different tissues and are helping with the normal process of biology as opposed to fighting viruses or bacteria or fungi. But these cells, when they are not appropriately regulated, they are also the source of autoimmune diseases because they are by design reactive against auto antigens. And so, this is a whole new framework to think about, a different arm of the immune function, which is really looking inside of our body and not really fighting against pathogens, but we believe these cells exist, and we know that the counterpart of Tx cells, which is the T regulatory cells, are indeed well known for its physiological functions. So we're hoping that this new perspective will trigger a new set of approaches in the field to try to understand this interceptive property of T-cells.Eric Topol (25:59):Yeah, well, I thought it was fascinating, of course, and I wanted to get into that more because I think what we're learning is this immune system not only obviously is for cancer whole. We're only starting to get warmed up with immunotherapy where checkpoint inhibitors were just the beginning and now obviously with vaccines and all these different ways that we can take the CAR-T cells, engineered T-cells, take the immune system to fight cancer and potentially to even use it as a way to prevent cancer. If you have these, whether it's Tx or Tregs or whatever T-cells can do this. But even bigger than that is the idea that it's tied in with the aging process. So as you know, again, much more than I do, our senescent immune cells are not good for us. And the whole idea is that we could build immune resilience if we could somehow figure out these mysteries that you're getting at, whereby we get vulnerable just as we were with Covid. And as we get older, we get vulnerable to not just infections, but everything going wrong, whether it's the walls of our arteries or whether it's the cancer or the immunity that's going on in our brain for Alzheimer's and neurodegenerative diseases. How can we fix the immune system so that we age more healthilyThe Immune System and Healthy Aging Akiko Iwasaki (27:37):Oh yeah. A lot of billionaires are also interested in that question and are pouring money into this question. It's interesting, but when you think about the sort of evolutionary perspective, we humans are only living so long. In the very recent decades, our life expectancy used to be much shorter and all we had to survive was to reproduce and generate the next progeny. But nowadays, because of this amazing wealth and health interventions and food and everything else, we're just living so much longer than even our grandparents. The immune system didn't evolve to deal with such one to begin with. So we were doing fine living up to 30 years of age or whatever. But now that we're living up to a hundred years, the immune system isn't really designed to keep up with this kind of stressors. But I think you're getting at a very important kind of more engineering questions of how do we manipulate the immune system or rejuvenate it so that we can remain healthy into the later decades? And it is well known that the immune system itself ages and that our ability to produce new lymphocytes, for example, decline over time and thymus that is important for T-cell development shrinks over time. And so anatomically it's impossible to help stop that process. However, is there a way of, for example, transferring some factors or engineering the immune cells to remain healthy and even like hematopoiesis itself can be manipulated to perhaps rejuvenate the whole immune system in their recent papers showing that. So this is a new frontier.Eric Topol (29:50):Do you think that some point in the future, we'll ex vivo inject Yamanaka factors into these cell lines and instead of this idea that you know get young plasma to old folks, and I mean since we don't know what's in there and it doesn't specifically have an effect on immune cells, who knows how it's working, but do you foresee that that might be a potential avenue going forward or even an in vivo delivery of this?Akiko Iwasaki (30:22):Yeah, it's not impossible, right? There are really rapidly evolving technologies and gene therapies that are becoming online. So it's not impossible to think about engineering in situ as you're suggesting, but we also have to be certain that we are living longer, but also healthy. So we do have to not only just deal with the aging immune system, but preventing neurodegenerative diseases and so on. And the immune system may have a role to play there as well. So there's a lot of, I mean, I can't think of a non-genetically mediated disease that doesn't involve the immune system.Eric Topol (31:03):Sure. No, I mean, it's just, when I think about this, people keep talking about the digital era of digital biology, but I actually think of it more as digital immunobiology, which is driving this because it's center stage and in more and more over time. And the idea that I'm concerned about is that we could rejuvenate the relevant immune cells or the whole immune response, but then it's such a delicate balance that we could actually wind up with untoward, whether it's autoimmune or overly stimulated immune system. It's not such a simple matter, as I'm sure you would agree. Now, this gets me to a broader thing which you've done, which is a profound contribution in life science and medicine, which is being an advocate for women in science. And I wonder if you could speak to that because you have been such a phenomenal force propelling the importance of women in science and not just doing that passively, but also standing up for women, which is being an activist is how you get things to change. So can you tell us about your thoughts there?An Activist for Women in ScienceAkiko Iwasaki (32:22):Yeah, so I grew up in Japan, and part of the reason I left Japan at the age of 16 was that I felt very stifled because of the societal norm and expectation of what a woman should be. And I felt like I didn't have the opportunity to develop my skills as a scientist remaining in Japan. And maybe things have changed over the years, but at the time when I was growing up, that's how I felt. And so, I was very cognizant of biases in society. And so, in the US and in Canada where I also trained, there's a lot less barrier to success, and we are able to do pretty much anything we want, which is wonderful, and that's why I think I'm here. But at the same time, the inequity still exists, even in pay gaps and things like that that are easy to fix but are still kind of insidious and it's there.(33:32):And Yale School of Medicine has done a great job partly because of the efforts of women who spoke up and who actually started to collect evidence for pay gap. And now there's very little pay gap because there's active sort of involvement of the dean and everyone else to ensure equity in the medical school. But it's just a small segment of the society. We really need to expand this to other schools and making sure that women are getting paid equally as men in the same ranks. And also, I see still some sexual harassment or more just toxic environment for people in general in academia. Some PIs get away with a lot of behavior that's not conducive to a healthy environment, so I have written about that as well and how we can have antidotes for such toxic environments. And it really does require the whole village to act on it. It's not just one person speaking up. And there should be measures placed to make sure that those people who does have this tendency of abusive behavior that they can get training and just being aware of these situations and corrective behavior. So I think there's still a lot of work left in academia, but things have obviously improved dramatically over the last few decades, and we are in a very, very good place, but we just have to keep working to achieve true equity.Why Don't We Have Immunome Check-Ups?Eric Topol (35:25):Well applauding your efforts for that, and I'm still in touch with that. We got a ways to go, and I hope that we'll see steady and even more accelerated and improvement to get to parity, which is what it should be. And I really think you've been a model for doing this. It isn't like you aren't busy with everything else, so to fit that in is wonderful. In closing up, one of the things that I wonder about is our ability to assess back to the immune system for a moment isn't what it should be. That is we do a CBC and we have how many lymphocytes, how many this, why don't we have an immunome, why doesn't everybody serially have an immune system checkup? Because that would tell us if we're starting to go haywire and then maybe hunt for reactivated viruses or what's going on. Do you foresee that we could ever get to a practical immunome as we go forward? Because it seems like it's a big missing link right now.Akiko Iwasaki (36:33):Yeah, I think that's a great idea. I mean, I'll be the first one to sign up for the immunome.Eric Topol (36:40):But I'm depending on you to make it happen.Akiko Iwasaki (36:44):Well, interestingly, Eric, there are lots of amazing technologies that are developed even during the pandemic, which is monitoring everything from antibody reactivity to reactivated viruses to the cytokines to every cell marker you can imagine. So the technologies out there, it's just I think a matter of having the right set of panels that are relatively affordable because some of these things are thousands of dollars per sample to analyze, and then of course clinical validation, something that's CLIA approved, and then we can start to, I guess the insurance company needs to also cover this, right? So we need to demonstrate the benefit to health in the long run to be able to afford this kind of immunome analysis. But I think that very wealthy people can already get this done.Eric Topol (37:43):Yeah, well, we want to make it so it's a health equity story, not of course, only for the crazy ones that are out there that are taking 112 supplements a day and whatnot. But it's intriguing because I think we might be able to get ahead of things if we had such an easy means. And as you said during the pandemic, for example, my friends here in La Jolla at La Jolla Immunology did all kinds of T-cell studies that were really insightful and of course done with you and others around the country and elsewhere to give us insights that you didn't get just from neutralizing antibodies. But it isn't something that you can get done easily. Now, I think this immunome hopefully will get us to another level in the future. One of the most striking things I've seen in our space clinically before wrapping up is to take the CD19 CAR T therapies to deplete the B cells of people with lupus, systemic sclerosis and other conditions, and completely stop their autoimmune condition. And when the B cells come back, they're not fighting themselves. They're not self-directed anymore. Would you have predicted this? This seems really striking and it may be a clue to the kind of mastering approaches to autoimmune diseases in the future.Akiko Iwasaki (39:19):Yeah, absolutely. So for multiple sclerosis, for example, where B cells weren't thought to be a key player by doing anti-CD20 depletion, there's this remarkable clinical effects. So I think we can only find the answer experimentally in people when they do these clinical trials and show this remarkable effects. That's when we say, aha, we don't really understand immunology. You know what I mean? That's when we have to be humble about what we think we understand. We really don't know until we try it. So that's a really good lesson learned. And these may be also applicable to people with autoimmune phenotype in Long Covid, right? We may be able to benefit from similar kinds of depletion therapy. So I think we have a lot to learn still.Eric Topol (40:14):Yeah, that's why, again, going back to the paper you just had in Cell about the mysteries and about some new ideas and challenging the dogma is so important. I still consider the immune system most complex one in the body by far, and I'm depending on you Akiko to unravel it, not to put any weight on your shoulders. Anyway, this has been so much fun. You are such a gem and always learning from you, and I can't thank you enough for all the work. And the fact is that you've got decades ahead of you to keep building on this. You've already done enough for many people, many scientists in your career, and I know you'll keep going. So we're all going to be following you with great interest in learning from you on a frequent basis. And I hope we'll build on some of the things we've talked about like a Long Covid treatment, treatments that are effective nasal vaccines, maybe even some dab of Neosporin, and keep on the momentum we've had with the understanding of the immune system, and finally, someday achieving the true parity of gender and science. And so, thank you for all that you do.Akiko Iwasaki (41:35):Thank you so much, Eric.************************CreditsHeadshot photo credits by Robert Lisak, Yale School of MedicineMy producer for Ground Truths is Jessica Nguyen, Scripps Research and our technical support for audio/video is by SInjun Balabanoff at Scripps Research.I hope you found the spot informative. Please share itThe Ground Truths newsletters and podcasts are all free, open-access, without ads.Voluntary paid subscriptions all go to support Scripps Research. 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Rebecca Culshaw reports regularly on the Truvada lawsuit. The Truvada disaster - by Rebecca Culshaw Smith (substack.com)

Rebecca Culshaw Smith is the only journalist covering the Truvada disaster on a regular basis. The Truvada disaster - by Rebecca Culshaw Smith (substack.com)

China's medical regulators recently approved two foreign drugs, bringing new hope to patients with Alzheimer's disease and groups at risk for HIV/AIDS.中国医疗监管机构最近批准了两种外国药物，为阿尔茨海默病患者和艾滋病高危人群带来了新的希望。The National Medical Products Administration announced last week that it had granted market approval for the injected drug Leqembi, developed by Tokyo-based pharmaceutical company Eisai, to treat minor dementia and cognitive dysfunction triggered by Alzheimer's.美国国家医疗产品管理局上周宣布，已批准注射药物Leqembi上市，该药物由制药公司卫材(Eisai)开发，用于治疗阿尔茨海默氏症引发的轻微痴呆和认知功能障碍，该公司总部位于东京。The Economic Observer, a Beijing-based news outlet, reported that China is the third country to approve the drug, after the United States in July and Japan in September. The drug targets amyloid betaprotein, widely believed to be associated with neurotoxicity and Alzheimer's.总部位于北京的新闻媒体《经济观察报》报道称，继美国7月和日本9月批准该药物后，中国是第三个批准该药物的国家。该药物针对的是淀粉样β蛋白，人们普遍认为该蛋白与神经毒性和阿尔茨海默病有关。The pharmaceutical company added that current drugs on the market only target symptoms and have a hard time dealing with the root cause. During a global clinical trial, taking the drug was shown to reverse the progression for about 60 percent of early-stage patients and help them improve cognitive impairments, the company said.该制药公司补充说，目前市场上的药物只能针对症状，很难解决根本原因。该公司表示，在一项全球临床试验中，服用该药物可以逆转约60%的早期患者的病情进展，并帮助他们改善认知障碍。Eisai set the price at 2,508 yuan ($350) per 2-milliliter dose, or about 180,000 yuan annually for a patient weighing 60 kilograms.卫材将价格定为每2毫升剂量2,508元，对于体重60公斤的患者来说，每年费用约为18万元。According to the Economic Observer, the drug was priced at 3,328 yuan per dose during a trial in Boao Hope City, a pilot medical zone in Hainan province, which allows drugs approved elsewhere to be used for real-world clinical trials in China. The first batch of 200 doses has been used up, the report said.据经济观察报报道，该药在海南省医疗试点博鳌希望城进行试验时的售价为每剂3328元，允许在其他地方批准的药物在中国进行真实临床试验。报道称，第一批200剂已经用完。China has 9.83 million people with Alzheimer's, and the disease is the fifth-largest cause of death in the country, according to an annual report on the disease released last year. Meanwhile, the diagnosis and treatment rate is low, and awareness among the general public is inefficient, the report said.根据去年发布的阿尔茨海默病年度报告，中国有983万阿尔茨海默病患者，该病是中国第五大死亡原因。并且诊疗率低，公众了解度有限。Separately, Descovy, a tablet developed by US-based pharmaceutical company Gilead, has been approved by the NMPA for pre-exposure prophylaxis, or PrEP, to lower the risk of HIV infection due to high-risk sexual activities. Previously, the drug had been approved to treat HIV infections in adults.另外，美国吉利德制药公司开发的片剂Descovy已获得国家药监局批准用于暴露前预防（PrEP），以降低因高危性活动而感染艾滋病毒的风险。此前，该药物已被批准用于治疗成人艾滋病毒感染。The NMPA said that clinical trials showed that Descovy had effectiveness as a PrEP drug no worse than Truvada, the first PrEP drug approved in China, and that it displayed very low side effects.国家药监局表示，临床试验表明，德可维作为PrEP药物的有效性并不比中国首个获批的PrEP药物Truvada差，而且副作用非常低。"Groups with a high risk of HIV exposure can take this drug regularly to help maintain a certain density of the drug in the blood to prevent HIV infections," said Wang Hui, chief expert of the HIV/AIDS center at Shenzhen Third People's Hospital, adding that the drug offers a new choice for those involved in high-risk sexual activities, such as those engaging in unprotected homosexual sex, sex with unfixed partners, or prostitution.深圳市第三人民医院艾滋病中心首席专家王辉表示，艾滋病暴露高风险人群可以定期服用这种药物，帮助维持血液中一定的药物浓度，预防艾滋病毒感染。该药物为那些从事高风险性活动的人提供了新的选择，例如进行无保护措施的同性恋群体以及与不固定伴侣发生性行为或卖淫的人。Sexual activity is a major means of HIV transmission among adults. As of late 2022, China has 1.2 million people living with HIV, according to the Chinese Center for Disease Control and Prevention.性活动是成人中艾滋病毒传播的主要途径。根据中国疾病预防控制中心的数据，截至2022年底，中国有120万艾滋病毒感染者。The World Health Organization said oral PrEP is highly effective in preventing HIV when used as directed, and recommends people at substantial risk of HIV infection be offered PrEP drugs as an additional choice as part of comprehensive prevention.世界卫生组织表示，按照指示口服PrEP对预防HIV非常有效，并建议向HIV感染高风险人群提供PrEP药物，以助力全面预防艾滋病。However, awareness and prevalence of PrEP in China are relatively low compared with developed countries. Based on a study published in the Chinese Journal of Epidemiology in 2020, only 56 percent of some 600 interviewed men who have sex with men said they were aware of the method, and just 10.6 percent said they were absolutely willing to use it.但与发达国家相比，我国PrEP的知晓率和普及率较低。根据2020年《中国流行病学杂志》发表的一项研究，在约600名接受采访的男男性接触者中，只有56%的人表示他们知道这种方法，只有10.6%的人表示他们非常愿意使用这种方法预防感染艾滋病。Alzheimer英/ˈɔltsˌhɑɪ·mərz / 美/ˈɔltsˌhɑɪ·mərz /n. 阿兹海默症homosexual sex同性恋性行为

We have a fun this day in legal history entry for today, on this day, May 15, in 1911, the US Supreme Court ordered the dissolution of Standard Oil pursuant to the Sherman Antitrust Act, holding that Standard Oil's monopoly “unduly” restrained trade. The ruling resulted in breaking Standard Oil up into 34 independent companies. These companies became known as the "baby Standards." The breakup aimed to promote competition and prevent the concentration of economic power in a single entity.Among the prominent companies that emerged from the Standard Oil breakup were Exxon (formerly Standard Oil of New Jersey), Mobil (formerly Standard Oil of New York), Chevron (formerly Standard Oil of California), and Amoco (formerly Standard Oil of Indiana). These companies went on to become major players in the oil industry. Ultimately, they've merged back down in to 4. Perfect.President Joe Biden and congressional Republicans are engaged in critical debt-ceiling talks in an effort to reach a deal on spending levels and energy regulations to prevent a damaging default. While both sides are not close to an agreement, the White House has not ruled out the annual spending caps that Republicans insist on for any increase in the $31.4 trillion debt limit. Republicans, on the other hand, are not demanding conditions that the White House considers off-limits, such as repealing green-energy incentives in Biden's Inflation Reduction Act. Energy regulations could potentially be an area of common ground. Biden expressed optimism about reaching a deal and meetings between staff from both sides were described as constructive. However, time is running out, with the United States projected to run out of money to pay its bills as early as June 1. A default would have severe economic consequences and worry investors and consumers. Republicans argue that there is still plenty of time for a deal to be reached. Biden has called for Congress to increase the borrowing capacity without conditions but has also indicated a willingness to discuss budget matters with Republicans. Republicans face pressure from former President Donald Trump, who suggested allowing the country to default unless all their demands are met. House Republicans previously passed legislation that combines a $1.5 trillion debt-ceiling hike with $4.8 trillion in spending cuts, but Democrats oppose certain elements of that legislation. However, they have not ruled out spending caps more generally. The White House and Republicans might also consider easing permitting requirements for energy infrastructure. The longer it takes to reach an agreement, the narrower the scope of the deal is expected to become.Biden, Republicans search for outline of debt-limit deal | ReutersXCast Labs, a Voice over Internet Protocol (VoIP) provider, has been sued by the U.S. Federal Trade Commission (FTC) for allegedly facilitating billions of illegal robocalls. The FTC is seeking a court order to compel the company to cease the practice. XCast is accused of assisting other companies, including one that falsely claimed to be a government entity, in contacting individuals on the National Do Not Call Registry and using deceptive tactics to persuade them to make purchases or contributions. The lawsuit requests unspecified penalties against XCast. The company has not yet provided a comment in response to the allegations. The case was filed by the Justice Department on behalf of the FTC in a California district court.Robocall company behind 'billions' of illegal calls sued by FTC | ReutersGoogle, a unit of Alphabet, has agreed to pay $8 million to settle claims made by Texas Attorney General Ken Paxton that the company used deceptive advertisements to promote its Pixel 4 smartphone. The allegations stated that Google hired radio announcers to provide testimonials about the phone, even though they were not allowed to use it. This settlement comes as Google faces scrutiny from both federal and state authorities regarding antitrust and consumer protection issues. Google stated that it takes advertising compliance seriously and is “pleased” to resolve the matter.Google to pay $8 million to settle claims of deceptive ads -Texas AG | ReutersWe have previously reported on the fact Gilead Sciences recently won a patent-infringement case brought by the federal government over HIV drug patents, causing mixed opinions among industry insiders and healthcare advocates about the impact on future collaborations. The jury voided three government-owned patents and ruled that Gilead's Truvada and Descovy for pre-exposure prophylaxis (PrEP) did not infringe them. While some believe the verdict won't significantly affect government-industry collaborations, others worry it may discourage pharmaceutical companies from entering license agreements with the government. The case highlights the complex relationship between the government and industry regarding intellectual property rights in research partnerships. Now the issue is that the outcome could potentially lead to a more deferential approach by the government towards pharmaceutical companies, raising concerns about high drug prices and limited access for consumers. The case underscores the ongoing tension between the government's desire to protect its rights and the pharmaceutical industry's need for collaboration, leaving the future of such partnerships uncertain and signaling potential implications for not only pricing but also access to innovative treatments.Big Pharma, US Research Pacts in Flux After Gilead's Trial WinRush-Copley Medical Center Inc., located in Illinois, has been denied summary judgment in a medical malpractice case where a non-employed doctor, Hinna Khan, is accused of negligence. The court ruled that the degree of control exerted by the hospital over Khan was a matter of fact that needed to be determined by a jury. Typically, hospitals have no control over the medical judgment of non-employee physicians, but this case raises the question of whether the hospital can be held vicariously liable for the alleged negligence of a doctor perceived by patients to be employed by the facility.Nathaniel Pryor Sr. and Adriana Madrigal filed the lawsuit against Rush and Khan, alleging that negligent care by the pediatrician caused brain damage, leading to their son's cerebral palsy, seizure disorder, and permanent disability. Rush argued that it couldn't be held liable because Khan was not its employee, as indicated on an admission form signed by the baby's mother. However, in Illinois, hospitals can be held responsible for the actions of doctors who are their actual or apparent agents.Apparent agency is established when a physician's actions would reasonably lead someone to believe they are an employee of the hospital, and the hospital acquiesces to such conduct, causing the plaintiff to rely on it. This is a highly fact-dependent question that the court determined should be resolved by a jury. The plaintiffs asserted that Rush's discharge policy required Khan to fulfill certain obligations before discharging a patient, which she allegedly failed to do.Rush contended that the discharge policy only applied to nurses, but there was evidence suggesting that doctors were also expected to follow it. Judge Franklin U. Valderrama concluded that there was an unresolved question of fact regarding Rush's control over Khan's discharge decisions, denying the hospital's motion for summary judgment. The case will now proceed to trial, shedding light on the complex issue of hospital liability for non-employed physicians and the importance of clarifying the nature of their relationship in such cases.Illinois Hospital Faces Trial Over Doctor's Alleged Negligence Get full access to Minimum Competence - Daily Legal News Podcast at www.minimumcomp.com/subscribe

Apple has lost its lawsuit against Corellium, a company that provides virtual iOS devices for security research purposes. The court ruled that the use of Corellium's CORSEC simulator falls under copyright law's fair use doctrine. This means that third-party virtual iOS devices are allowed and Apple cannot stop it. The ruling allows security researchers to run virtual desktops and OSs for research purposes. Concerns have been raised that developers may use Corellium's security-focused VMs to try out apps without having to acquire the related hardware. Apple tried to acquire Corellium in 2018, but was obviously unsuccessful.Apple just lost its lawsuit trying to ban iOS virtual machines | TechRadarTexas billionaire and GOP donor Harlan Crow has refused a request from Senate Finance Committee Chairman Ron Wyden to detail the extent and tax treatment of luxury gifts he provided to Supreme Court Justice Clarence Thomas. Crow's attorney argued that the inquiry "appears to be a component of a broader campaign against Justice Thomas and, now, Mr. Crow, rather than an investigation that furthers a valid legislative purpose." Democrats who control the Senate are ramping up inquiries into the relationship between Crow and Thomas and his wife, conservative activist Ginni Thomas, following reports that Thomas never reported luxury trips and other gifts funded by Crow. ProPublica also reported last week that Crow paid tuition at two private schools for Thomas's grandnephew in the late 2000s. Wyden said he is "disappointed but unsurprised" by Crow's refusal to comply and will be talking with other lawmakers on the committee about using "any tools at our disposal" to compel a response. Republicans are pushing back on Democrats' efforts, including their call for a high-court code of ethics similar to one that applies to all other federal judges.Harlan Crow Refuses Senate Request in Justice Thomas InquiryRepublican Representative George Santos, who was elected to a district in New York City and Long Island in 2022, is facing federal criminal charges over possible campaign finance violations. The charges could be unsealed as early as today and the case could be prosecuted out of the Eastern District's central office in Islip on Long Island. Santos has previously rejected calls to resign after it was revealed that he fabricated much of what he had claimed about his education and career. During the campaign, he claimed to have worked for Goldman Sachs and Citigroup, graduated from Baruch College in New York, played on a championship volleyball team and that he was Jewish, but none of those things were true. Santos was part of a Republican wave that picked up House seats in New York State during the 2022 midterm elections. With Republicans holding the House by just five seats, Santos's vote is a critical part of House Speaker Kevin McCarthy's hold on power. McCarthy said he would ask Santos to resign if he's found guilty.George Santos Faces Criminal Charges by US Justice DepartmentA quick follow-up to an earlier story wherein we covered a rare suit by the US government to enforce a patent against Gilead Sciences.Gilead Sciences has won a lawsuit brought by the US government over patents for its HIV-prevention regimens using Truvada and Descovy. The Delaware jury found the government's patents were invalid and not infringed following a five-day trial and a morning of deliberations. The US government had argued that Gilead failed to compensate the US Centers for Disease Control and Prevention for discovering that Truvada, first approved to treat HIV, could also help prevent infection by the virus. Gilead reported worldwide sales of more than $2 billion last year from Truvada and Descovy.Gilead Sciences prevails in US government lawsuit over HIV drug patents | ReutersSidney Powell, a former lawyer for Donald Trump, is facing a professional misconduct complaint in Michigan over a failed bid to challenge the 2020 US presidential election results. Powell and other lawyers filed a lawsuit in November 2020 claiming that widespread voter fraud undermined the legitimacy of President Joe Biden's win over Trump. The Michigan Attorney Grievance Commission filed the case on Friday, claiming the plaintiffs' lawyers brought a “frivolous lawsuit” and engaged in “conduct that is prejudicial to the administration of justice”. Powell and Wood did not immediately respond to messages seeking comment. Giuliani, Eastman and Wood are among other lawyers in Trump's orbit facing attorney misconduct claims related to election-related litigation.Trump ally Sidney Powell, others face misconduct case in Michigan | ReutersFormer President Donald Trump has been found liable for sexually assaulting writer E. Jean Carroll and defaming her by calling her a liar. This is the first verdict against him in a string of legal cases that threaten to erupt during the 2024 presidential campaign. The panel of six men and three women returned the verdict after deliberating on the civil lawsuit for less than three hours. Carroll had accused Trump of attacking her in the dressing room of a Fifth Avenue department store in the 1990s and then harming her reputation by saying she made it up when she went public with her account in 2019. He must pay her $5 million in damages, $3 million of it for defamation. The trial renewed attention on Trump's fraught history with women, and anyone who thinks women shouldn't be abused, as he embarks on another run for the White House.  Despite the relatively high-profile trial, recent polls show Trump as the clear front-runner for the GOP presidential nomination. Trump's attorney Tacopina said Trump would appeal Tuesday's verdict and seek to reduce the damages. Because it was a civil rather than criminal case, and because the wealthy and powerful are rarely actually held to account, Trump was never at risk of imprisonment over Carroll's allegations. Trump Liable for Sex Abuse, Must Pay $5 Million to Carroll (2) Get full access to Minimum Competence - Daily Legal News Podcast at www.minimumcomp.com/subscribe

A Senate panel is set to hold a hearing on Tuesday to scrutinize ethics concerns relating to US Supreme Court justices, following revelations about luxury trips and real estate transactions involving members of the nation's top judicial body. None of the nine justices will appear at the hearing, but lawyers and academics versed in the subject will provide testimony. The news outlet ProPublica has detailed ties between conservative Justice Clarence Thomas and wealthy Republican donor Harlan Crow, including real estate purchases and luxury travel paid for by the Dallas businessman. Additionally, Jane Roberts, the wife of Chief Justice John Roberts, reportedly earned over $10 million in commissions as a legal recruiter from 2007 to 2014, including from law firms that had cases before the Supreme Court. A whistleblower complaint from her former colleague argues that Roberts' commissions were largely due to her husband's role and should be subject to oversight. The complaint also alleges that John Roberts submitted financial disclosure documents identifying his wife's income as "salary" rather than commission, which the colleague argued is misleading. Again, none of the nine justices will appear at the hearing. Senate panel to examine US Supreme Court ethics as questions swirl | ReutersChief Justice John Roberts' Wife Made Over $10 Million As Legal Consultant, Report SaysGilead Sciences is facing a trial in Delaware federal court as the US government seeks more than $1 billion from the company for allegedly failing to compensate the Centers for Disease Control and Prevention (CDC) for discovering that Gilead's HIV-treatment drug Truvada could help prevent the disease. The government claims that the patents it received for HIV prevention drug regimens cover Gilead's pre-exposure prophylaxis (PrEP) drug regimen for lowering HIV infection risk. Gilead denies the allegations and argues the patents are invalid. The trial marks one of the first times the US government has sued a drug maker to enforce its patent rights.Gilead, US square off in billion-dollar HIV drug patent trial | ReutersMy column this week discusses the use of "cashports," also known as "citizenship by investment" programs, that allow wealthy individuals to purchase citizenship, typically in countries that offer tax anonymity. I'm coining the term “cashport,” so I need the help of all the Minimum Competence listeners to make sure it really takes the world by storm. These programs, such as those offered by St. Kitts and Nevis, allow individuals to avoid paying taxes in their home countries and to hide their financial dealings. I argue that this practice is not only detrimental to tax revenues but also facilitates organized crime and terrorism. I call for greater transparency and for imposing penalties on individuals who use these programs to evade taxes. Additionally, I suggest curtailing financial access to tax havens and imposing restrictions on transfers to and from these countries.One recent individual in the news making use of a cashport is The latest example of a billionaire keeping his money offshore is Harlan Crow. We've learned much about Crow over the past few weeks—as a friend and benefactor of Justice Clarence Thomas, a collector of Hitlerania and garden gnome versions of history's greatest monsters, and a holder of a “cashport” to St. Kitts and Nevis. His use of offshore banks will likely obfuscate his financial dealings sufficiently that, barring a confession, the extent to which his largesse was used for Clarence Thomas will never be known.Golden Visas Let People Like Harlan Crow Keep Too Much HiddenJPMorgan Chase & Co, new owners of First Republic Bank, and Deutsche Bank AG could be held liable for Jeffrey Epstein's sexual abuse if former executive Jes Staley had first-hand knowledge of the financier's sex-trafficking venture, according to a US judge. Judge Jed Rakoff said that if Epstein's accusers can prove that Staley knew about the venture, they could show that JPMorgan "actually knew" or "recklessly disregarded" its existence. The decision concerns two lawsuits against the banks by Epstein's accusers, and a lawsuit against JPMorgan by the US Virgin Islands. All of the lawsuits are scheduled for trial this year.Judge says JPMorgan could be liable for Epstein sex trafficking if Staley knew about it | Reuters Get full access to Minimum Competence - Daily Legal News Podcast at www.minimumcomp.com/subscribe

Hey, Communitea, Here's What's Brewing, Today! HIV Activist, Paris Mullen, joins Yo Aunteas to discuss his journey living with HIV as a queer black man! Time Stamps: 0:00- Paris Mullen 46:00- Tea Break- MinoriteaReport.com 46:48- AYA: Gay Relationships 1:04:50- RIP Harry Belafonte 1:07:40- Noah's Arc Movie 1:14:00- Curiositea: Paris Mullen   Follow Us-   MERCH: MinoriteaReport.com   Youtube: https://www.youtube.com/channel/UCo_xKK1VRhPrVMQxm1SzTCg   Instagram: https://www.instagram.com/minoriteareport/   Facebook: https://www.facebook.com/MinoriTeaReport/   Twitter: https://twitter.com/MTeaReport   Email Us- AYA@minoriTeaReport.com   Spotify Playlist- https://open.spotify.com/playlist/0rVJtKJmesMkCgVKmJwc46?si=1455491d0a4049b5

This episode, Long-Acting Injectable PrEP and HIV Treatment, is the second in a three-episode series about new evidence-based strategies for addressing HIV and AIDS.Guests featured in this episode:Jeremiah JohnsonProgram ManagerPrep4All Amy Killelea, J.D., Killelea Consulting Aviva Cantor, PA-C, AAHIVS, PhD, Callen-Lorde Community Health CenterModerator: Alexandra Walker, Digital Communications Director, NACHCAlexandra: Hello and welcome to Health Centers on the Frontlines, the podcast of the National Association of Community Health Centers. Today is the second in a three-episode series we're doing about an epidemic that the nation's health centers have been battling for decades: HIV and AIDS. During these episodes, we're sharing promising news about how community health centers, health center controlled networks and primary care associations are employing the latest strategies to link people to ongoing HIV prevention, treatment, and care services. Today, we're happy to be joined by a panel of experts, Jeremiah Johnson, who is the Program Manager at Prep4All, an organization of professionals and patients based in New York City who advocate for greater access to lifesaving medication for HIV. Also joining us is Amy Killelea, JD, an expert in policy, medication access, and health care financing to develop sustainable HIV and Hepatitis programs. And Dr. Aviva Cantor, HIV specialist and primary care provider at Callen-Lorde Community Health Center, which serves New York City's lesbian, gay, bisexual, and transgender communities. So in late 2021, the US public was introduced to a bi-monthly injectable form of PrEP, which stands for Pre-Exposure Prophylaxis. Taken in pill form and now also available as an injectable this medication reduces the chance of getting HIV from sex or injection drug use. When taken as prescribed, PrEP is highly effective for preventing HIV, a landmark push to end the HIV epidemic. At the same time, people living with HIV have been introduced to a monthly injectable form of treatment that similarly puts them in charge of their healthcare needs without having to remind themselves to take a daily oral medication. This is revolutionizing the field of treatment and prevention of HIV because we never have had a form of either that was this long lasting. Also, it's exciting news because it expands the number of tools we have in our hands to fight HIV. Health centers have been taking their first steps in implementing these tools. So, starting with our health center guest. Aviva, can you explain to our audience the two types of injectable antiretroviral medication? We've heard that one can be used as PrEP for people who are HIV negative and the other as an HIV treatment for people who are living with HIV. Can you tell us about the similarities and differences?Aviva: Sure. Yeah. So the two medications and we use brand names here. I normally don't like to use brand names, but we'll use them so that they're more clear for patients in the community. So one is called Cabenuva. That's the medication that's used for HIV treatment. And the other is called Apretude. That is the medication that's used for HIV prevention. What they both have in common are that they are both what I describe to patients and my colleagues as deep intramuscular injections. So they're a little different than your regular intramuscular injections. They have to be done by nurses who have been trained just a little bit differently to make sure they do it the right way. So they're both these deep intramuscular injections. They're actually both now available as bi-monthly or every-two-month injections. They actually sort of follow the same schedule where you're given your initial injection, you're given one one month later as a loading dose, and then you take an injection every two months, every eight weeks, essentially. The big difference between these medications is, first of all, for HIV treatment (Cabenuva), it's two (injections;) it's a combination of two medications. So it's two separate injections, one in each buttock (one medication in each buttock). For HIV treatment, for Apretude, for prevention, it's just the one injection in one buttock.Alexandra: Yeah, that's a good first start. We can get back to some of those issues in more depth. Jeremiah, drawing from your experience as a community member and advocate, what do you think is important for the community health centers that we represent around the country to know and consider as they see these new options for prevention and treatment?Jeremiah: Yeah, happy to talk about that. Thanks for having me on the podcast today. And really, you know, I think, Dr. Cantor, you really set us up really well because I think you clearly have a clear sort of centering of your patients and the way that you're sort of talking about things. Because I think one of the first things that I'll say about long acting injectable is it is exciting. I also, as a community advocate, am very cognizant of the price issue with this, so when you're looking at $22,500 a year for Apretude compared to less than $20 a month for generic TDF FTC (Tenofovir/emtricitabine) or generic Truvada, this is going to be a complicated intervention to get to people. And I do worry as a community advocate, given that there's such important adherence requirements if you're going to be on this, that, you know, community health centers are checking with patients and really making sure that they're not going to run into any sort of unexpected coverage issues or anything that's going to interrupt their ability to continue with their treatment in terms of all of this. And so, you know, one thing that I like to put out there at these sorts of conversations is that, you know, sometimes I think we get really excited about the new modality. We get excited about the new way to sort of put things out there and forget the old classics, you know, and in this case, we have, you know, new sort of access to these generic medications that can be more nimble in a complicated health care system to get to people and we can be more creative in terms of getting that out to people. And so, you know, one thing that we're working a lot here at PrEP4all right now is to try and build a national PrEP program calling for a federal program with centralized reimbursement of laboratory costs and medications, particularly for uninsured and underinsured individualsAlexandra: Thank you. Some really good points there. I want to turn it to Amy. As health centers consider delivering these services, what are the financial or policy hurdles that they need to be aware of?Amy: Yeah. So I think this is a really good question. And, and, you know, the short answer is that there are a lot. So, I think the first one is that, and this has been mentioned several times, the price of the drug and combined with the fact that it is a provider- administered injectable product, so that is just a different administration route than the vast majority of the antiretrovirals that are available right now. And those two things, both apart and combined, do, I think, add some complexity to the finances and the procurement and delivery of both Apretude and Cabenuva. And I'm going to go through some of these challenges and note throughout that the challenges are different depending on what population you're talking about, whether the population is insured or uninsured. So I'm going to try to underscore what some of those differences look like. And, you know, the number one piece and to sort of tie this to specifically for community health centers, so that the price of both drugs was raised, and it is, you know, pretty, it could be higher. Right? But in the grand scheme of things, over $22,000 a year for a list price for an ARV is in the upper threshold of ARVs that are available for HIV treatment and prevention, so it's not an insignificant list price. If we talk about community health centers and their status as 340B entities, there is a discount available to purchase that drug for your uninsured population, and yet even with the discount, the price is still fairly significant. So that's an important factor as community health centers look at budgeting and programmatic decisions on both routes, on both Apretude and Cabenuva. And when we talk about the insured, I think even now when these products have been on the market and available in the case of Apretude for, you know, a little less than a year and for Cabenuva longer than that, we still have sort of complexity challenges and, and murkiness, I would say, with regard to payer behavior for insured clients.You know, on the PrEP side, we don't have a U.S. Preventive Services Task Force grade for long-acting Cabotegravir. The grade A that we have is based on the oral products for PrEP. We are waiting for a USPSTF grade and that would carry with it a requirement that the vast majority of payers cover long-acting Cabotegravir/Apretude without cost sharing.Alexandra: Thank you. Would you like to add to that in terms of considerations that other community health centers who are considering offering these should factor in?Aviva: Yeah, I mean, Amy brought up a lot of things that we are currently dealing with. I present on PrEP and on long-acting medications for PrEP and HIV a lot. And I have this slide (Slide 1) that shows how incredibly excited we are for these medications to be here. And then the next slide (Slide 2) is just total chaos because that's what it feels like. It's sort of like, “Hold up, wait, yes we're excited, but let's be realistic about this.” This is really hard. It's really hard right now. You know, you need the people to do the work, but you also need the fuThis show is part of the Spreaker Prime Network, if you are interested in advertising on this podcast, contact us at https://www.spreaker.com/show/5468540/advertisement

Episode 98: Apretude and code blue. Apretude is a new injectable medication for HIV pre-exposure prophylaxis (PrEP), Dr. Yomi presents how to use it. Then, Mandeep, Jon, and.  Introduction: Apretude, a new injectable for HIV PrEP.  By Timiiye Yomi, MD. Moderated by Jennifer Thoene, MD.   What is HIV PrEP? Pre-exposure prophylaxis (or PrEP) consists of taking medication when a patient has a high risk of contracting HIV to lower their chances of getting infected.  Who can take HIV PrEP? Individuals who may benefit from PrEP include but are not limited to: Male who have sex with male (MSM), people with multiple sexual partners with no consistent use of condoms, or people who have been diagnosed with an STD in the past 6 months, IV drug users who share needles, syringes, or other injection equipment. History of HIV PrEP: In 2012, the first medication for HIV PrEP was approved—Truvada® (tenofovir-emtricitabine). Truvada is a once-daily oral prescription drug. Seven years later, in 2019, the next medication for HIV PrEP was approved— Descovy® (tenofovir alafenamide and emtricitabine). It is also a daily PO medication. But today we want to introduce you to the newest medication for HIV PrEP—Apretude® (cabotegravir). On Dec 20, 2021, FDA approved Apretude (cabotegravir), an extended-release injectable for HIV-1 pre-exposure prophylaxis for at-risk adolescents and adults who weigh at least 35 kg (77 lbs). Mechanism of action: Apretude is a long-acting integrase inhibitor that works by binding to the HIV integrase active site and blocking the strand transfer step of retroviral DNA integration. How is it given? Comes as a 600-mg (3-mL) injection. Patients receive 2 initiation injections administered 1 month apart, thereafter every 2 months. Patients can start medication immediately or first take the oral formulation for 4 weeks to assess how well they tolerate the medication before beginning the injection. Trials: The safety and efficacy of Apretude in reducing the risk of contracting HIV-1 were evaluated in two randomized double-blind trials comparing Apretude and Truvada (once-daily oral medication).Trial 1: Participants who took Apretude had a 69% less risk of contracting HIV compared to Truvada.Trial 2: Participants who took Apretude had a 90% less risk of contracting HIV compared to Truvada. Common side effects: Fever, malaise, fatigue, sleep problems, myalgias and arthralgias, headache, rash, red and swollen eyes, edema of face, lips, mouth, tongue; GI discomfort, hepatotoxicity, and depression. Note: Some drug-resistant HIV variants have been identified in people with undiagnosed HIV prior to beginning Apretude. People who test positive for HIV while on Apretude must transition to a complete HIV treatment regimen as Apretude is not approved for HIV treatment.  Requirements to receive Apretude: -Patient must be HIV-1 negative-Patient must remain negative to continue receiving Apretude-Patient must not miss any injections as this increases their risk of contracting the virus Apretude does not protect against other sexually transmitted infections. Patients must be sexually responsible and use other forms of protection such as condoms during sexual intercourse. This is the Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California. Our program is affiliated with UCLA, and it's sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.___________________________A code blue in clinic.  By Manpreet Singh, MS3; Jon-Ade Holter, MS3; and Sheinnera Gerongay, MS3. Ross University School of Medicine. What is a code blue?Arreaza: Today we will present to you a case to remind you about some principles of cardiopulmonary resuscitation (CPR). The term “code blue” in the United States refers to a situation where a patient is in cardiac arrest, respiratory arrest, unresponsive, or experiencing another medical emergency that requires immediate attention. “Code blue” is commonly used in hospitals and clinics to call a rapid response team to arrive immediately to evaluate the patient. We hope you can benefit from this brief review and feel ready for your next code blue. Of course, you will need more than we provide during these few minutes, but we hope it triggers your curiosity to keep learning or practicing. By the way, “code blue” is not standard for medical emergency in the whole world. For example, in the United Kingdom, they call it “code red”. Case presentation: Mr. DD 56-year-old man with a past medical history of coronary artery disease, recent MI, DM2, and CHF presents today to our clinic for hospital follow. He had an MI 2 weeks ago. He reports that when he was at home working in the yard, he suddenly had 8/10 retrosternal chest pain, pressure-like, accompanied by shortness of breath and diaphoresis. The pain radiated to the left side of his neck/jaw and down his left shoulder and arm. Jon: Nitroglycerin was taken by Mr. DD 3 times without resolution of symptoms. The patient was taken by EMS to Kern Medical ER. In the hospital, there was a 4mm ST elevation on ECG on leads II, III, and aVF. Q waves were also seen in anterior leads V4-V6. Patient was taken to cath lab and stent was placed in the RCA. ECHO showed decreased left ventricle wall motion and dilated left ventricle with an ejection fraction of 28%. Mr. DD was discharged after 5 days in the hospital.M: He is currently on lisinopril, carvedilol, atorvastatin, aspirin, clopidogrel, metformin, and digoxin. He states he is not compliant with all the medications because he forgets to get refills at times. He has a 35-pack year history of smoking and drinks 3-4 4oz drinks every day after work. He states he has used methamphetamine and cocaine intermittently within the last 6 months.J: Today, he lets the MA know that he is having some chest pain at night, shortness of breath with minimal activity for the last week, and at times he feels his heart is beating too fast. He has a follow-up appointment with cardiology in 2 weeks. The MA tells you that the patient vitals today are BP:195/105, HR: 108, RR: 28, and O2% 89% on room air. M: You are reviewing the patient's chart when you hear a loud thud coming from the room, you rush into the room and find the patient on the ground. The patient is unresponsive and is not moving. What is your next action? A. Try to lift the patient off the ground and back onto the chair or bed B. Give the patient nitroglycerin sublingually C. Call and wait for the EMS before proceeding D. Obtain IV accessE. See if the patient is arousable and check pulse and breathing E is the correct answer to this question because before initiating any type of treatment, first, you must assess the patient for alert response and their basic vitals such as their pulse and breathing.J: We do this because we need to know if the cardiopulmonary systems are intact. When they are not intact, regardless of the level of medical training, we must start CPR protocol. M: This patient most likely suffered a tachyarrhythmia, a very common post-MI-complication that causes the highest mortality rates. The most common cause of death are ventricular fibrillation and ventricular tachycardia. J: These are the steps we must take in order to start resuscitation of the cardiopulmonary system in any environment before the patient can be taken to a higher level of care. In this situation, Doctor Holter and Doctor Singh will perform 2-patient CPR. This is only an introduction of basic life support and advanced cardiac life support. You will need additional training to get the BLS and ACLS certificates. M: First, assure your environment is safe before preceding to render care. You want to be able to give the best uninterrupted care to your patient without becoming a patient yourself. Jon: Doctor Holter. Mandeep: Doctor Singh.J - Doctor Holter: I will reach down and check the patient. “Sir, Sir, are you okay” – I am assessing for reactions from visual or verbal cues given by me. When the patient is unresponsive to verbal and visual cues, I will give a painful stimulus to the patient such as a nail bed pinch or sternal rub. Next, it is necessary to assess the pulse and breathing of the patient. Narrator: The reason we check if the patient is alert is to assess the neurologic activity. The lack of response to painful stimuli indicates there is no self-protect response. To assess the carotid pulse, you must palpate the carotid artery by placing the index and middle fingers near the upper neck between the sternomastoid and trachea roughly at the level of the cricoid cartilage. Assess breathing by checking the rise and fall of the chest. Lack of responsiveness, pulse, and breathing indicates that immediate Cardiopulmonary Resuscitation (CPR) needs to be initiated. J - Doctor Holter: Please call 911 and get an AED.M - Doctor Singh: I will call 911 and get an AED.J- Doctor Holter: I will place the person on their back and start single-person CPR until Doctor Singh comes back. Narrator: CPR is performed by placing the patient flat on their back on an even surface. Place the heel of your hand on the center of the person's chest (on the mid sternum) then place the palm of your other hand on top. Press down 5-6 cm (2-2.5 inches) at a rate of 100-120 beats per minute. Compressions should not be interrupted because they serve as an artificial way of contracting the heart and circulating the blood to maintain blood perfusion. For 1 or 2 person CPR on an adult: Give 5 cycles of 30 compressions to 2 breaths.For 1 person CPR on a child: Give 5 cycles of 30 compressions to 2 breaths.For 2 person CPR on a child: Give 5 cycles of 15 compressions to 2 breaths.M - Doctor Singh : Doctor Holter, continue the compressions and I will give rescue breaths and start to place the AED pads on the patient. Let me know if you are tired and we can switch to give high-quality CPR with adequate depth and rate. Narrator: The AED comes with a diagram made on the pads to instruct where to place the pads. Once an AED is positioned correctly on the patient's chest, let it detect if a shockable rhythm is present. Shockable rhythms include ventricular fibrillation and ventricular tachycardia. If there is not a shockable rhythm detected, then continue with CPR until a higher level of care is reached. If a shockable rhythm is detected, the AED will advise the users to step back and verbalize “clear” in order to ensure that everyone is clear of the patient. It will then administer a shock to the patient in the range of 120-200 Joules, based on the device manufacturer's recommendation.M - Doctor Singh: Doctor Holter, stay clear of the patient. The AED advises shocking the patient. I will press the button to administer the shock now.Narrator: After administration of the first shock, ACLS guidelines recommend continuing CPR for 2 minutes without checking for a pulse, as effective cardiac contractility lags behind the restoration of an organized electrical rhythm. After the next 2-minute cycle of CPR, the AED will reanalyze the patient's rhythm to determine if the rhythm is once again shockable. J - Doctor Holter: Doctor Singh , continue high-quality CPR while I initiate ACLS protocol. I will get an IV and start epinephrine. M- Doctor Singh: I will continue CPR in the meantime. Narrator: ACLS starts with again CPR, AED rhythm reading, and shock administration but with a higher level of care (ACLS). You must obtain IV or IO access. Epinephrine is administered every 3-5 minutes during the cycle in doses of 1 mg at a time. After each dose of epinephrine and CPR for 2 minutes the AED should reassess if the rhythm is shockable, and then continue CPR for another 2 minutes. At this time, it is recommended to use amiodarone or lidocaine. CPR will continue but at this time patient will likely be in the ambulance on the way to the hospital, and EMS will be managing the cycles. The cycles will continue until return of spontaneous circulation is obtained.J: Myocardial infarction is the most common cause of shock-refractory ventricular fibrillation, along with coronary artery disease. If CPR does not resume spontaneous circulation within 40-50 minutes, there is a decreased chance of recovery. Spontaneous circulation may be achieved in patients with refractory Vfib with coronary revascularization. Therefore, in addition to traditional CPR, venoarterial ECMO (extracorporeal membrane oxygenation) can be used as an adjunct and can result in much better systemic perfusion. Essentially, this is a technique in which blood is drained from the body and circulated outside through an oxygen and heat exchanger and is then reintroduced into the body. This technique can be used if preparing for coronary revascularization. M: Vfib is a great risk in the acute phase after MI, up to 72 hours after revascularization, due to the recent ischemia and reperfusion. After the first 72 hours and up to a month following, Vfib remains a risk due to the continued remodeling of the heart. This newly remodeled tissue can cause interruptions in the normal electrical signaling of the heart leading to dissociated contractions and subsequent lack of perfusion through the body, which can quickly lead to death within minutes if not recognized and managed immediately with CPR and defibrillation as described.J: Clinicians should be aware of their patients who would be more susceptible to serious events such as this and be on top of their training about management. This may not be a common occurrence in clinics, but it is a very serious event and requires a prompt and appropriate response. Conclusion: Now we conclude our episode number 98 “Apretude and code blue.” Dr. Yomi concisely explained how to use the new injectable medication for HIV Pre-Exposure Prophylaxis (PrEP). Then, Manpreet, Jon, and Sheinnera presented a case that can actually happen in clinic and anywhere. CPR is a life-saving skill that needs to be learned and practiced over and over so we are not taken by surprise. Remember that heart disease continues to be the number 1 killer in the United States. So, make sure you know where your AED is and be ready to use it when needed. Even without trying, every night you go to bed being a little wiser.This week we thank Hector Arreaza, Timiiye Yomi, Jennifer Thoene, Manpreet Singh, Jon-Ade Holter, and Sheinnera Gerongay.Thanks for listening to Rio Bravo qWeek Podcast. If you have any feedback, contact us by email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. Audio edition: Suraj Amrutia. See you next week!_____________________References:American Heart Association 2022 CPR cheat sheet. American Heart CPR Class, BLS, ACLS Ft. Myers all Lee County. (n.d.). Retrieved June 2, 2022, from https://www.cprblspros.com/cpr-cheat-sheet-2022. Algorithms. CPR & First Aid, Emergency Cardiovascular Care, American Heart Association, cpr.heart.org. Retrieved June 2, 2022, from https://cpr.heart.org/en/resuscitation-science/cpr-and-ecc-guidelines/algorithms. Bhar-Amato J, Davies W, Agarwal S. Ventricular Arrhythmia after Acute Myocardial Infarction: 'The Perfect Storm'. Arrhythm Electrophysiol Rev. 2017 Aug;6(3):134-139. doi: 10.15420/aer.2017.24.1. PMID: 29018522; PMCID: PMC5610731. Farkas, J. (2021, November 29). Post-mi complications. EMCrit Project. Retrieved June 2, 2022, from https://emcrit.org/ibcc/post-mi-complications/#ventricular_tachycardia. 

Over the years we've had thousands of attractive, charming folks on the podcast, people we've had great chemistry with, and others who when we met, it was murder.So naturally since we get so intimate with the guests on the show, one of the most common questions we get asked is: “did you sleep with them?”Today, licensed marriage and family therapist Damon L Jacobs is back once again to answer our hard questions on relationships and creating content in this complex Instagram age we live in.Damon is best known for his work with PrEP and HIV prevention, and has a lot of great insights into the ethics behind doing a talk show where we, as Carol Channing once said, ask “very penetrating questions.”DAMON L JACOBS: https://damonljacobs.comListen as we take a look at hating on men when you are sexually attracted to them, and right wing media's “War on Men” where they talk about low testosterone levels, but avoid discussing environmental polllution, healthcare and mental health as a source of these problems.Plus-- Just as we were about to board a flight, a Federal judge strikes down the CDC mask mandate for travelers.Episode #3022

In today's episode we run for Your Gay Cousin official Historian, pitch a reheat of Unwrapped sponsored by Truvada, film POV videos at each other's funeral, predict gay rides at Nintendo land coming 2023 & much more! Available everywhere podcasts are streamed, tweet along using #YourGayCousins Be a part of the show-- call the Gay Cousins Hotline 310-431-9788 and leave us a voicemail (chisme, questions, advice, good news!) Don't forget to subscribe, rate, and listen every Tuesday for a new episode! And be sure to follow us on Instagram & Twitter: tiktok.com/@yourgaycousins instagram.com/YourGayCousins twitter.com/YourGayCousins yourgaycousins.com/shop

The brilliant & beautiful John Grant joins me to talk yardbird curry, Cuddle Dungeon, Squirt, Truvada loans, double features, “Wild At Heart”, hefty selections, the magic of Mort Garson, Siskel & Ebert, RomperRoom, John's fabulous “Boy From Michigan” album, touring again, mandatory quizzes, Susan Sohmerz, root-beer floats, Barry DeMuir, Randy's Donuts and much much more! Head on over to https://www.patreon.com/CraigAndFriends to support the show and get hours and hours of exclusive content, including more John Grant chats

On this episode of the J n H Podcast, Juanki N Hulk discuss hot topics! Hot Topics:Ukraine / Russia InvasionWendy WilliamsDating During EndemicTruvada Medication 

"As individual patients, we often don't think about these costs. In my Instagram poll, nearly everyone taking Descovy reported receiving the drug effectively for free, largely due to Gilead's copay coupons. However, as with anything in life, nothing really ever is free. More patients taking Descovy rather than generic Truvada means higher overall spending by insurance companies. This eventually comes back to haunt us in the form of higher premiums, and is why we shouldn't simply adopt a costlier drug like Descovy without good reason to do so." Frank F. Zhou is a medical student. He shares his story and discusses his KevinMD article, "Is Descovy really the better option?" Reflect and earn 1.0 AMA PRA Category 1 CME for this episode.

Episode 70: HIV Prevention. Prevention is key in controlling HIV-AIDS. Listen to ways to prevent HIV, mainly by using condoms, PrEP and PEP.Introduction: HIV and AIDSBy Robert Dunn, MS3.Introduction: The Human Immunodeficiency Virus (HIV) is a retrovirus that is primarily transmitted via sex, needles or from mother to fetus. Once infected, the virus increases in its copies and decreases the individual's CD4+ cell count, thus leading to an immunocompromised state known as Acquired Immune Deficiency Syndrome (AIDS). Once with AIDS, the patient is susceptible to opportunistic infections. Prevention from AIDS includes several options. Condoms for safe sex practices are the least invasive and most readily accessible option for all patients. Pre-exposure prophylaxis (PrEP) is also an option for men who have sex with men (MSM) and transgender women. If the patient is also exposed to HIV, post-exposure prophylaxis (PEP) may also be an option to prevent infection but must be administer ideally 1-2 hours after exposure but no later than 72 hours after. Today we will briefly discuss how to prevent HIV infection.This is Rio Bravo qWeek, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California. Our program is affiliated with UCLA, and it's sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home.___________________________HIV Series IV: HIV Prevention. By Robert Dunn, MS3.Participation by Huda Quanungo, MS3; Bahar Hamidi, MS3; and Hector Arreaza, MD.  HIV PreventionIntroductionThe Human Immunodeficiency Virus (HIV) is a retrovirus that is primarily transmitted via sex, needles or from mother to fetus. Once infected, the virus increases in its copies and decreases the individual's CD4+ cell count, thus leading to an immunocompromised state known as Acquired Immune Deficiency Syndrome (AIDS). Once with AIDS, the patient is susceptible to opportunistic infections. Prevention from AIDS includes several options. Condoms for safe sex practices are the least invasive and most readily accessible option for all patients. Pre-exposure prophylaxis (PrEP) is also an option for men who have sex with men (MSM) and transgender women. If the patient is also exposed to HIV, post-exposure prophylaxis (PEP) may also be an option to prevent infection, but it must be administered ideally 1-2 hours after exposure but no later than 72 hours after. We will concentrate in prevention during this episode.   What is HIV?The Human Immunodeficiency Virus (HIV) is a retrovirus. When the virus gains access to our body via cuts on the skin or mucosa:The virus injects its 10kb sized RNA genome into our cells. The RNA is transcribed to DNA via viral reverse transcriptase and is incorporated into our cellular DNA genome. This causes our cells to become a virus producer. Viral proteins translated in the cell are transported to the edge of the cell and can bud off into new viruses without lysing the cell.  Acute HIV symptoms. Some potential early symptoms of HIV can include fever, chills, rash, night sweats, muscle aches, sore throat, fatigue, lymphadenopathy, and mouth ulcers. The most common acute symptom is NO SYMPTOM. Many people do not feel sick with the acute infection of HIV. Some people can live years with HIV in “clinical latency” without knowing they are infected, but they can still be contagious during this time. As viral load (the amount of virus copies you have in your blood stream) increases, the CD4+ cells that contribute to our adaptive immunity continues to fall. That's why the best test during this period is not going to be HIV antibody but you should test for antigens. Specifically, the 4th Generation HIV test, which tests for both antibody and p24 antigens.Chronic symptoms. Once patients begin to present with opportunistic infections (i.e. Pneumocystis pneumonia – PCP), or have a CD4 count below 200, the patient is considered to have Acquired Immune Deficiency Syndrome (AIDS) and makes them susceptible to more serious infections. Without treatment, patients with AIDS typically survive about 3 years. Epidemiology of HIVHIV incidence: In 2019, there were 34,800 new HIV infections in the United States. This is an 8% decline from 2015. Amongst age groups: Age 25-34 had the highest rate of incidence (30.1 per 100,000)Age 35-44 had the second highest rate (16.5 per 100,000)Age 45-54 remained stableAge 13-24 had decreasing rates of incidence Amongst ethnic groups: Black/African-American groups has the highest rate of incidence (42.1 per 100,000)Hispanic/Latino had the second highest rate (21.7 per 100,000)Person of multiple races had the third highest (18.4 per 100,000) Amongst sex: Males had the highest rate of incidence (21 per 100,000)Females had the lowest rate of incidence (4.5 per 100,000) HIV Prevalence:In 2019, 1.2 million people (Ages 13 and older) in the US have HIV and 13% of them do not even know it. In 2020, there were an estimated 1.5 million people worldwide that acquired a new HIV infection. This is a 30% decline since 2020. An estimated 66% are receiving some HIV care and 57% were virally suppressed. Mortality: In 2019, there were 15,815 deaths among adults and adolescents diagnosed with HIV in the US. Preventative ScreeningThe USPSTF gives a Grade A recommendation for HIV screening for: Pregnant people and everyone between 15-65 years of age. All pregnant people at any point of their pregnancy, including those who present in labor or delivery and have an unknown status of HIV.The USPSTF only recommends a one-time screening and shows no benefit of repeat screening thereafter. Women may also be screened for subsequent pregnanciesAlso screen all Adolescents and adults ages 15-65.  An effective approach is routine opt-out HIV screening. This approach includes HIV screening as part of the standard preventive tests. This approach removes the stigma associated with HIV testing, it promotes earlier diagnosis and treatment, reduces risk of transmission, and it is cost-effective. The determination for repeated screening of individuals should take into account the following risk factors: -Men who have sex with men (MSM)-Individuals who live in areas with high prevalence of HIVIncluding attending to tuberculosis clinics, stay in a correctional facility, or homelessness-Injection drug use-Transactional/commercial sex work-1 or more new sexual partners -History of previous STIs Annual screening for HIV is reasonable, however, clinicians may want to screen patients every 3-6 months if they have an increased risk of HIV.  CondomsA simple and very effective method in HIV prevention is the use of condoms for safe sex practices. In 2009, the American College of Physicians (ACP) and the HIV medicine Association called for the wider availability of condoms and education to minimize HIV transmission. A meta-analysis of 12 HIV studies amongst heterosexual couples demonstrated the use of condoms in all penetrative sex acts reduced the risk of HIV transmission 7.4 times in comparison to those who never used condoms. Other studies show a 90-95% effectiveness in HIV prevention when “consistently” using condoms. A Cochrane review shoed that the use of a male latex condom in all acts of penetrative vaginal sex reduced HIV incidence by 80%. Overall, condoms are effective in HIV prevention.Pre-Exposure Prophylaxis (PrEP)Truvada and Descovy:Another option for prevention amongst HIV negative individuals is the use of Pre-Exposure Prophylaxis (PrEP). It is an anti-retroviral pill that is taken daily to maintain a steady-state level of the medication in the blood stream. The medication specifically a combination of 2 antiretroviral medications – Tenofovir and Emtricitabine. Both medications are nucleoside reverse transcriptase inhibitors (NRTIs) that work by blocking the viral reverse transcriptase from HIV and prevent the enzyme from copying the RNA genome into DNA. Therefore, it stops viral replications. There are 2 formulations of PrEP: Truvada and Descovy. Truvada's primary side effects are renal and bone toxicity with long-term use. Descovy's primary side effects are mild weight gain and dyslipidemia. Truvada is the most commonly prescribed PrEP because it has the most data since it has been around the longest. However, extra consideration should be taken for: Adolescents should weigh at least 35 kg before being prescribed PrEPDescovy may be preferred for adolescents by the prescribing physician as it is not associated with reduction in bone density, as Truvada is. Estimated GFR between 30 – 60Truvada is associated with acute and chronic kidney disease whereas Descovy is safe for patients with a GFR greater than 30Patients with osteoporosisTruvada is associated with bone toxicity, whereas Descovy is not. It is important to note that PrEP has only been studied in men or people who were assigned men at birth. So, its efficacy in vaginal sex and with vaginal fluids cannot be generalized at this time. Future of PrEP: In May 2020, the HIV Prevention Trials Network (HPTN) 083 randomized trial demonstrated the potential of an injectable PrEP. Carbotegravir, is an integrase inhibitor, which prevents the HIV integrase from incorporating the HIV genome into the cellular genome. This study demonstrated its efficacy as PrEP in comparison to Truvada with few new infections (13 versus 39, respectively). Carbotegravir would be given via injection once every 8 weeks. In September 2021, the pharmaceutical company Moderna will begin 2 human clinical trials for an HIV vaccine that use mRNA technology. Previous studies conducted with non-mRNA vaccines demonstrated that B cells can be stimulated to create antibodies against HIV. Since HIV becomes integrated in the cellular genome within 72 hours of transmission, a high level of antibodies must be produced and present in the body to offer an adequate level of immunity. Post-Exposure Prophylaxis (PEP)If an individual is exposed to blood or bodily fluids with high risk of HIV via percutaneous, mucus membrane or nonintact skin route, post-exposure prophylaxis (PEP) may be an option. PEP is indicated when the HIV status of the exposure source is unknown and are awaiting test results, or if the exposure source is HIV positive. Therapy should be started within 1 or 2 hours of exposure and it is not effective after 72 hours of initial exposure. The recommended duration of therapy is 4 weeks but no evidence has been shown for an optimal duration. Occupational exposure. There are 2 regimens for PEP: Truvada with Dolutegravir Truvada  with Raltegravir Both Doltegravir and Raltegravir are integrase inhibitors which block the integration of the viral genome into the cellular DNA. The regiments are chosen based on efficacy, side effects, patient convenience, and completion rates. Dolutegravir is chosen because it is given once daily. While Raltegravir is taken twice daily, most experience with PEP has been with Raltegravir. Other risk with Raltegravir are potential skeletal muscle toxicity and systemic-cutaneous reactions resembling Steven-Johnson syndrome. One final word about prevention of vertical transmission is making sure pregnant women are treated during pregnancy and if the baby is delivered from a patient whose viral load is “detectable”, the baby needs to be treated, but we'll let that topic for another time to discuss. Joke: What do you call the patient zero of HIV? First Aids.HIV incidence is decreasing thanks to many prevention measures taken globally, and we discussed screening, condoms, PrEP and PEP as part of this prevention efforts. Stay tuned for more relevant medical information in our next episode. ____ Now we conclude our episode number 70 “HIV Prevention.” Robert, Huda and Bahar explained some ways to prevent HIV, mainly by screening those at risk, using condoms, PrEP (pre-exposure prophylaxis) and PEP (post-exposure prophylaxis). Let's also remember that having a monogamous relationship and avoiding high risk sexual behaviors confer significant protection against HIV. Even without trying, every night you go to bed being a little wiser.Thanks for listening to Rio Bravo qWeek. If you have any feedback about this podcast, contact us by email RBresidency@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. This podcast was created with educational purposes only. Visit your primary care physician for additional medical advice. This week we thank Hector Arreaza, Robert Dunn, Huda Quanungo, and Bahar Hamidi. Audio edition: Suraj Amrutia. See you next week!   References:About HIV. Center for Disease Control and Prevention, CDC.gov, June 1, 2021. https://www.cdc.gov/hiv/basics/whatishiv.html . Accessed September 21, 2021. Simon V, Ho DD, Abdool Karim Q. HIV/AIDS epidemiology, pathogenesis, prevention, and treatment. Lancet. 2006 Aug 5;368(9534):489-504. doi: 10.1016/S0140-6736(06)69157-5. PMID: 16890836; PMCID: PMC2913538. [https://pubmed.ncbi.nlm.nih.gov/16890836/]   US Statistics. HIV.gov, June 2, 2021. https://www.hiv.gov/hiv-basics/overview/data-and-trends/statistics . Accessed September 21, 2021.  The global HIV/AIDS Epidemic. HIV.gov, June 25, 2021. https://www.hiv.gov/hiv-basics/overview/data-and-trends/global-statistics. Accessed September 21, 2021.  Human Immunodeficiency Virus (HIV) Infection: Screening. U.S. Preventative Services Task Force, June 11, 2019. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/human-immunodeficiency-virus-hiv-infection-screening. Accessed September 21, 2021.  Holmes KK, Levine R, Weaver M. Effectiveness of condoms in preventing sexually transmitted infections. Bull World Health Organ. 2004 Jun;82(6):454-61. PMID: 15356939; PMCID: PMC2622864. [https://pubmed.ncbi.nlm.nih.gov/15356939/] Weller S, Davis K. Condom effectiveness in reducing heterosexual HIV transmission. Cochrane Database Syst Rev. 2002;(1):CD003255. doi: 10.1002/14651858.CD003255. PMID: 11869658. [https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003255/full] Mayer, Kenneth H, MD, and Douglas Krakower, MD. Administration of pre-exposure prophylaxis against HIV infection. UpToDate, June 24, 2020. Accessed September 21, 2021. [https://www.uptodate.com/contents/administration-of-pre-exposure-prophylaxis-against-hiv-infection?search=8)%09Administration%20of%20pre-exposure%20prophylaxis%20against%20HIV%20infection&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1] Zachary, Kimon C, MD. Management of health care personnel exposed to HIV. UpToDate, June 07, 2019. Accessed September 21, 2021. [https://www.uptodate.com/contents/management-of-health-care-personnel-exposed-to-hiv?search=9)%09Management%20of%20health%20care%20personnel%20exposed%20to%20HIV&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1]

Joey Gentile (@Joey.Gentile) joins host Jeff Perla (@thetravelinbum) to talk about Truvada, Descovy, & Pep. What's the difference between Truvada and Descovy? How many people actually take Prep? Do you need insurance to get Prep? Grab a glass of wine and keep up with us on this episode of Behind the Bum! I think my most asked question is "How can I get Prep with or without insurance"? You can checkout Mistr here. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app Support this podcast: https://anchor.fm/behindthebum/support

Devannon Hubert is the host of Sex, Drugs, and Jesus, a podcast that highlights taboo concepts and the people that enjoy them. He joined me on Ramble by the River to discuss his life as a gay man, his experience of being excommunicated from his church, his time in the military, his rise to prominence in the black-market drug trade; his HIV diagnosis; and his eventual arrest by SWAT team. We covered a lot of ground over two hours and kept coming back to ideas about how to practice acceptance and tolerance in a world that sometimes feels so hostile and unforgiving that selfless love feels impossible. We covered hypnosis, drug abuse, religion, romance, social manipulation, oppression, hate, love, and podcasting. Devannon brings his irreverent and hilarious sense of humor to these heavy topics and the result is something magical. I really like this episode. I think it shows how two people can appear to be quite different on the surface, but deep down we all share so much in common. I had a great time making this thing and I hope you enjoy listening to it. If you want to support the show... Go to the all new Ramble by the River Patreon. Thank you so much for being part of the Ram-fam, Jeff Topics/Keywords: podcasting; starting a podcast; Podmatch.com; Alex Sanfilipo; matchmaker.fm; Descript.com; audio editing, audio production; podcast community building; church; LBGTQ; children's church; community service; volunteering to serve; gay-affirming church; The Golden Compass; Nicole Kidman; The Matrix; mass-deception; hypnotherapy; stage hypnosis; highly-suggest-able state; critical thought; executive control; willful suspension of disbelief; personality types; LSD-assisted hypnotherapy; psilocybin; Triumph of the Will; Adolf Hitler; Hitler Youth; propaganda; evangelical church; evangelists; Don't Ask Don't Tell; gay in the military; The Village People; homosexuality conversion; conversion therapy; gold-star gay; dreams; dreaming; dream-interpretation; Sigmund Freud; dream symbols; prophetic dreams; supernatural abilities; premonitions, deja vu; collective unconscious; Carl G. Jung; Buddhists; religious diversity; philosophical autonomy; drunkenness; sobriety; abstinence; wine; alcohol; addiction; Alcoholics Anonymous, 12-step programs; environmental correlates of addiction; Dr. Carl Hart; Columbia University; Drug Use For Grown-ups; relapse; harm-reduction strategy; Sex and Love Addicts Anonymous; heroin injection sites; needle exchange; morality; psychoactive substances; methamphetamine; cocaine; sugar; Christianity; Jesus Christ; free will; women's right to choose; abortion; The Bible; Love; apostle Paul; House of Cards; Book of Acts; Joel Olstein, Joyce Meyers; John the Baptist, social isolation; idolatry; wealth; Sex, Drugs, and Jesus: A memoir of Self-destruction and Resurrection; HIV; AIDS; Hepatitis B; drug dealers; selling meth; trauma; PTSD; SWAT; Houston, TX; trap house; bug chasers; HIV treatments; Truvada; Magic Johnson; Mary J. Blige; Chik-fil-A; Donald J. Trump. Guest Links: Devannon Hubert -Podcast: Sex, Drugs, and Jesus -Book (Coming soon): Sex, Drugs, and Jesus: A Memoir of Self-Destruction and Resuection Connect: Facebook: https://www.facebook.com/SexDrugsAndJesus/ (https://www.facebook.com/SexDrugsAndJesus/) Twitter: https://twitter.com/TabooTopix (https://twitter.com/TabooTopix) LinkedIn: https://www.linkedin.com/in/devannon (https://www.linkedin.com/in/devannon) Websites: www.sexdrugsandjesus.com Ramble by the River Links: Business inquiries/guest booking: Ramblebytheriver@gmail.com Website: (For episode catalogue): https://my.captivate.fm/Ramblebytheriver.captivate.fm (Ramblebytheriver.captivate.fm) (Podcast main page): RamblebytheRiver.com Facebook: https://www.facebook.com/jeff.nesbitt.9619 (https://www.facebook.com/jeff.nesbitt.9619) Instagram: https://instagram.com/ramblebytheriver?r=nametag (@ramblebytheriver) Twitter: @RambleRiverPod Youtube:...

The HIV medication tenofovir has been prescribed for years to delay the progression of HIV, the virus that causes AIDS. Studies are now showing serious problems from this medication, including toxicity to kidneys, bone loss, and bone injury. Join us on this episode to learn more about tenofovir and its problems. We are joined by my friend and fellow product liability lawyer, Whitney Butcher, an attorney with Hilliard Martinez & Gonzales. Whitney has a long history of representing individuals injured by harmful medications and defective medical devices. In today's conversation, we discuss tenofovir and the brand-name medications (like Truvada) that have been developed from this compound, the problems that have been discovered, and the litigation that has followed.  Show Highlights: How antiretroviral drugs target HIV cells and keep them from replicating Tenofovir: a compound found to be effective in preventing the replication of HIV cells but also nephrotoxic How tenofovir began in IV form but was then put in pill form around 2001 with specific delivery agents The TDF combination developed by Gilead Sciences that hit the market in 2001 under the brand names Viread, Truvada, Atripla, Complera, and Stribild How TDF can damage the kidneys Why TAF is safer than TDF and more stable in the body, leading to less systemic exposure and toxicity How Gilead allegedly prioritized TDF medications over safer TAF options to maximize profits for 14-15 years Why warning labels about TDF were stronger in Canada and European Union countries than in the US How TDF leads to bone injury and stress fractures in patients The lawsuits against Gilead in state and federal courts in CA and how they differ from class-action lawsuits   Resources: https://www.northcarolinaproductliabilitylawyer.com  

62% of people now have a positive opinion of drug companies, up from 32% in 2020. What's responsible for the sudden shift, and do pharmaceutical companies deserve this newfound adoration? We're joined by Shannon Rotolo, co-founder of Pharmacists for Single Payer and a clinical pharmacy specialist at the University of Chicago Medicine, to debunk industry lies about research and development, innovation, the market, and more. Show Notes Public opinion seems to be driven by the belief that pharmaceutical companies mainly function to discover and manufacture important new drugs. While the big pharma companies do do some research and development, they primarily buy the intellectual property of smaller biotech research companies, and then mostly act as marketing and sales reps for the product. They actually spend a lot less on research and development, and much more on marketing and profits for shareholders. Image description: Congresswoman Katie Porter, holding a whiteboard at a House Oversight Committee hearing about drug prices. The smallest circle on the whiteboard is labeled Litigation and Settlements, the next circle is labeled R&D, the next largest is labeled Marketing and Advertising. The largest circle, Stock Buybacks and Dividends, is more than 10 times the size of the next largest circle. https://www.businessinsider.com/video-katie-porter-tears-into-pharma-ceo-whose-company-inflated-its-prices-for-two-major-drugs-2021-5 The vast majority of breakthrough innovative pharmaceuticals are actually funded by taxpayers through the National Institute of Health. Some studies are funded through the Veteran's Administration. There are countless examples of pharmaceutical companies profiting off of publicly-funded research, making billions and denying any royalties to the government. Those royalties could be used to provide lower cost drugs to patients, but the pharmaceutical companies instead have driven prices up, making life-saving drugs unavailable to people who need them. A recent example is the drug Truvada, marketed by Gilead. Shannon explains some of the games pharma plays to make more money regardless of patient needs. Patent extensions, me-too drugs and changes to delivery methods all allow drug companies to maximize profits and minimize research costs and risks, ultimately driving up costs for patients. While drug companies argue that lowering prices will stifle innovation, the profit motive actually works against the innovation motive. If you can tweak a drug and profit from it, the incentive isn't there to take the risk and put in the work to develop something new. (Socialize the risk, privatize the profit, as they say.) If you've always wondered what Pharmacy Benefit Managers (PBMs) add to healthcare, Shannon breaks it down. Insurance companies, large employers and Medicare Part D contract with PBMs to facilitate prescription drug benefits. They negotiate rebates with drug companies, ultimately setting the price the payer will pay for the prescription. Essentially, PBMs are yet another corporate middleman that skims profits off the system without adding any actual care for patients. What would single payer mean for pharmaceutical prices? Removing insurance companies and PBMs, and negotiating prices would all help bring down costs. But the key benefit of single payer would be simplifying the process and eliminating out-of-pocket costs for drugs that patients need to live. We sometimes hear concerns about a single payer system limiting the drugs that are covered. Shannon explains that there would be a formulary in the system, which would limit coverage of some of the duplicative me-too drugs; but that's already the case with the insurance plans that most Americans have now. The benefit of a single national formulary is that it's transparent. Your provider will know what's covered and you'll get it. There would be an exception process for patients with rare conditions,

Tapakorn and Marcus inform Steve on the New Generic HIV Prevention Medication; while Steve sparks a conversation about crypto currency SHIBA INU  Coin (SHIB). Go SHIBArmy. --Additional Notes, Links, Corrections, and Context for this Episode--Center for Health Empowerment ClinicTeleCHECHE ReliefAvita PharmacyQCarePlusNews ArticleShiba Inu CoinShiba Inu TokenDogecoin CryptocurrencyVtalik ButerinElon MuskHODL

Ever wonder why some generics cost so much? Dr. Kyle McCormick and I dive into this topic as well as how his pharmacy, Blueberry Pharmacy, is changing the prices people pay for medication by NOT taking bill insurance. Dr. McCormick has developed a pharmacy that can save people money and reduce the impact on insurance by PBM games like spread pricing. We dive into the weeds here and even talk about how generic Truvada has drastically dropped in price and how to buy it (safely and legally) for substantially less as well as other drugs like Vesicare (solifenacin). You can find Blueberry Pharmacy (and some great breakdowns of drug pricing) here: https://blueberrypharmacy.com/ Linkedin: https://www.linkedin.com/company/blueberry-pharmacy/ Facebook: https://www.facebook.com/BlueberryPharmacy/reviews/?ref=page_internal

For Boston Health Care for the Homeless nurse Megan Sonderegger, providing client-centered care means literally meeting her clients where they are."To want to take PrEP, you have to have some hope for your future. If you have no hope and you don't have any idea that you're going to live past the next year, there's no reason to take Truvada. It just doesn't matter." -- Meagan Sonderegger, Healthcare for the HomelessDuring this month's episode of Connecting Care, Drs. Alex Walley, Jessica Taylor, and Sim Kimmel, HIV primary care doctor and addiction specialists, sit down with two clinicians from Boston Health Care for the Homeless Program, who share their experiences on the front lines, delivering innovative substance use treatment, HIV prevention, and HIV treatment where patients are.

We start by bidding an overdue farewell to Costco Wholesale Club. It’s not you, it’s us….and we are 100% OK with walking the walk. Thanks, Betch! Big News! Doctor Jon Paul was published in Ebony Magazine and we are thrilled! Congrats, Jon! Next, Jim pulls back the veil on some top-secret man on man action in San Antonio, Texas! Key words: zaddy, twink, grindr, Truvada, Pfizer, bullrider. WHAT DOES THAT EVEN MEAN? Anyways, how do you feel about hooking up during a pandemic? Hit play now to get all the T! Then we introduce you to a brand-new segment: Sixty with Stephanie! Also, Jon asks us about Disney’s new pickle corndog (would you eat it!?) and Christine teaches us about the historic Coney Island Incubator Baby Exhibit! Christine has a personal connection to the exhibit and – trust us – you do not want to miss this story! Shout out Fagsy Malone Automatic Pen Writer for the inspo! Finally, which of Jim’s IRL friends has a secret Only Fans account? This is getting GOOD. Want to support us behind the scenes? Become a monthly contributor! Simply go to https://anchor.fm/jim-lanahan/support and choose your monthly donation level. You can contribute as little as $0.99/month or as much as you like! Every little bit helps! Thank you! Wanna be Friends with Benefits? This episode of Jim Lanahan and Friends is sponsored by Jim Lanahan on https://cameo.com/jim_lanahan. All proceeds support this pod! Your personalized video comes with a link to join our live studio audience when we record the podcast. Who knows, you might even get to be IN the podcast! Connect with us! Podcast: FB and Insta: Jim Lanahan and Friends Podcast Jim Lanahan: @jimlanahan on Insta @IamJimLanahan on Facebook Website: https://jimlanahan.com Christine Sinacore: @csinacore on Twitter and FB Insta: @christinesinacore Website: https://christinesinacore.com Doctor Jon Paul Higgins: @doctorjonpaul on Twitter, Insta, FB Website: https://doctorjonpaul.com Scott Sheldon: @scottysheldon on Twitter and FB Insta:@scottasheldon, @scottysheldontheactor Website: https://scottysheldon.com Stephanie Laffin: @chickylaff on Twitter and Insta @billytherescuepup on Insta --- Send in a voice message: https://anchor.fm/jim-lanahan/message Support this podcast: https://anchor.fm/jim-lanahan/support

This week Jess and Brandon discuss a new project with Walgreens related to PrEP, medication that reduces the sexual transmission of HIV by over 99%. They discuss Jess' early work in sex education and answer listener questions including: How can I initiate sex with confidence? How do you flirt? What are the “apology languages”? How do you keep your cool during conflict? How can I get my partner to be more dominant in bed? To learn more about Walgreens PrEP, click here. Rough transcript of this podcast below: Brandon: Welcome! Hope everyone is well. Jess: I'm really excited because I'm swamped this week and I like the buzz. I have lots going on with V-Day on the horizon and a big announcement as well, so I'll start with that topic, as it relates to HIV prevention and involves a new partner and I really think that raising awareness of this topic can make a big difference because While rates of HIV in the U.S. have continued to decrease, but the epidemic is far from over. During the COVID-19 pandemic, many people have faced barriers to HIV testing, prevention and treatment. Obviously sexual health and pleasure intersect with overall health and I really want to increase conversations and understanding when it comes to prevention of HIV through the use of tools like PrEP, or Pre-Exposure Prophylaxis. This is why why I am excited to be working with Walgreens to encourage anyone at risk for HIV to reach out to their local Walgreens pharmacist to discuss their options. Walgreens pharmacists are specially trained to offer compassionate, confidential HIV care, including prevention options such as medication counseling and how to qualify for free programs like Ready, Set, PrEP, a nationwide effort led by the U.S. Department of Health and Human Services, which provides PrEP medications at no cost to those who qualify. These confidential discussions with a pharmacist can take place in private rooms in stores, by phone and online via Pharmacy Chat. To learn more, visit walgreens.com slash prep. That's walgreens.com slash P-R-E-P.” Now most people probably don't know that I started my career in sexuality working in HIV. My focus when I was doing research in teacher training involved three topics: healthy relationships, HIV/AIDS and sexual pleasure, because these were the topics that Toronto teens identified as their top priorities via the Toronto Teen Survey, which was a partnership research project between three universities that spoke with teens who wouldn't normally be included in research — so newcomer teens, more queer students, and other students forced to the margins. And when or while I completed by research, I started working freelance with some AIDS service organizations as a trainer, as a speaker and I worked with the ASO up in Fort Mac Alberta to help launch a sexual health & STI counselling line in a region that was hit hard in terms of HIV and STI rates on account of the way the oil economy had affected population movement and growth. The ED of that ASO, Daven Seebaran really focused on sexuality as a part of the HIV discussion — this was over a decade ago and he really realized that you can't talk about HIV prevention without also talking about sex — pleasure, options, activity, behaviour and not just condom use. He was young at the time and way ahead of his time. And he gave me so many opportunities in this field at a time when many people in public health still refused to talk about sex and definitely were leaving pleasure out of the equation. Back then, PrEP was in its infancy and was, in fact, still in clinical trials, but fast forward a decade plus and we're in a very different situation now. PrEP, or pre-exposure prophylaxis, is a daily pill that can reduce the risk of sexually transmitted HIV by about 99% when used consistently. You may have heard of the brand names for PrEP. Truvada was the first drug approved for use as PrEP for both men and women by the Food &...

Some definitionsPrEP: pre-exposure prophylaxis - referring to a daily medication taken to prevent the acquisition of HIVPEP: post-exposure prophylaxis - referring to a combination of medications taken after a potential exposure to HIV in order to reduce the likelihood of transmissionWho should take PrEP?People who have condom-less anal sexPeople who have sex partners they don't know very well or whose partners know they have HIVPeople who come from communities that have a greater burden of HIV because of less access to care and other systemic barriersAnyone who has had a bacterial sexually transmitted infection, like gonorrhea, chlamydia, or syphilis in the past six monthsWhy is PrEP special?PrEP is a powerful form of prevention that allows people to have autonomy and make decisions about their own sexual healthPrEP is not only a medication that prevents HIV, but it's also a very emotionally significant drug for many. For those who feel the legacy of the AIDS crisis of the 1980s and 1990s, having an HIV prevention drug can provide agency and control It can serve as a gateway into lent-term primary care (which we here at QHP are big fans of!)A brief PrEP timelineIn 2012, Truvada (otherwise known as tenofovir/emtricitabine/TDF) - a medication previously used to treat HIV - was approved by the FDA for PrEP, or to prevent HIV.It became apparent that Truvada as PrEP worked. The first big study looking at Truvada showed that daily PrEP lowered the risk of getting HIV by 92% if exposed.Slowly but surely, the queer community got on board (with the help of groups like PrEP Facts). More and more people began using PrEP to prevent HIV transmission.2019: a scientific trial called the DISCOVER trial published preliminary dataIt investigated the possibility of a second PrEP medication, another HIV medication called Descovy (otherwise known as tenofovir/emtricitabine/TAF)It also suggested that Descovy may have a better side effect profileBased on the preliminary data, the FDA approved Descovy as a second PrEP option. Some folks started getting switched from Truvada to Descovy (with or without their consent).At which point many people started wondering: which PrEP medication to opt for? Which is the better option?Truvada vs. Descovy: the scientific dataWhen Truvada came onto the scene as PrEP, it did so with multiple large studies of high quality evidence and in multiple populationsiPrEx: a study that put Truvada on the map. Studied side effects and efficacy at HIV prevention in men who have sex with men as well as transgender women.Partners PrEP: showed that Truvada was effective at HIV prevention within heterosexual couples where one partner is HIV+Descovy, in turn, so far has less scientific literature discussing its efficacy as PrEP in a variety of populationsBasically, all we have is the DISCOVER trial - which only looks at cisgender men and some trans womenAnd note: up until 2020 (a year after FDA approval) the DISCOVER trial had not officially released its data, just a preliminary abstractIt's unusual that Descovy was such a popular and widely-used option before the data was officially published – before healthcare providers could read the data for themselves and help their patients make informed decisionsIn addition to the above differences in how the drug came to the market, Truvada has an additional study (called IPERGAY - you can't make this stuff up) This study demonstrates Truvada's efficacy as PrEP “on demand” – meaning, taken in the days right before and right after a sexual encounterDescovy, in turn, has no such data supporting its use as PrEP on demandTruvada vs. Descovy: side effectsTruvadaAbdominal discomfort: observed in roughly 1 out of 5 people. Usually goes away on its own after two to six weeks on medicationChanges in kidney function (as measured via a substance called creatinine), largely reversibleChanges in bone density - also reversible once taken off the medicationDescovyBased off of what we know about Descovy as HIV treatment, it can increase cholesterol, blood sugar levels, or weight gain, risk factors for the development of heart attack and stroke. Unclear if these effects will be seen or will have impact on people's health in the long-term when Descovy is used as PrEP given that the drug is dosed differently in this context.The DISCOVER data also suggests that there may be fewer kidney and bone side effects -So who actually should be taking Descovy as PrEP?As of right now, the medication is approved in cisgender men who have sex with men. It is not approved for folks with vaginas, since that group was not studied in the DISCOVER trial.Ultimately, the decision is an individualized one that depends on personal medical history and preferences. For example: for folks with kidney disease, Descovy may be a better option. Long story short: it depends. Bring it up with your primary care provider! (And if you don't feel comfortable bringing it up, we encourage you to find a care provider with whom you do feel comfortable – all while acknowledging that this is likely far easier said than done.)A generic PrEP optionTruvada's patent expired in 2019, at which point it became generic. How does having two PrEP options – one brand name, one generic – change the HIV prevention landscape?The goodOn face value, having a generic PrEP option seems like a good thing since it will increase financial access. Additionally, having two options gives folks agency, which may increase PrEP uptakeHowever…Having a fancy brand name option (Descovy) may stigmatize the generic option (Truvada). This is tricky for folks who only have generic options available to them.One drawback is that the Gilead co-pay assistance programs will not pay co-pays so there may be some back and forth with providers, insurance and pharmacies as this transition occurs. However, there should always be an option to have PrEP covered.

On this episode, communist psychic from the 16th century, Tom, and the time wizard bent on seeing Osmosis Jones in the theater, V, skim the complete works of Nostradamus looking for clues about the next major international incident (and winning lottery ticket numbers). Tom tries to avoid contracting HIV by downing a handful of Truvada despite being allergic to Truvada, and V dons his VR headset for some extended porn star eye contact.

In honor of World AIDS Day we have a discussion on gay sex, from HIV to STIs, PreP, & AIDS. Erick (host) unveils his HIV Positive status for the first time & walks us through his journey. Miguel Bujanda from REACH LA discusses stigma, testing, prevention, & safe sex. Follow Us: @TheHomoHomiePodcast @TheHomoHomie @TheJoseResendez @REACH_LA @IPapaMigz   Website Sources: Reachla.org AHF HIV Basics CDC on HIV A Timeline of HIV History of HIV

Gilead, the biopharmaceutical company responsible for manufacturing Truvada, has come under scrutiny for its HIV drug pricing. This hour, we get the latest on this story. We also preview an upcoming Hartford rally, scheduled to coincide with AIDS Awareness Day. Plus, for various reasons, a couple might decide to have their embryos frozen. But what happens to those embryos after the couple divorces? We learn about a state Supreme Court case, which centers on this very issue. And finally, the SAT has a new score. An adversity score, to be more specific. We find out what this means and check in on Connecticut’s SAT requirements.Support the show: http://wnpr.org/donateSee omnystudio.com/listener for privacy information.

In this episode, we talk to writer Bryn Nelson about how PrEP is great at blocking HIV, but as its use grows, so do fears that people will be more sexually reckless and spread other STDs. But researchers are coming to think that the opposite could be true. See acast.com/privacy for privacy and opt-out information.

There is a saying "No Glove, No Love" but how many actually hold fast to that mantra. People love sex; some more than others and in the heat of the moment decisions are made that can place one at-risk for exposure to HIV. In addition, there are sero-discordant couples (one living with HIV, one HIV negative) that would love to engage in risk-free condomless sex. Truvada for PrEP provides 92%-99% reduction in HIV risk for HIV-negative individuals who take the pills every day as directed. If a daily dose is missed, the level of HIV protection may decrease. It only works if you take it. People who use PrEP correctly and consistently have higher levels of protection against HIV. Yep..it's true, there is a pill that will eliminate your chances of contracting HIV! Listen in and learn more about this groundbreaking HIV prevention tool.  Visit: http://www.dontamorrison.com to learn more about Dontá. FB: The Donta Show IG: Donta_Morrison 

Íbúar í Mosfellsdal hafa lengi haft verulegar áhyggjur af umferðinni um dalinn sem hefur aukist gífurlega undanfarin ár. Mikill umferðarþungi og hraðakstur veldur því að íbúar segja það nánast rússneska rúllettu að fara út í búð en á laugardaginn varð banaslys á veginum eftir framúrakstur. Boðað hefur verið til íbúafundar á morgun og Guðbergur Guðbergsson, formaður íbúasamtaka Mosfellsdals, kom til okkar og ræddi þetta ástand. Stjórnarráð Íslands leitar nú að unglingi fæddum árið 2003 til að ferðast til Úganda og taka þátt í verkefni sem snýst um að kynna heimsmarkmið Sameinuðu þjóðanna. Sigtryggur Magnason veit meira um þetta mál og hann kíkti til okkar í spjall. Útlit er fyrir að bílar muni hækka um 20-30% í verði í haust með innleiðingu nýs mengunarstaðals sem tekur gildi 1. september og mun hafa áhrif á tollaálagningu á bílum en hún fer meðal annars eftir útblæstri. Bílainnflytjendur hafa kallað eftir mótvægisaðgerðum frá yfirvöldum og bent á að slíkt hafi til að mynda verið gert í Svíþjóð og Danmörku. Runólfur Ólafsson, framkvæmdastjóri FÍB, ræddi þetta við okkur. Nýtt lyf sem fyrirbyggir HIV smit er nú orðið aðgengilegt á Íslandi í fyrsta sinn. Lyfið heitir Truvada en kallast öllu jafna PreP en í Bandaríkjunum og Bretlandi hafa nýsmit HIV dregist verulega saman eftir að notkun lyfsins hófst. Við heyrðum í Bryndísi Sigurðardóttur smitsjúkdómalækni. Einar Örn Jónsson þróttafréttamaður hjá RÚV kom til okkar og sagði frá helstu íþróttaviðburðum helgarinnar. Anna Sigríður Þráinsdóttir, málfarsráðunautur RÚV, ræddi íslenskt mál og skoðaði mismunandi orð sem notuð eru yfir sömu hlutina. Tónlist: Dikta - To be grateful. John Grant - It's easier. U2 - Red Hill Mining Town. Hafdís Huld - Take me dancing. Prefab Sprout - Cars and girls. Toto - Rosanna. Shannon Shaw - Broke my own. Leon Bridges - Beyond. Stuðmenn - Örstutt lag. Hjaltalín - Þú komst við hjartað í mér.

In this week's LGBTQ headlines: • Texas Gov. Greg Abbott is calling a special session of the Texas legislature to try an pass an anti-transgender “bathroom bill” • The FDA has approved a generic version of Truvada • Transgender leaker Chelsea Manning gave her first interview since being released from prison • "Guardians of the Galaxy" star Dave Bautista has a message for homophobes • Just a few predictions of who might win at this year's Tony Awards All that and more in this episode of The Randy Report

The drug Truvada, licenced for HIV PrEP, costs £350 a month but is shown to be cost effective in preventing infection. However, in the English NHS, a row has broken out about which body should fund the treatment - NHS England claims local authorities have responsibility, local authorities believe NHS England does. In this podcast Jim McManus, director of public health at Hertfordshire County Council, explains why he believes local authorities cannot afford the treatment, and describes the pressure that public health budgets are under. Read the full editorial: http://www.bmj.com/content/354/bmj.i3515

In hour one of EyesWide Open,  Blog TalkUSA'sTJ Powell will give us an update on the progress of Hope Osceola and will introduce the founders of a company that could revolutionize access to medication for the prevention and treatment HIV and AIDS.  NuRx is making Truvada for PrEP available via a mobile app, to reach the people who need it the most. Edvard Engesæth is an MD and has experience with providing healthcare remotely. Hans Gangeskar is a lawyer and engineer and has worked for the Andreessen Horowitz backed startup uBiome. Learn more about PreP and Truvada at:  www.nurx.co   Also, please visit Hope Osceola's GoFundMe page and help us reach our goal of providing much needed testing and counseling services to people who live in high risk circumstances http://www.gofundme.com/hopeosceola In the second hour we discuss the GOP's White Supremacist problem, the South Carolina flag, and new developments in the response to the act of terrorism committed by racist, white supremacist Dylann Root.

In hour one of EyesWide Open,  Blog TalkUSA'sTJ Powell will give us an update on the progress of Hope Osceola and will introduce the founders of a company that could revolutionize access to medication for the prevention and treatment HIV and AIDS.  NuRx is making Truvada for PrEP available via a mobile app, to reach the people who need it the most. Edvard Engesæth is an MD and has experience with providing healthcare remotely. Hans Gangeskar is a lawyer and engineer and has worked for the Andreessen Horowitz backed startup uBiome. Learn more about PreP and Truvada at:  www.nurx.co   Also, please visit Hope Osceola's GoFundMe page and help us reach our goal of providing much needed testing and counseling services to people who live in high risk circumstances http://www.gofundme.com/hopeosceola In the second hour we discuss the GOP's White Supremacist problem, the South Carolina flag, and new developments in the response to the act of terrorism committed by racist, white supremacist Dylann Roof.

Rod and Karen discuss Tweet Harassment to Rod and from Karen, actual Street Harassment, Captain America, Twitter and relationships, Truvada, Revenge Porn federal bill, Beyonce pays in selfies, to catch a James Franco, suicide on April Fool's Day, Obama impersonator does ad, anti-Ivy League article misses the point, DWI critic caught drunk, biology teacher caught giving extra credit and sword ratchetness. Twitter: @rodimusprime @SayDatAgain @TBGWT @rhymeoverreason @itsthebrandi Email: theblackguywhotips@gmail.com Blog: www.theblackguywhotips.com Voice Mail: 704-557-0186 Sponsors: www.tweakedaudio.com Code: TBGWT