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1/ I've aggregated several studies and their findings about the potential interactions between CHLOROQUINE + AZITHROMYCIN with a focus on cardiac outcomes.

This is very important given this potential combination therapy in the treatment of #COVID19 #coronavirus
2/ Efficacy & safety of azithromycin-chloroquine in pregnant women. Kimani et al.

Summary: Randomized, Phase 3 trial showing no drug related deaths in 1446 pregnant women treated with 620mg chloroquine and 1000mg azithromycin daily for 3 days.

ncbi.nlm.nih.gov/pmc/articles/P…
3/ Pharmacokinetic interaction between azithromycin & chloroquine. Cook et al.

Summary: Randomized, Phase 1 trial showing no clinically relevant pharmacokinetic interaction in 24 subjects receiving 500-1000mg CQ & 1000mg AZM daily for 3 days.

ajtmh.org/docserver/full…
4/ AZM + CQ for protection against malaria in pregnancy. Chico et al.

Summary: Expert opinion finds CQ + AZM safely given any time in pregnancy. Pharmacokinetics in pregnancy suggest dose adjustments not necessary for AZM but CQ dosing needs to be 600 mg.
ncbi.nlm.nih.gov/pmc/articles/P…
5/ CQ + AZM does not increase cardiac instability in anesthetized guinea pig. Fossa et al.

Summary: CQ + AZM in anesthetized pig showed no increase in alternans (action potential duration alternations) indicating no additional arrhythmia liability.

ajtmh.org/docserver/full…
6/ WHO, The cardiotoxicity of antimalarials, 2016: “Antimalarial medicines that prolong the QT/QTc interval, such as quinine, chloroquine, artesunate-amodiaquine and dihydroartemisinin-piperaquine, have been associated with a low risk of cardiotoxicity.”

who.int/malaria/mpac/m…
7/ TLDR; The evidence from the above studies shows life threatening or fatal side effects from azithromycin + chloroquine combination therapy in healthy persons to be exceedingly rare.

This is not medical advice. Please consult your physician. @elonmusk @realDonaldTrump
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James Todaro, MD
@JamesTodaroMD
1/ Here is my summary of the relevant points from the breaking open-label clinical trial on the use of hydroxychloroquine (HCQ) and azithromycin in the treatment of COVID-19 by Didier Raoult, MD/PhD. @DiderRaoult
2/ Trial included 36 adult patients, 26 received HCQ & 16 controls. Six out of 42 patients meeting inclusion criteria lost to follow up. (All from treatment group: 3 transferred to ICU, 1 death, 1 left hospital, 1 stopped HCQ bc nausea. No control patients lost to follow-up.)
3/ HCQ-treated patients average age 51.2 yrs vs control patients average age of 37.3 yrs. Six patients receiving HCQ received azithromycin on day 1 (unclear how certain patients were selected to receive azithromycin).
Read 6 tweets
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James Todaro
@JamesTodaroMD
Five INSANELY bullish charts for bitcoin. 🚀🚀🚀 $BTC #bitcoin

1/ Bitcoin looks nothing like the Tulip Mania or South Sea Company bubbles, which only lasted an illiquid and brief 3 years.

Bitcoin has been growing for 10 years with billions of dollars traded daily.
2/ If you dollar cost averaged into bitcoin weekly, every year would result in positive returns at today's prices, including 2018 and 2019.
3/ Bitcoin dominates the best performing tech stocks in returns over the past decade, even when giving tech companies a 4 year head start. 🔥🔥🔥

Berkshire Hathaway added for fun.
Read 5 tweets
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James Todaro
@JamesTodaroMD
They didn't change their minds when Bitcoin was $200.

Or $1,000.

Or $20,000.

Will they at $100k?

Famous quotes from Bitcoin critics in 2013/2014... {a thread}

1) “[Bitcoin] is a terrible store of value." Jamie Dimon, Jan 2014
2) “A Central Bank that is democratically controlled remains our best hope for a form of money that is for the people & by the people. Bitcoin...can never be that.” Yanis Varoufakis, former Greek Minister of Finance, Apr 2013. (2 yrs before Greece’s Debt Crisis & his resignation)
3) “Bitcoin is Evil.” Paul Krugman, Dec 2013

4) “It’s a bubble. It has to have intrinsic value. You have to really stretch your imagination to infer what the intrinsic value of Bitcoin is.” Alan Greenspan, former Federal Reserve Chairman, Dec 2013
Read 7 tweets

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Eliana Golberstein Rubashkyn💛💜
@ElianaGolber
Several studies in situ in Italy suggest that #hydroxychloroquine and #azithromycin have determinant effects over the ribosome RNA poly3' aaa sensitive polymerases, that are protein assembly units from RNA messenger into proteins.
It appears based on evidence (n=250), [not a randomised double-blind studies], that these two drugs have a synergistic effect in the hosts cells that make the virus partially unable to kidnap the ribosomes polymerase protein assembly of our cells.
Hydroxychloroquine is a zinc Inophore, which means it allows the external Zn to go inside the cell. Zn by itself is not easy to be carried inside the cells, however high amounts of Zn+2 inside the cell have the ability to reduce attachment of RNA 3'aaa dependent polymerases.
Read 9 tweets
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IT Guy
@ITGuy1959
Greg was just on @TuckerCarlson

Effectiveness of chloroquine against #coronavirus has been reported in other credible articles / papers.

Journos need to stop harping on political correctness & ask questions to the Admin re this kind of information.
This is further encouragement..👇🏼

If chloroquine is effective, I have no doubt humans can crank up production 10x in the metaphorical blink of an eye.

PS- I believe this is what the 4-8 weeks of lockdown is really about.

It keeps the medical system from being overwhelmed while we figure out treatments & scale our testing.

Then we gradually loosen restrictions as we become increasingly equipped to manage it.
Read 15 tweets
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Xy5Z89🇩🇪
@Xy5Z89
#Important #News! #Threade

#Israel #Jerusalem #Russia #Syria

#Russia's #ambassador to #Syria released this week what some saw as a veiled threat to #Israel if Israel continued to #bomb #Iranian positions in the war-torn country.
On February 6th, 20 #Syrian and #Iranian military officials were #killed in an airstrike on a target near #Damascus. The attack also resulted in #Syrian air defense systems accidentally firing on a #Russian 172-passenger plane.
The plane was able to land safely at a nearby airport. However, #Russian #ambassador Alexander Yefimov was not interested in the Israeli justifications. In an interview with Sputnik arabic, Yefimov described the #Israeli #attacks as “#provocative and very #dangerous”.
Read 8 tweets
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guek
@guek_jc
I didn't expect my deep dive into Bernie's doctor letters to get so much attention. Thank you all for the kind words! Due to popular demand, I'll go over the remaining 2 letters. Well, really only one of them since the other doesn't say much. Let's get to it #Bernie2020 1/?
The first letter written by Dr. Monahan that I previously discussed was a general health summary. The next letter written by Dr. Ades and Patrick Savage MS from the Uni of Vermont Medical Center is strictly dealing with the results of his post-heart attack stress testing 2/?
The second letter helps us understand his long-term prognosis with more being said in this short paragraph than you might suspect. On the surface, it's easy to understand that the doctors are saying his stress test went well and Bernie is healthy for his age/risk factors 3/?
Read 18 tweets
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Christophe Barraud🛢
@C_Barraud
🇺🇸 🇨🇳 Mnuchin, Kudlow Invite U.S. #Tech Giants to Discuss #Huawei Ban - Bloomberg
bloomberg.com/news/articles/…
🇨🇳 🇺🇸 #China, US said to be wrangling over text before #trade talks can resume - SCMP
scmp.com/news/china/dip…
🇺🇸 🇨🇳 #Technology Supplier to U.S. Police Agencies Bans Chinese Drones - Bloomberg
bloomberg.com/news/articles/…
Read 672 tweets
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Christophe Barraud🛢
@C_Barraud
🇺🇸 🇨🇳 U.S.-#China #Trade Pact Takes Aim at Currency Manipulation - WSJ
*Deal could include penalties for China if it manipulates its currency to increase exports
wsj.com/articles/u-s-c…
🇺🇸 🇨🇳 Mnuchin Says U.S. Open to Facing Penalties in China Trade Deal - Bloomberg
bloomberg.com/news/articles/…
🇺🇸 🇨🇳 U.S. negotiators have tempered demands that #China curb industrial subsidies as a condition for a trade deal after strong resistance from #Beijing, marking a retreat on a core U.S. objective for the trade talks - Reuters
reuters.com/article/us-usa…
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