←An utterly
hilarious, bogus, Arthur Weinstein "detector" (see it below) Google: chromatography
detectors. Weinstein made up this bullshit and got away with it because
most MDs are total morons and know nothing about chemistry or what goes on at BigPharma.
THE RICO PERPS, SELF-IDENTIFIED (There's
more bullshit here than truth, otherwise.):
"The entrepreneurial trio are
Durland Fish, Ph.D., former director of
the College's Lyme Disease Center and
now a research scientist at Yale; Gary
P. Wormser, M.D., still professor of
medicine and pharmacology and chief of
the Division of Infectious Diseases at
the College; and John J. Connolly, Ed.D., former College president and current
chairman of the board of the American
Lyme Disease Foundation, Inc., which had
its genesis on the Valhalla campus in
1990."
Rheumatologist
Arthur Weinstein, M.D., has two NIH
grants to research why some patients
continue to suffer even after treatment
with antibiotics.
 |
|
Arthur Weinstein, M.D.,
checks out Andra Sramek, who
volunteered for a research study in
the Division of Rheumatic Diseases
and Immunology. Taking notes is Sara
Guardino, research assistant. |
While some doctors
attribute the discontent to depression,
Arthur Weinstein, M.D., takes his
patients seriously when they complain
about aches and pains, fatigue and
difficulty in concentrating after a bout
with Lyme disease--even if they were
initially treated with antibiotics.
Apparently, so does the National
Institutes of Health (NIH), which has
awarded Dr. Weinstein, professor of
medicine and chief of the Division of
Rheumatic Diseases and Immunology, two
major grants to study why people
continue to suffer and how they
can finally be cured of the tick-borne
infection. The research may go a long
way toward assuaging Lyme disease
support groups, which continue to press
for a longer course of drug therapy,
earlier accurate testing and further
research into treating what has become a
significant health problem for residents
of Westchester and Fairfield (Conn.)
counties and Long Island communities.
From lupus to Lyme
This year, Dr. Weinstein
is working with more than half a million
dollars in grants from the NIH,
pharmaceutical companies and private
foundations on research that includes
systemic lupus, rheumatoid arthritis and
scleroderma. But the bulk of the funds
belong to chronic Lyme disease, which
was not his interest when he joined New
York Medical College from the University
of Connecticut School of Medicine in
1985; lupus was. Still, Dr. Weinstein
became intimately involved in the
evolution of Lyme here as his experience
with the disease went from nothing to
plenty, and fast.
"The College has
recognized that Lyme disease is a major
clinical and research interest on this
campus. The main players in the
development of the program were Fish,
Wormser and Connolly," Dr. Weinstein
advises. The entrepreneurial trio are
Durland Fish, Ph.D., former director of
the College's Lyme Disease Center and
now a research scientist at Yale; Gary
P. Wormser, M.D., still professor of
medicine and pharmacology and chief of
the Division of Infectious Diseases at
the College; and John J. Connolly, Ed.D.,
former College president and current
chairman of the board of the American
Lyme Disease Foundation, Inc., which had
its genesis on the Valhalla campus in
1990.
A golden opportunity
"When I came here, Lyme
tests were being sent to Albany and it
took four to six weeks to get results,"
Dr. Weinstein recalls. "I set up a lab
to do testing because I saw the need--to
have testing done reliably on this
campus. There was an educational need,
too, for rheumatology residents to see
how the tests were performed and
interpreted. And it was also important
for my clinical research to have serums
frozen away...For 10 years, our lab did
all the Lyme testing for faculty
practice. Now Lyme tests are also being
done by other labs on campus."
(Besides Lyme testing,
the lab in Munger
Pavilion--co-designated the Lyme Disease
Research Laboratory and the Diagnostic
Immunology Laboratory and owned by the
Department of Medicine--also screens for
lupus and connective tissue disorders
such as scleroderma and vasculitis.)
Over the years, testing
for Lyme has become controversial, which
disturbs Dr. Weinstein. Since he was a
member of the committee that developed
the standards for Lyme testing--now
referred to as the Dearborn criteria and
used throughout the nation--he is
especially perturbed when the tests are
maligned as unreliable. "What is
unreliable is the interpretation of
results by doctors and patients," he
claims. "A patient can have nine
negative tests and then one positive one
and the diagnosis is mistakenly
confirmed...The best test would be to
culture the bug, like you do for a
urinary infection. But the Lyme bug is
slow growing and you have to decide
whether to treat or not before the
culture is finished. Besides, the lab
test to grow the bug is not very
sensitive and too many patients have
negative cultures of the skin or blood
for it to be a routine test."
Perfection denied
It is true that in early
acute Lyme disease, an antibody test may
be of little value because it will read
negative for the first several weeks
and, in fact, may never be positive. But
overall, 70 to 80 percent will have a
positive test one to two months after
being infected, says Dr. Weinstein, and
in late Lyme arthritis, the test is
virtually always positive months after
the infection.
"A test usually isn't
all or nothing. It is just a statistical
probability of something," he insists.
"A test is always evaluated as a range
of normal, which includes 95 percent of
people in that range. So at anytime, 5
percent can be outside the range, but
not far outside, and still be normal." [WRONG-
EACH ANTIBODY IS AS ACCURATE for DIAGNOSIS AS ITS ASSIGNED PERCENT SPECIFICITY.
For example, OspC is about
95% specific, so if you have band 23 (OspC), there is a 95% chance you have Lyme...]
Essentially a two-tier
system, the Lyme tests comprise a
screening analysis called ELISA,
followed by the Western blot which is
considered more reliable. In the ELISA
test, an "alphabet soup" of proteins of
the Lyme disease bug, Borrelia
burgdorferi, is placed on a plastic
plate with wells and a patient's serum
is added. If the patient has antibodies
to Lyme they will stick to the bug's
proteins.
Just say Lyme
But there are more than
100 proteins in the mixture, so the test
can be positive even when Lyme is not
present. So diagnosis is confirmed by
Western blot, where the proteins are
separated out by electric current so
that you can determine if the antibodies
react with proteins specific to
Borrelia. They can be read visually or
interpreted by computer through a
program that Dr. Weinstein developed
with the help of a graduate student. Dr.
Weinstein mentions that Western blot is
not used right off the bat because,
among other reasons, it is too labor
intensive and expensive, as opposed to
the ELISA, which is automated.
 |
|
Arthur Weinstein, M.D.,
director of the Diagnostic
Immunology Laboratory, began testing
for Lyme disease in 1985. He is
evaluating an ELISA test, which is
confirmed by Western blot analysis,
with, from left, DeLona
Norton, laboratory
supervisor, and Lois
Zentmaier, laboratory
technician. |
After he established the
Lyme Disease Research Laboratory, Dr.
Weinstein found himself increasingly
drawn to Lyme despite its status as an
infectious disease. As a rheumatologist,
he found the complaints of lingering
aches and pains too seductive to
disregard. "Rheumatology is the
subspecialty of internal medicine that
deals with the diagnosis and treatment
of joints, muscle and bone disorders,"
he imparts. "If your family physician
can't figure out the cause of your pain,
you need to go to a rheumatologist."
Other specialties
involved
As the Lyme disease
program expanded to encompass other
clinicians and basic scientists on
campus, Dr. Weinstein found the time
right in 1994 to apply to the NIH for a
grant to study the "Pathogenesis of Lyme
Induced Fibromyalgia." The first major
funded study of Lyme's chronic rheumatic
symptoms, the research utilized SPECT
brain scans and other neurologic tests
to detect abnormal blood flood.
Psychiatrists performed psychological
and neurocognitive examinations while
biochemistry and molecular biologists
used DNA probes to study whether there
were active infections. And his own
rheumatology department examined samples
of blood and spinal fluid to measure for
quantities of specific Lyme antibodies
that came from the patients enrolled in
the study. Analysis of the data began
last spring.
In an effort to spread
credit around among his collaborators,
Dr. Weinstein says, "These years have
been a very academically productive time
for me, and I'm appreciative of my
colleagues in the clinical and basic
sciences and those in the school
administration who have helped me.
Working in Munger Pavilion, which
geographically is midway between the
Basic Sciences Building and Westchester
County Medical Center, is also a
symbolic link between basic science and
clinical activities."
Second post-Lyme study
While his fibromyalgia
study was proceeding, Dr. Weinstein was
awarded another NIH grant in conjunction
with New England Medical Center/Tufts
University School of Medicine in Boston.
The new five-year study into the cause
and treatment of post-Lyme disease
syndrome, awarded in 1996, has been
delayed in getting started because of
"legal complications from a competing
institution that wanted to wrest the
grant from us," Dr. Weinstein advises.
Now back on track, he started screening
in June for volunteers similar to those
in the fibromyalgia study. Subjects must
be able to document having had Lyme
disease and submit to a current spinal
tap to ensure they do not have active
infection in the brain. "Some people in
the study will get a placebo, but if
they actually have proven active Lyme,
they should be treated," Dr. Weinstein
explains.
|
|
A
Western blot of serum from a patient
with Lyme arthritis and the
corresponding intensity of each
band. Band positions and intensities
are calculated using a computerized
image analysis system developed by
Krzysztof Kowal, Ph.D., and Arthur
Weinstein, M.D. They conclude from
their research that this analysis
increases the objectivity and
accuracy of Western blot
interpretation for the diagnosis of
Lyme arthritis. |
"This is a double-blind,
placebo-controlled study. Treatment will
be for three months," he continues,
"which is longer than usual. During the
first month subjects will be prescribed
intravenous ceftriaxone, followed by two
months of oral doxycycline...So these
patients will get both drugs or
nothing."
Lots of questions
The purpose of the
research is to determine whether this
treatment regimen results in
long-lasting improvement in patients
with these chronic symptoms. "Lyme
patients claim to feel better on
antibiotics and relapse when they stop,"
says Dr. Weinstein, "but this is not
typical in treating other infections.
Does it mean we are not really treating
an infection in post-Lyme disease
syndrome, and that they are getting
better from a placebo effect? Or is
there really an infection, but the bugs
are hiding and not reached by
antibiotics, only to start growing again
when the antibiotics are stopped? Or,
are the antibiotics working by some
different mechanism unrelated to killing
bugs--say, are they just having some
chemical effect on the brain?...
"I think this study will
help to clarify which, if any, patients
with chronic Lyme disease symptoms
really have Lyme and should be treated
with antibiotics long term. This result
is a very important answer."
Considering his
familiarity with the subject, is there a
gut feeling about what he will find? In
his best impartial viewpoint of a
principal investigator, he replies, "I
have no idea."
