admin – Page 5

AARP article misses the boat – DRUG SAMPLES AND DRUG REPS – MAYBE NOT SO BAD – BUT LIMIT THE DIRECT-TO-CONSUMER ADS and LAWSUITS

A recent article in the AARP Bulletin highlighted an email of a drug company's inside commentary on drug representatives and their impact on physicians' practices. Congress was on this subject of how doctors obtain information years ago, and rather than mandating legislation, the Pharma Industry limited themselves. Now the irony here is that, all the Pharma Industry now advertises the millions and millions of dollars for their new drugs on television, cable and non-cable, radio, and the print media. How many ads of erectile dysfunction have you seen or watched in the last few years? What about allergy drugs? Those ads seem to be everywhere also.

Meanwhile, most doctors get some of their information from drug company representatives. The doctors of yesteryear were wined and dined – alot. But all that has changed. Company meetings for continuing medical information and education are sponsored for cost. However, the rules are tight. No trips to Hawaii have ever been offered to me, in 25 years or so.

Now the medical appliance industry, like the artificial hips, pacemakers, etc., are not included in the Pharma SELF-imposed rules. This industry works like many others. Recently my awareness was stretched when a person told me ALL hundreds of employees of a beer industry were wined and dined, golfed, and brought to a city with alot of casinos! All on the company. And recently a marketing company took hundreds of employees to another city for 3-4 days, for their needs.

Now, most doctors do like to see drug representatives. We do get good and current information from the reps. If the doctor has a brain, he or she will and can challenge the drug rep with his product, his information, and his competition. This is good information.

Literally, thousands of patients through the years have asked for "Any free samples?" Many times we can accomodate some starter paks of medicines that have been given to us by the pharmaceutical representatives. Most clinics get some samples for patients. According to a recent study over 75% of clinics get free samples. Many times the reps will sponsor quick to the point luncheons. Some doctors join company panels to discuss the highlights and controversies of new therapy. So, what is the big deal?

Most pharmaceutical reps are good people. Most earn their living by providing information currently and timely. Most doctors are good people. Most earn their living by providing good patient care. Most patients are good people. Most enjoy and sincerely appreciate a "few samples" to start their drug regimen.

Now, with the costs of drugs so high, and the pressure on the drug companies to limit free samples or starter paks, it would seem to be soon – a policy that will be forced out. This will be a loss for the underinsured, uninsured, family of four parents, and others that look at the costs in general of healthcare and delay or eliminate their prescription all together.

Narsimhapur The billions of dollars spent on "direct-consumer-advertising" that is endorsed by the FDA and other federal, state, and societal organizations is the first place to cut drug costs. Those ads drive the physician by patient requests. Get rid of direct to consumer advertising. Next, get rid of the massive class action suits against all the companies. The U.S. has driven the vaccine industry out of the U.S. and the drug making is not far behind. If the vaccine shortage concerns did not awaken some fear in you, this should.

So, soon, patients will say good bye to free samples, free starter cost reduction cards, and reduced up to date physician information.

As for me, trips, rock n' roll collections, and tennis racquets have not crossed my desk….And to say they do is just crazy by a biased author. And some of the doctors will stay "chummy" with professional colleagues in the pharmaceutical representative business. Some might call that professional interaction and ethical education…

SALT USE AND CARDIOVASCULAR DISEASE AND HYPERTENSION

http://dnasab.net/2008/02/ Stroke and other cardiovascular diseases are linked closely to high blood pressure. In many studies, hypertension is a strong predictor of these severe problems, including stroke (brain attack), congestive heart failure, and even myocardial infarction (heart attack).

The importance of salt intake (sodium chloride) with regard to high blood pressure is well linked. Most of these studies have been a type of case control showing high probable causal relationship. Some other studies have shown that higher salt intake predicted the higher incidence of cardiovascular diseases over time.

But a recent published and peer reviewed study, with randomized NON-hypertensive persons, about 3000 of them, has put a strong lock on this issue. In the study, persons were given about 2.6 gms or 2.0 gms of salt daily. Another group of placebo was a control also. The groups were followed out to 18 months or 36-48 months. Then all the groups (cohorts) were followed over the next 10-15 years!

There was a remarkable 30% (approximate) lower incidence of cardiovascular events during this period. This finding was controlled for age, body mass, sex, ethnic origin, and initial blood pressure – when compared to the placebo group.

We have long known this concern of salt and high blood pressure and other cardiovascular diseases. Even back in about 1985, the World Health Organization recommended the salt intake to be reduced to about 5 grams per day.

In "Westernized" countries, bread and processed foods account for the great majority of salts in the diet, with personal use being about 15-20 %. In many developing countries however, the personal use is the burden of salt. Some countries have tried to "legislate" salt reduction, however most of the time, this effort turns to "voluntary" agreement programs with good intent, rather than hard legislation. More efforts of education and the reason for limiting salt intake should be forwarded by all the main agencies such as the American Heart Association (AHA), the American Diabetes Association (ADA), and others that take the lead to limit cardiovascular disease, morbidity, and mortality.

So think about it. Should we legislate the prepared foods, soda and beer, snack, eat 'n run, cafe, restaurant, and bar industries to limit the salt in their products? Dear ol' Mom probably had it right when she said, "Not so much salt!"

So next time you pick up the product, do a salt survey. Remember less that five grams a day is highly recommended, while 2 grams a day really makes a difference in your actual risk. The debate appears to be over. Salt can take a toll. Be a wise shopper and a wiser eater.

Salty popcorn with butter anyone? Remember, more fiber, less salt, less trans-fats….Yuk!

DROWNING AND WATER SAFETY – DO IT RIGHT

JUNEAU, Alaska (May 14, 2007)–Passengers from the Cruise Ship Empress of the North being offloaded onto the Coast Guard Cutter Liberty and civilian vessels after running aground at aproximately 2:00 a.m. here today. The Liberty took on 130 of the 248 passengers before offloading them onto the Alaska State Ferry Columbia, which will transport them back to the city of Juneau. (Official Coast Guard photo by Petty Officer Chris Caskey) (from Coast Guard website)

Did you know that most drownings happen just a few feet from safety! Many data sets show that as high as 90 % of all drownings are close to safety, in one form or another.

Often, the victims of drownings are not only close to safety, but have personal safety devices close or have personal flotation devices. But…the victims are not using them or wearing them.

Each boating season, the personal flotation devices should be checked for leaks, tears, rips, cuts, and general wear and tear. They should be replaced.

Each season, your kids also change…bigger, taller, heavier, the kids need to be sized for proper fit and make sure the PFD fits each child snuggly and properly. Do this in shallow water to practice. Have the child put the PFD on, tilt his head back, and see that the water stays below the chin level. The mouth must be well above the water level if the device is used in turbulent waters or waves. Therefore proper weight and age sizing is very important.

It is a fun family event to practice throwing a type 4 (IV) flotation device. Important techniques typically come with the device. This few minutes may save a life.

Local and national groups say alcohol is the biggest common thread of up to 75-80 % of boating accidents. Always monitor the skipper of any craft if she or he has been drinking. Best rule is do not drink and captain the boating craft.

The types of PFDs include:

Type I – the offshore, rough water type

Type II – the near shore, calmer waters type

Type III – called a flotation aid, wearable, and quick rescue most likely

Type IV – is the throwable device

HAVE A SAFE BOATING SEASON. KNOW YOUR PASSENGERS. KNOW YOUR VESSEL.

DVT – DEEP VEIN THROMBOSIS – POTENTIAL SILENT KILLER – planes, trains, and surgeries

YEARS AGO, MY FATHER RETURNED AFTER SEEING MY GRANDFATHER, FROM THE SMALL HOSPITAL IN THE LITTLE TOWN IN MIN-NEE-SOOO-TAH.

My grandfather had been in the hospital after a minor surgery. Remember years ago, even small procedures were done in the hospital by the general practitioners or early surgeons and patients were held in the hospital for days. Just shortly after my father returned from seeing his father, our telephone rang. I remember seeing his face change and his voice quiver slightly. But dad was a strong man. He said to all of us, a big family, and my mother, that grandpa had "some trouble" and that he needed to go to the hospital right away. Only, not just dad went, but mom went hurriedly along also. Grandpa died that few moments between my dad seeing him, and returning home, about 5-10 minutes. Grandpa died of a pulmonary embolism, a clot in the lungs that travelled from his leg, after that small procedure. Certainly a sudden and quick death, a reality that still exists these days.

Deep vein clot (thrombosis) is a relatively common, and a very serious potential disease. We see those patients in the emergency room, immediate care, and certainly worry about many more. The mortality and further injury (morbidity) from clots in the legs is not in the leg! The risk occurs from associated lung clots (pulmonary embolism) and a rare condition of post-clot syndrom (post-thrombotic syndrome).

There is not one specific symptom or sign that clinches the diagnosis. The elderly have rates of DVTs in the 200/100,000 range while younger people have rates of about 50 per 100K. The clots occur in the higher deep veins of the legs, or from extension of clots in the lower legs – even though this risk is lesser. When clots in the lower leg veins extend, the risk of lung clots goes up. The problem with DVTs creating the lung clot (PE) is that symptoms can range from sudden death to minimal at all symptoms.

In a doctor I knew, his clot formed during a long airplane ride and he lived. In my grandpa's case as told by my father, it was sudden death.

Risks for developing DVTs in the leg veins are:

conditions: cancer, pregnancy, blood disorders, kidney disorders, estrogens, and smoking

stagnant movement: surgery, immobility, paralysis, obesity, extended travel

other: previous DVT or PE increases risk, and trauma increases risk.

If patients have any two or more of these, they really become at risk. Symptoms that patients can feel or see are: swelling of the leg compared to the other side, calf swelling, localized tenderness of the calf or leg, new pain or numbness in the leg. There are other causes of these same symptoms, therefore you should see a doctor without hesitation.

Your doctor will most likely go through the above lists with you. But your doctor will be concerned. Lab tests will be drawn most likely and an ultrasound of your leg will be ordered stat. Usually if both of these are negative, the cause is not a clot. If the ultrasound is positive, you will begin treatment. If the blood test is positive and the ultrasound is negative, you will probably have a repeat ultrasound in about a week.

Treatment consists of starting the pill, warfarin, for "thinning the blood." But this takes days for the body to change. Therefore, almost all patients will need to use injections of a heparin substance that "thins" the blood quickly. Usually, patients will need to be on heparin medicine for 5 days or so, or at least until the pill warfarin reaches a therapeutic level in your bloodstream.

Patients will need to use compression stockings during this time and after the event to minimize risk of recurrence of DVT. These stockings also help prevent the post-thrombotic syndrome of pain, swelling, inflammation that can become a chronic condition.

Risk of recurrence never goes away. That is why proper treatment and post-event planning is so important. Expect to be on medicine for 3-12 months after a DVT or PE. Risk reduction knowledge goes a long way.

TALK WITH YOUR DOCTOR ABOUT CONCERNS AND PREVENTION.

DRUG ERROR – COLCHICINE – POSSIBLY LINKED TO FATALITIES

THIS IS IMPORTANT INFORMATION FOR THOSE PERSONS SEEKING MEDICAL AIDES AND MEDICAL CURES. (REFERENCE CITED.)

(generic photos from tufts.edu and generic medicines)

The Herald – Everett, Wash. – www.HeraldNet.com

Published: Saturday, April 28, 2007

Toxic drug at Portland clinic causes three deaths

Associated Press

PORTLAND, Ore. – Three people in the Pacific Northwest have died after receiving a drug that was erroneously made 10 times more potent than intended, the Oregon State Medical Examiner’s Office said Friday.

ApotheCure Inc., a drug-compounding pharmacy company in Texas, said an employee made a weighing error in the creation of the drug colchicine, which lead to the deaths. Colchicine is commonly used to treat gout, but in these cases it was being given intravenously to treat back pain.

The drug was sent to the Center for Integrative Medicine in Portland, where three people received injections of the defective batch of the drug this spring. All three people, two from Portland and one from Yakima, died between the end of March and beginning of April from the toxic levels of the drug.

The defective doses were sent only to the Portland clinic, ApotheCure said.

The Food and Drug Administration said it is investigating the case but believes the problem has been contained.

The Center for Integrative Medicine has since closed, and representatives from the organization could not be reached.

Colchicine works by stopping cells from dividing, which reduces inflammation in conditions such as gout, said Dr. Rob Hendrickson, associate medical director for the Oregon Poison Center. But in excess doses, the drug stops all cells from dividing – eventually leading to organ failure and death.

The medication is not commonly used anymore and the use as a back pain treatment is less common than for gout.

Gary Osborn, a pharmacist and certified clinical nutritionist for ApotheCure, said the situation could have been contained earlier, but the clinic did not contact ApotheCure until nearly two weeks after the first death. He said the second death occurred before the company was able to complete recalling the batch and sending them a new lot. He said this is ApotheCure’s first incident of this sort.

“We are kind of the leaders in the industry,” Osborn said. “But you know what people say, stuff happens.

POISON CENTERS AND TOXINS AND POISONINGS METH to METHANOL to MUSHROOMS – One Call 1-800-222-1222

This is the time of year when lawn chemicals, yard cleanups, and neighborhood events start to be exposed and available to little hands. Certainly many chemicals, including pesticides, herbicides, fuels, and cleaning agents are ubiquitous in homes and garages. But beware. Many of these chemicals are poisonous and dangerous with regard to flammability, explosiveness, and chemical burns.

Each dollar invested in poison centers saves about seven dollars in expenses not needed if the patients go into their doctor, their clinics, or their hospitals. This is a great public health service.

Over the years since the early 60's, the poison centers have become an integral part of the healthcare network. Now with the terrorism issues, the poison centers have become an integral monitoring source of information, as many times calls come to the poison centers early and often, thereby making a grid of what is happening and where it is happening.

For instance, when the bad botulism toxin product that was being used by spas and clinics that were trying to save money by not buying and using the approved botulinum toxin brand, the poison centers were seeing a problem early. Patients across the country, in pockets, were being paralyzed – not just the muscles of the eyebrow, forehead, and other smaller muscles.

The poison centers across the USA now have a single number. Depending on your area code, your call will be forwarded to the center in your area, or the one contracted by your state officials. For instance, Idaho calls go to Denver's poison center. Alaska's poison calls go to Oregon. Washington's poison center gets all of Washington State's calls. This year that number will be around 150,000 calls! Poison calls are answered by an expert group of pharmacists, nurses, Pharm Ds and have backup by physicians specializing in toxicology and poisonings. It is the number that the experts in all fields, from dermatologists to kidney specialists, call when the patient has been poisoned, or is toxic from unknown sources, or when the patient doesn't act or change based upon "normal" disease states.

The goal of Poison Prevention Week is to reduce illnesses, injuries, and deaths due to poisonings; build safer communities; and reduce unnecessary health care costs for everyone.

Here are some ways to be poison cautious:

Obtain syrup of ipecac and keep it in your home – but use it ONLY if instructed to do so by a poison center or physician

Use child-resistant containers and remember, they are not childproof

Keep products in their original containers

Never call medicine candy or take it in the dark

Return products to storage areas immediately after use

Teach children about Mr. Yuk

Put Mr. Yuk stickers on all poisonous products

Call the Poison Center for a free information packet and Mr. Yuk stickers

Keep emergency numbers next to your phone:

1-800-222-1222

What is National Poison Prevention Week?

Public Law 87-319 authorizes the President to designate annually the third week in March as National Poison Prevention Week. This act of Congress was signed into law on September 16, 1961, by President Kennedy, after which the Poison Prevention Week Council was organized to coordinate this annual event. Congress intended this event as a means for local communities to raise awareness of the dangers of unintentional poisonings and to take such preventive measures as the dangers warrant.

(PC week and listing adapted from WAPC.org website with commentary from castMD.com)

IN MEMORIAM – UNCLE EB AND AUNT JOSEPHINE – VISTA CA

God bless the Irish and friends
May the wind be forever at your back
May all the roads lead homeward
May all the paths be downhill
May all your dreams come true
May you find your pot oâ€™ gold
May God bless the Irish and friends

It can be administered orally to mimic the effects of estrogen normally produced by the ovaries. Compare Estrace prices from every licensed pharmacy & save 20 to 85%. Buy Estrace Estradiol-17b (micronized) Estrogen EstraceGet The Facts About EstraceIncredible prices. Deciphers the medication estradiol (Estrace, Climara, Estraderm), a drugOral versions: Estrace, Activella (also contains a progestin), Estradiol acFast Relief From Hot Flashes, Mood Swings & More.com will help answer your questions about bipolar mania and mixed episodes, offer resources and tools to help you understand the illness, and describe how GEODONMastertopforum. Lose 20 lbs in ten days. Buy Geodon WorldMedConnect. Buy cheap Geodon.