ppp 07-07-08

Quote of the day: All sanity depends on this: that it should be a delight

to feel heat strike the skin, a delight to stand upright,

knowing the bones are moving easily under the flesh.

Doris Lessing

Which is easier… sitting on the couch in front of the TV with a big snack or taking a walk? The answer: It depends upon your timeframe. Today it probably is the video option. In 20 years movements such as walking, getting out of bed, and the other activities of daily living will be easier if you keep those muscles moving. The term “disuse atrophy” is used to describe the loss of muscle from lack of exercise. Strength training programs in nursing homes have shown dramatic health improvements. Working the quadricept muscles helps lift the legs and comes in pretty handy in walking. Quad training works in a preventative manner http://seniorliving.about.com/od/basicexerciseseries/ss/kneeexercise.htm . Quads help stabilize the kneecaps and keep the leg bones in line. (prevention costs less in terms of pain and financial cost).

Moving not only strengthens the muscles but prevents pooling of blood that can lead to blood clots, heart attacks, and strokes. Hospital patients on bedrest should receive some form of prophylactic treatment to prevent clots. If drugs, such as heparin, are not advisable then pneumatic boots are often used to keep the blood pumping.

“Energy drinks” may be another short-term/long-term choice. They may give the user a burst of energy from sugar, caffeine, and other stimulants but people with poor blood glucose regulation (such as diabetics or “pre-diabetics”) may have unpleasant effects while others may experience a late day “crash”. Coffee may be a better alternative for the caffeine starved.

Keeping the weight off, maintaining muscle strength, and the obvious avoidance of tobacco, drugs, poor driving habits (you do wear your seat belts don’t you) and excessive alcohol may not guarantee longevity but could make advanced years more pleasant should you make it that far.

ps. Best answer this week to the question "How are you?" was "Peachy" (a physician wearing a peach colored shirt and tie... funny by my standards)

pps. Occasionally, some of the links require FREE registration.... I'm sure you can handle THAT slight inconvenience.

SureScripts and RxHub to merge. Looks like there will be ONE place to go for pre-adjudication of prescriptions and saved prescription records. This is the key to electronic prescribing… The Commerce Department will probably not step in and mess things up because only 2% of all prescriptions are presently e-prescribed and the Fed REALLY wants e-prescribing.

Lodamin prevented tumors in mice injected with cancer cells while the controls faired poorly. The drug was discovered when fungi invaded another laboratory experiment. The drug when given orally prevented angiogenesis or the vascularization of tumors. The theory is that tumors can’t grow out of control if they can’t increase their blood supply. This one may be a long way off but it sure looks good from even this distance.

Physicians will now have to pony up money (or go to sessions funded by other drug makers).

FDA panel has recommended more cardiovascular testing for all new anti-diabetic drugs. While this may enhance safety down the road it will delay new drug approval or prevent some from being pursued due to added research costs (unless, of course, the generic companies want to contribute to the research… FAT CHANCE)

Teva has 6 months of exclusivity on the generic form of the antipsychotic drug so don’t expect huge saving until others enter the fray… then things will get crazy.

Experimental oral anticoagulant beats subcutaneous enoxaparin for orthopedic surgery. Outcomes and side effect profile were better. Sounds like rivarobaxin (Xarelto) will have the added benefit of being an oral drug. The tricky part will be in convincing patients of the importance of taking the oral drug. No news when the FDA will get a chance to review the drug for approval.

The department of Defense has once again selected Express Scripts to serve their 9.1 million lives. High rating on service for the service men and women as well as driving outlay to the lowest net cost appear to have been the keys. Now if ESI could only take over the rest of the Federal government.

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