Saturday, January 19, 2008

Weekly Wellness

New Hearts: When hearing a CNN story about scientists who were able to generate heart growth from the cells of rats, I couldn’t help but wonder. Are these the same rats (or their descendents) that have been coated with cigarette tar and dosed with sweet n low? [just kidding!]

Sirtris:
A few weeks back I noted this company which is working to create a chemical form of resveratrol that might promote health in people who take it. I noted the company for its error in calling an illness a disease of “aging”. Recently the company released preliminary results of a small human trial where blood sugar levels were improved. The study is taking place in India, however, I do not know the ethnicity of the population in the study (sometimes it matters and it matters in order to make generalization outside of the study group). None the less, the point I wanted to share from the K. Winstein WSJ article was this quote from a cofounder of the company, “we chose diabetes because it’s a big market.” Sad but true.

Garlique:
Time for another commercial introspection. A man says that his doctor has told him he has high cholesterol so he watches what he eats, exercises and takes Garlique. Garlique, he says, contains an ingredient that has been found to lower cholesterol levels. Here is what he does NOT say, “My doctor told me to take Garlique or that this particular product, Garlique, has been found to lower cholesterol.” Remember savvy readers, at this point the law that addresses herbals and supplements does NOT include that they are tested for purity, effect or ingredient quantity. Many times they also contain additives that may be harmful. Tell your doctor about ANY meds, pills, tinctures or liquid supplements you take.

Vytorin: Anyone who reads this blog on a regular basis would expect I was going to blast this report. It happens to come in the same week that a NEJM study reported that the popular antidepressants so many people take may or may not be more effective than placebo. Both incidents regard drug companies not publishing all of their study results, or skewing their study results. With Vytorin the company took two cholesterol meds and combined them. They re branded them and raised the price. It was alleged that people who took the new drug would have less plaque buildup and less adverse events, but the research does not support that at all. It is not so much that this medicine is harmful, but that it is no more helpful than cheaper meds. With regards to antidepressant sales at 21 billion a year, must ask, “WHY are so many people depressed?” The study calls into question whether or not the meds are effective, but I want some accountability regarding the criteria of use in the first place. These drugs have perhaps the highest rate of side effects of any medication and viewing a commercial for Cymbalta while having a bad day does NOT make one clinically depressed.

Avoidable Days: For the hospital business, any extra time a person spends there can be costly in a number of ways. Insurance companies tend to pay a lump fee per condition whether it takes five or ten days to treat it, as they have a predetermined idea of how long it SHOULD take. Prolonged days in the hospital also increase the risk of illness not wellness and when hospital acquired illness does occur, treating it is considered to have been avoidable. It should not have happened. Some examples include bladder and blood infections, falls and bed sores. After Medicare declared that it would not pay to treat avoidable illnesses other big insurance companies began following suit. This can be good, i.e. less use of catheters, less time in bed, more hand washing, increased communication amongst staff. The fall issue concerns me the most. One way hospitals address fall risk is to stop the patient from moving around especially an older person. Hospitals usually have a protocol in place to prevent clots, also an avoidable incident. They administer drugs. ($$$$) Another way is to keep the person ambulating. I definitely argue for the ambulation which will require more staff. And there were days when I did hospital work that the only people what wanted to leave the hospital sooner than later were the NURSES! [no one blames them either!]

Kudos: Combining a few themes here. A hospital has changed its policy so that no drug company gift, promo, pens, notepads, coffee cups, etc etc are allowed and to initiate the policy, administration had ALL such products rounded up and removed. That is one awesome move from SMDC Health System, which has four hospitals and multiple clinics. They came up with nearly 19,000 items and are sending them to another country where the drugs advertised on the materials are not available to prescribe. Interestingly, one of the drugs promoted in that HUGE roundup, Vytorin!

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