Saturday, 26 February 2011

Tai Chi: A gentle approach to Martial Arts

Angele Cano
ENFIELD: Slow fluid movements, gradual rotations, and gentle gestures. This is what you might see a group of dedicated individuals practicing in Enfield on any given Wednesday night.
For the past two years, Phil Blois has been teaching Taoist Tai Chi (TTC) at the Enfield Legion Hall in Enfield, but his own practice began when he was 25. Now, he, along with more than 40,000 people who practice this form of the gentle martial art, tout the health, social, and rehabilitative benefits of the practice—increased flexibility, balance, agility, relaxation and coordination are a few.
“As I get older, instead of losing mobility, strength, and flexibility, I’ve actually found mine have been improving” said Blois. “These are things things people usually associate with aging, but I tend to surprise students in my class with what I can do, as far as strength and flexibility.”
Taiost Tai Chi society was founded in 1970 by Moy Lin-shin, a monk who immigrated to Canada from Hong Kong. The practice now spans 25 countries across the globe practicing ‘the internal art of taijiquan’, a sequence of 108 movements that flow together, and is said to improve health from the inside, from a holistic perspective.
The movements incorporate balance, weight bearing from lifting limbs, rotating, hopping, reaching, and stretching, and while the practice tends to associated with an older crowd, Blois said it benefits all ages. Blois said the age range of people who practice tends to follow the demographic, so in Nova Scotia, the average age of students is higher, although he’s had members attend his class who are as young as 18.
“The benefits of Tai Chi for someone younger come much quicker because there’s less to overcome,” said Blois. “It’s unfortunate that most of us have to be around 40 before we realize we have to change the way we treat our bodies.”
Dr. Mary Lynch, director of the Pain Management Unit at Capital Health Nova Scotia (CDHA) and Dalhousie professor, said the practice can aid in pain management. She referred to a recent study that followed people suffering with fibromyalgia and began to incorporate Tai Chi and the similar practice of Chi Gong. Participants reported improved sleep, energy levels, and decreased pain.
“I think it’s very promising,” said Lynch, “It’s a self practice technique that patients and people living with pain can learn, and then have it with them for the rest of their lives. It’s also less invasive than any other treatments out there. Every drug has side effects. Every treatment has potential adverse consequences. (Tai Chi) does not appear to have any adverse effects.”
The TTC society’s medical advisor claims the practice provides benefits for those suffering from rheumatoid arthritis, osteoarthritis, Parkinson’s disease, and Multiple Sclerosis.
“It’s easy to get started,” said Blois. “It’s not terribly demanding in the beginning and can learn at your own pace as your strength improves, and your balance and coordination improves.”
And those who work desk jobs take note. According to a recent study completed by York University in Toronto, in the journal, WORK: A Journal of Prevention, Assessment and Rehabilitation, Tai Chi can help to alleviate musculoskeletal disorders from the effects of sitting in front of a computer for extended periods.
The study followed 50 female computer users who followed a twice weekly, four month mid-day Tai Chi program. It found that participants achieved improved spinal and back health, reduced the effects of tendinitis and carpal tunnel syndrome, lower resting heart rate and a reduced waist circumference. They also experienced a psychological boost.
Blois said he began practicing because he was looking for something to maintain his health, along with running and cycling, and was more attracted to this non-competitive martial art.
“I really liked doing it,” he said. “I liked the atmosphere of the club, and my overall health improved. I really appreciate the art and what it’s capable of doing and how people improve their health.”
He said he notices similar effects in the students in his class. He recalled a few former students, one, who was able to stand on her own unassisted to cook a meal on her stovetop. Another student had ankylosing spondylitis, a condition that causes fusing of vertebrae in the spine and he experienced increased mobility and a straighter spine. Still another student who was wheel chair bound was walking within a few months of beginning practice.
But for results like this, Blois said the practice takes major commitment, time, determination and dedication.
“It’s not a cure all for disease,” he said, “but a lot of times symptoms are reduced as the body gets healthier, symptoms of diseases are lessened, some people find that they need to take less medication if they’re practicing Tai Chi.”
Blois is a veteran instructor—he’s been at it for 21 years, and he does it all for free. Another thing about the society, they are a no-for-profit organization and registered charity. Registration fees—also paid by instructors—go towards administrative costs, and extending the reach of the practice to places like Enfield. Instructors are also required to attend workshops, paid for out of pocket, to improve their practice and teaching skills.
“This really is putting your money where your mouth is,” said Blois. “It’s not just face value. It’s showing you believe in what you’re doing. The organization has done a lot for me, health wise social activity wise, I learned a lot about the Chinese culture and people from all different walks of life. That’s something I value.”
It’s advised to consult your family physician before starting any exercise program. For more information, visit

MEDA (AB) and Flupirtine

As I predicted and communicated last year, fiscal 2010 was somewhat of an off-year for company growth.   I would rather characterize the year past as a very eventful year.
Meda's pipeline has been further strengthened, and several products have made great headway during the year such as flupirtine (treatment of fibromyalgia).
Meda's focus on growth markets, such as Russia, Turkey, Poland, and Mexico, has also shown excellent results in 2010 with an average increase in sales of more than 20 percent

FDA decision on Xyrem

Xyrem (sodium oxybate), which was recently denied as a fibromyalgia treatment, is on the list because of the risk of death. Xyrem is approved for narcolepsy symptoms and is a Schedule III federally controlled substance.

Saturday, 12 February 2011

Lyrica and anti-convulsants

Feb 08, 2011 – Various anticonvulsants, both branded and off-label are being used for the treatment of many indications such as epilepsy, fibromyalgia, migraine, neuropathic pain, bipolar disorder and anxiety.The patents of leading anticonvulsants such as Topamax (topiramate), Trileptal (oxcarbazepine), Depakote (divalproex sodium), Keppra (levetiracetam), Lamictal (lamotrigine) and Tegretol (carbamazepine) expired in 2007-2008. The wide applicability of the anticonvulsants for management of the various indications has caused the emergence of generics for these anticonvulsants in the market. This generic erosion will cause decline in the anticonvulsant market in the future.
Two anticonvulsants, Fosphenytoin and Stedesa have been filed in the US with FDA and 44% of the total anticonvulsants product pipeline is in Phase III clincal studies. The majority of these molecules are being studied as monotherapies for the treatment of epilepsy.The expected launch of these new anticonvusants in the future is expected to to stabilize the declining anticonvulsant market.

Lyrica (pregabalin) is the branded anriconvulsant product of Pfizer.Lyrica is indicated for the treatment of the epilepsy, fibromyalgia and neuropathic pain. Lyrica along with Neurontin (gabapentin) is the first line of therapy for the treatment of neuropathic pain, especially when tricyclic antidepressants are contraindicated. Lyrica is the only anticonvulsant which has been approved for the treatment of fibromyalgia. Lyrica generated revenue of $2.57 billion and $2.84 billion for Pfizer, in 2008 and 2009 respectively.

GBI Research, the leading business intelligence provider, has released its latest research, “Anticonvulsants Market to 2016 - Cost Advantage and Dosage Convenience Provided by Generic Anticonvulsants Will Limit Commercial Opportunities for Novel Therapies”, which provides insights into global anticonvulsant market and market forecast until 2016.

Report is built using data and information sourced from proprietary databases, primary and secondary research and in-house analysis by GBI Research’s team of industry experts.

The report provides an in-depth analysis of the top five therapeutic indications for which often anticonvulsants are prescribed which includes epilepsy, fibromyalgia, migraine, neuropathic pain and bipolar disorder. The report also examines the Global anticonvulsant treatment usage patterns for the covered indication. In addition, the report also includes insights into the anticonvulsant R&D pipeline.

Saturday, 5 February 2011

ranking of effective pharma websites

With pharma's online marketing growing apace, we're naturally curious about the results. Drug websites can be snazzy, but do they really help pump up sales? Well, a new report from Decision Resources' Manhattan Research division suggests that at least some branded drug sites inspire web surfers to follow up with their doctors.
Without further ado, here's the Manhattan Research ranking of the most successful brand sites and the companies behind them: Levitra (GlaxoSmithKline/Bayer); stop-smoking drug Chantix (Pfizer); ED remedy Cialis (Eli Lilly); heartburn treatment Nexium (AstraZeneca); Yaz (Bayer); fibromyalgia and pain drug Lyrica (Pfizer); birth control product NuvaRing (Merck); asthma treatment Symbicort (AstraZeneca); ED drug Viagra (Pfizer); and sleep inducer Lunesta (Sunovion).

 Levitra, Chantix top ranking of effective pharma websites - FiercePharma

Pfizer profits soar but Lyrica revenue flat

World News | February 01, 2011

Pfizer has reported a major rise in sales and earnings for the fourth quarter, though the results have been overshadowed, at least in the UK, by the news that the drugs giant is to close its R&D facility at Sandwich, with 2,400 jobs affected.
The decision is part of Pfizer’s strategy to "create a more focused and sustainable R&D engine for innovation", the company said, part of which involves exiting certain therapeutic areas, including allergy and respiratory, which is based at Sandwich. Over the next 18-24 months, a majority of the 2,400 positions at the Kent plant will be redundant, but the company hopes to transfer "several hundred positions to other Pfizer sites or to external partners".
Revenues from Lyrica (pregabalin), for epilepsy, fibromyalgia and neuropathic pain were flat at $821 million. As for Wyeth products, the antidepressant Effexor (venlafaxine) contributed $206 million, down 60% as a result of generic competition,

Prescription drug abuse skyrockets in Windsor (Ontario) area

Brian Cross, The Windsor Star February 2, 2011
 The number of people seeking treatment in Windsor for addiction to prescription drugs is more than five times the provincial average and the number for women is even higher, experts in the field say.
Seven hundred and twenty-six of the 1,650 people entering the local detox centre as they went through withdrawal in 2009 listed prescription opioids as one of their primary substances, compared to 527 of the 1,599 entering detox two years earlier.
Alcohol is "not the big one anymore," said CAW Local 444 employee assistance program rep Bruce Malcolm, who sends Chrysler workers for treatment. "Most of them are Oxy-Contin or Percoset."
These are regular folks, most of whom have not had addiction problems in the past. But they get an injury, or surgery, or suffer some sort of chronic pain, and painkillers are prescribed.
"And unfortunately before they know it they start missing time and they start misappropriating the dosages. And before you know it they're buying them elsewhere," Malcolm said.
Drug addiction among women in Windsor has reached "epidemic" levels and the wait for help is at least six months, according to the operator of a women's treatment centre.
"We have an epidemic of women who are hooked on narcotic pain relievers; it's overwhelming us," said Deborah Gatenby, executive director of the House of Sophrosyne, a women's addiction treatment centre.
Provincially, 5.2 per cent of people seeking drug treatment are addicted to prescription opioids. But locally, in the region covered by the local health integration network, 27.8 per cent of people and 39 per cent of women seeking treatment are hooked on prescription opioids, which is eight times the provincial average, Gatenby said.
A U.S. study showed that 85 per cent of women and 79 per cent of men entering treatment for opioid addiction were first exposed to them through a prescription to treat pain.
Pat Keenan, who was the Local 444 EAP rep before retiring two years ago, watched OxyContin use steadily grow. "From occasionally to just about the everyday drug of choice for everybody."
The reason is fairly simple: "You can get scripts, and when you can't get scripts you can buy them off the street."
Percosets sell on the street for $3 or $4 for a five-milligram dose. A 10-milligram dose of OxyContin sells for $5, while 20-milligram doses sell for $8 to $10. Stronger doses of 40 milligrams sell for $12 to $15 and the 80 milligram pills sell for $35.
A recent study showed prescriptions for oxycodone -- the drug in both OxyContin and Percoset -- rose 900 per cent from 1991 to 2010 in Ontario. One of the reasons is there's nothing preventing someone in Ontario from going to many different doctors and getting multiple prescriptions.
Ontario Health Minister Deb Matthews is worried about what's happening. "We have a major problem on our hands in Ontario," she says of the rapidly rising use -- and misuse -- of prescription painkillers.
She's hoping recently passed legislation allowing the government to track the prescribing patterns of patients, doctors and pharmacies will help prevent people from double doctoring, getting inappropriately high dosages or getting refills too frequently. She hopes it will be up and running some time this year.
"For physicians who don't know their patients really well, it will be a really, really useful tool," she said.
"It will allow doctors to know, before they prescribe, whether a patient has had a recent prescription from another physician."
Matthews said she had her eyes open to the rising use of prescription narcotics when she went on a ride-along in her hometown of London with an officer who worked with sex trade workers. "What I learned ... was that virtually all the women working in the sex trade on the street were addicted, and many were addicted to prescription narcotics."
Hotel-Dieu Grace emergency medical director Dr. Gord Vail has been involved in confrontations with patients desperately seeking narcotics.
"Lots of people come in and say 'I've lost my script, it's flushed down the toilet, my landlord took it, I had to move and the movers lost it.' We get every sob story you can think of."
Vail said patients resorting to the already overloaded ERs for painkillers is becoming a bigger problem because of the shortage of family doctors who can adequately monitor patients suffering chronic pain, prescribe refills and make adjustments in dosage and drug that are appropriate. That leaves people to either go to walk-in clinics, most of which refuse to refill narcotics because they don't know the patient, or go to the ERs.
"It puts us in a hard place to make that decision," said Vail, who is also his hospital's chief of staff. "They come in and say they're on OxyContin at some ridiculously high dosage and it's up to us to decide if that's appropriate or should be continued."
And there's no scan or blood test that can tell you a person's back pain is so severe he needs a narcotic painkiller.
"So it's up to us to decide is this person being truthful," Vail said. "Are they in a lot of pain, or is it something they're going to sell on the street two minutes later?"
Doctors are prescribing powerful and addictive drugs like OxyContin to treat chronic pain, a condition that only started being recognized about 15 years ago as a legitimate condition, said Dr. Allan Gordon, director of the Wasser Pain Management Centre at Mount Sinai Hospital in Toronto. Currently, between 20 and 30 per cent of the population has it -- back pain, joint pain, fibromyalgia. And alternative treatments to drugs, such as physical therapy, aren't always easy to access. So doctors turned to opioids like Percoset and OxyContin. "I think opioids can be effective and certainly do work," said Gordon. "But you have to be very cautious with who uses them and what restraints and boundaries you employ."
Every patient needs a risk assessment, a list of questions on such issues as family history of addiction that help a doctor gauge the risk of addiction, he said.
"Not everyone is equal. Ninety per cent of the population, if you give them this medication there's not going to be a problem. But with 10 per cent there's going to be a problem."
Mellissa, a 27-year-old with two kids and a job as a personal support worker, was prescribed Percoset for a herniated disc more than five years ago. When her doctor cut her off, a friend introduced her to OxyContin. "It started off with just one. They're horrible, they're the devil, those things," she said. Within a month she was taking massive quantities -- up to 400 milligrams a day. "I could spend anywhere from $80 to $250 every day," she said, recalling how she'd pawn possessions and borrowed money to pay for drugs. "Now I look back, I don't know how I got the money."
She's thankful she got off Oxy by entering a methadone maintenance program. "It saved my life, because if it wasn't for that I would probably have lost my children, my job and myself."

Friday, 4 February 2011

Fibromyalgia syndrome: Prevalence, pharmacological and non-pharmacological interventions in outpatient health care. An analysis of statutory health insurance data


Fibromyalgia syndrome (FMS) is a chronic pain condition impacting on quality of life, causing physical and psychological impairment resulting in limited participation in professional and social life. The objective of this study was to assess the prevalence, recommended pharmacological and non-pharmacological interventions of FMS, patients’ characteristics and to compare findings to current research.


About 1,6 Mio patients of a German statutory health insurance company (GEK) in 2007 were analyzed for: (a) the prevalence of FMS (ICD-10: M79.7); (b) and comorbid depression (ICD- 10: F32/33); (c) the recommended pharmacological and non-pharmacological intervention rates; (d) and characteristics of patients associated with being prescribed recommended interventions.


The (a) standardized prevalence of FMS in 2007 was 0.05% in men and 0.4% in women. (b) 51.9% of the patients with prevalent FMS had a comorbid depression in 2007 (88.2% female). (c) 66% of FMS patients received the recommended pharmacological treatment, 59% physical therapy, 6.1% cognitive-behavioural therapy and 3.4% a combination of these (multi-component therapy, MCT). (d) One year increase in age was associated with a 3% decrease in the predicted odds of receiving MCT (95%, CI 0.95–0.99).


The current data indicate an FMS-prevalence that differs from epidemiological surveys and screenings, probably due to methodological differences. Especially females with comorbid depression are affected. The likelihood of receiving MCT is not associated with gender, but with younger age. Yet, the findings seem to indicate insufficient and inadequate treatment, but FMS warrants more research.