Health care conglomerate Johnson & Johnson reported that its Q4 2008 revenues declined 4.9% to $15.2 billion, and braced investors to expect that 2009 will bring the first revenue drop for the company since 1933.

“Consumers and patients are becoming more frugal,” William Weldon told analysts last week. J&J’s Chief Executive added “there is downward [economic] pressure in lots of areas of health care.”

Until things went so wrong for everyone during Q4, J&J’s diversified product portfolio had served it rather nicely compared with competing organizations that concentrated on pharmaceuticals such as Merck and Pfizer.

In Q3, the company told investors the weakening economy was impacting only women’s health products and sports-medicine product lines, but this time around it expanded the list to include vision care products, diabetes monitors and other products that are often paid for out of pocket.

J&J’s pharmaceuticals unit fared poorly in Q4. There, revenues dropped 11% to $5.7 billion. J&J’s best-seller, the atypical antipsychotic Risperdal, lost patent protection in 2008 precipitating a 67% drop in Q4 revenues to $285 million.

Remicade, the company’s anti-inflammatory drug had sales of $886 million, off 2.4% from the previous year due to competition from Amgen’s Enbrel and Abbott’s Humira.

J&J did manage to post a 14% rise in Q4 profit, as expense reductions and one-time gains offset the revenue shortfall.

The weak stock market might tempt J&J to explore acquisitions in 2009, according to Weldon. “This economic environment creates opportunities we may never see again, so we need to be in a position to go after them,” he told the Wall Street Journal.

Mr. Weldon suggested that health IT and wellness companies were “fertile areas” for J&J.

In January, Russian cyber-militia knocked Kyrgyzstan off the grid for a week using a denial-of-service attack similar to the ones it leveled against Georgia and Estonia last year.

The attack targeted Kyrgyzstan’s 2 largest ISPs which provide over 80% of the nation’s bandwidth, according to Don Jackson SecureWork’s director of threat intelligence.

The cyber-attack overwhelmed key government Web sites and rendered emailing impossible, among other things.

At the time, neither Russian nor US officials would comment on the matter and Kyrgyz officials, ahem, couldn’t be reached for comment.

People wondered why would Russia cyber-bully an impoverished nation of 5.3 million that doesn’t mouth off to Vlad the Impaler or have a gas pipeline coursing through it, but now we have the answer.

Last week Kyrgyz President Kurmanbek Bakiyev announced he’s decided to shutter the US’ last remaining air base in Central Asia, just as the Big O was getting set to fire up the base in support of his plans to deploy 30,000 more troops to Afghanistan.

With Russian President Dmitry Medvedev glowering at his side, Bakiyev claimed the Americans were unwilling to pay more money for the use of Manas Air Base, and that locals were chafing at the military presence, established in 2001 to support the US-led invasion of Afghanistan.

“We have repeatedly raised with the United States the matter of economic compensation for the existence of the base in Kyrgyzstan, but we have not been understood,” he said.

Medvedev didn’t just call off the cyber-dogs though. Nice guy that he is, he agreed to loan the former Soviet Republic $2 billion, cough up $150 million in direct financial aid and write off $180 million in debt, according to the Washington Post.

The US pays Kyrgyzstan $150 million each year, 40% of which amounts to rent for the base.

Last fall, the Milbank Memorial Fund authored a white paper on the status of maternity care in the US.

The report concluded that excessive reliance on high tech gadgetry, monitoring and testing made our country by far the most expensive place on Earth to have a baby, yet we graded out average among developed nations when it came to neonatal and maternal mortality.

Last week NIH investigators reported in Obstetrics & Gynecology that if anything, things are getting worse.
 
Elena Kuklina and colleagues of the National Institute of Child Health and Human Development performed a cross-sectional study of 32 million discharge records from the Nationwide Inpatient Sample of the Healthcare Cost and Utilization Project.

They found that the rate of severe delivery-related complications increased 26% between 1998-1999 and 2004-2005; from 64% per 1,000 deliveries to 0.81%.

Meanwhile, Caesarean deliveries as a fraction of all deliveries rose during the period from 21.2% to 31.1%.

Roughly 2,760 women died from delivery-related complications during the study period, while 227,333 experienced one or more severe complications.

“During the study period, there was a greater than 20% increase in rates of renal failure, respiratory distress syndrome, shock, and ventilation, a 52% increase in rates of pulmonary embolism, and a 92% increase in rates of blood transfusion,” wrote the authors.

The findings could not be explained by differences in maternal age, multiple births (including Octomoms), pre-existing conditions or insurance status.

Increased utilization of C-sections “seemed to explain the observed change over time for renal failure, respiratory distress syndrome, and ventilation,” they wrote.

But that explained only half the rise in blood transfusions, shock and pulmonary embolism, according to the authors. As for the rest of it, who knows?