Family Practice News back issues from March 2000:
Doctors Use MBAs To Reshape Careers.
Mar 01, 2000; ... For most physicians, the idea of returning to school for an MBA may look like a lot of work and a lot of stress for an uncertain gain. But getting an MBA was a winning move for Dr. Leonard Wilkerson, a family physician who earned the degree in 1998 from the University of South ...
Mammography Enters Era of Digital Imaging.
Mar 01, 2000; ... Practical advantages not yet translated into superior detection of breast cancer. The Food and Drug Administration's approval of a digital mammography device in January is considered by experts to be the first step in harnessing digital technology to help find breast cancers at ...
New Antiarrhythmics Put Atrial Fibrillation on Hold.(dofetilide and azimilide)
Mar 01, 2000; ... Dofetilide, azimilide promise greater safety. SNOWMASS, COLO. -- New antiarrhythmic drugs offer a reasonably good chance of keeping patients with atrial fibrillation in sinus rhythm long-term, Dr. Roger A. Winkle said at a conference sponsored by the American College of ...
Virus Found in Association With Lou Gehrig's Disease.
Mar 01, 2000; ... Evidence of a virus in the spinal cords of victims of amyotrophic lateral sclerosis revives the possibility that this rare, devastating, and incurable neurological disorder is caused by an infectious agent. If this hypothesis is ultimately confirmed, amyotrophic lateral ...
BOTTOM LINE.(hepatitis A vaccine for gay men)
Mar 01, 2000; ... Hepatitis A Vaccine for Gay Men Providing hepatitis A vaccinations for homosexual men at age 20 saves society $10.72 in lifetime economic costs for every $1 spent, R. Jack Jacobs and Allen S. Meyerhoff estimated. Savings in treatment costs alone would offset 54% of ...
Breast CA Risk Rises Slightly Among HRT Users.(hormone replacement therapy)
Mar 01, 2000; ... Publication of a study indicating that long-term estrogen-progestin replacement therapy increases the risk of breast cancer in postmenopausal women has stirred up the long-standing controversy on breast cancer and HRT use. The study, which included 46,355 postmenopausal women, ...
HRT Reduces Sensitivity of Mammograms.(hormone replacement therapy)
Mar 01, 2000; ... Screening mammography is less sensitive among women who use hormone replacement therapy than among those who don't. In fact, 20% more cancers would be detected among HRT users if the sensitivity were equal to that in nonusers, according to Anne M. Kavanagh, Ph.D., and her ...
Adjuvant Chemo Benefits Even Small Breast Ca.
Mar 01, 2000; ... SAN ANTONIO -- Long-term outcome of even the smallest breast cancers is enhanced by postoperative chemotherapy, Dr. Elizabeth Tan-Chiu reported at a breast cancer symposium sponsored by the San Antonio Cancer Institute, And in patients with small estrogen receptor-positive ...
Simple Office Visits Help Mild Depression in Elderly.(Brief Article)(Statistical Data Included)
Mar 01, 2000; ... SAN FRANCISCO -- Six office visits over the course of 3 months plus a placebo can be just as effective as paroxetine or short-term behavioral therapy for treating mild depression in elderly patients. A randomized trial of more than 400 patients also shows that paroxetine works a ...
Nation's Health Agenda for Decade Announced.(Brief Article)(Statistical Data Included)
Mar 01, 2000; ... Federal officials have picked the priorities and set the benchmarks that will guide efforts to monitor and improve the nation's health over the next 10 years. Goals related to obesity, substance abuse, sexual behavior, mental health, immunization, and access to care are part of ...
Health and the Presidency.(Brief Article)(Statistical Data Included)
Mar 01, 2000; ... Once again, the health status and medical records of presidential candidates are in the national spotlight. Controversy over Sen. John McCain's release of his medical records has now been upstaged by Bill Bradley's paroxysmal atrial fibrillation. Mr. Bradley, a seemingly healthy ...
PRO & CON.(Brief Article)(Statistical Data Included)
Mar 01, 2000 ... Is low-dose aspirin an effective treatment for certain women at high risk for preeclampsia? Dr. Kent Heyborne is director of maternal-fetal medicine at Swedish Medical Center in Englewood, Colo. YES Low-dose aspirin may not work in women with chronic renal ...
LETTERS.(Brief Article)(Statistical Data Included)
Mar 01, 2000 ... Ovary Removal Unethical I was shocked to read the article concerning ovarian tissue transplant ("Ovarian Tissue Transplant Has Limited Applications," Nov. 15, 1999, p. 33). In the article, Dr. Kutluk Oktay described a 29-year-old woman who had one ovary removed in ...
Hoof beats.(Brief Article)(Statistical Data Included)
Mar 01, 2000; ... The purpura appeared the next morning. A cardinal sign of a feared disease was developing before our eyes under the bright lights of the ICU. Mary had been brought to the ER by her husband 2 days before Christmas. She had been suffering from flulike symptoms that morning, and the onset of ...
External Counterpulsation Cuts Stable Angina Pain.(Brief Article)(Statistical Data Included)
Mar 01, 2000; ... SNOWMASS, COLO. -- Enhanced external counterpulsation is not frontline therapy, but it does appear to be a highly useful outpatient procedure for relief of chronic stable angina pain, Dr. C. Richard Conti said at a conference sponsored by the American College of Cardiology. ...
Percutaneous Myocardial Revascularization.
Mar 01, 2000; ... SNOWMASS, COLO. -- Percutaneous laser myocardial revascularization is likely to become a common outpatient cardiology procedure later this year, Dr. Stephen N. Oesterle forecast at a conference sponsored by the American College of Cardiology. He predicted that the Food and Drug ...
Transmyocardial Revascularization in Refractory Angina.
Mar 01, 2000; ... Patients with refractory angina who underwent transmyocardial laser revascularization had markedly better rates of pain relief, fewer cardiac events, fewer cardiac-related hospitalizations, better exercise tolerance, and higher quality-of-life scores 1 year after surgery than did control ...
Redefining 'Normal' HDL Cholesterol Levels.
Mar 01, 2000; ... SNOWMASS, COLO. -- Get ready for 'the decade of HDL' in preventive cardiology, Dr. Robert A. Vogel predicted at a conference sponsored by the American College of Cardiology. Cholesterol lowering in recent years has focused upon LDL cholesterol level reduction, making HDL ...
Depression Raises the Risk of Cardiac Mortality.
Mar 01, 2000; ... SAN FRANCISCO -- Depression increases the risk of cardiac mortality, not only in outpatients with established heart disease, but also in older people without baseline cardiac disease, Dutch researchers have found. In fact, older community-dwelling individuals without established ...
Hypnosis Reduced Surgical Cost, Time, and Anxiety.
Mar 01, 2000; ... CHICAGO -- A simple form at hypnosis reduced the average nonemergency procedure time by 17 minutes and the average cost by $130 in a Harvard Medical School study of 161 patients undergoing angiography, angioplasty, and kidney drainage. Patients were more likely to be ...
Flu Season Marked by High Mortality, Early Onset.(Brief Article)(Statistical Data Included)
Mar 01, 2000; ... BETHESDA, MD. -- Did this year's influenza vaccine fail? Even though the vaccine was well matched to the virus strains that were detected, unusually high mortality and an early onset marked the 1999-2000 flu season. Explanations abound for the high mortality, ...
Dot Blot Immunoassay Identifies True Lyme Infection.(Brief Article)(Statistical Data Included)
Mar 01, 2000; ... BOSTON -- What do you do when that patient who's been vaccinated against Lyme disease walks into your office with symptoms of the disease and is seropositive? Seropositivity on conventional enzyme-linked immunosorbent assays (ELISA), and even some Western blot assays, may be a ...
Widespread Antibiotic Shortage Unexplained.(Brief Article)(Statistical Data Included)
Mar 01, 2000; ... Explanations ranging from "just in time" shipping to Y2K hoarding to generic drug recalls are being floated as possible reasons for the antibiotic shortages being reported by infectious disease specialists nationwide. In a survey, nearly 90% of 481 respondents, all of them ...
Low-Dose Steroids Slow Early Rheumatoid Arthritis.(Brief Article)(Statistical Data Included)
Mar 01, 2000; ... BOSTON -- In patients with early rheumatoid arthritis, first consider tried-and-true oral glucocorticoids, which at low doses appear to slow the progression of joint damage, experts advised at the annual meeting of the American College of Rheumatology. In the first of several ...
Personal History, Radiography Predict RA Course.(Brief Article)(Statistical Data Included)
Mar 01, 2000; ... BOSTON -- Personal history and radiograph results carry far more prognostic weight than family history in the prognosis of patients with rheumatoid arthritis, Dr. Timothy Radstake said at the annual meeting of the American College of Rheumatology. Dr. Radstake and his colleagues ...
Medical Therapy Avoids New Stones.(Brief Article)(Statistical Data Included)
Mar 01, 2000; ... WASHINGTON -- "Selective" medical therapy can prevent the formation of new stones in a high proportion of patients with nephrolithiasis, Dr. Glenn M. Preminger said at an update on urolithiasis sponsored by the American Urological Association. Selective medical therapy has been ...
Patients Advised to Moderate, Not Restrict, Calcium Intake.
Mar 01, 2000 ... Patients with hypercalciuria are now counseled to moderate, but not restrict, their dietary calcium intake to reduce their risk of recurrent kidney stones, Dr. Glenn M. Preminger said. These patients also should limit their intake of dietary sodium, a significant risk factor for ...
Don't Forget About Insulin for Type 2 Diabetes.
Mar 01, 2000; ... BOSTON -- When treating patients with type 2 diabetes, don't forget insulin. Although a second-line drug for patients with type 2 diabetes that should generally be used only when oral drugs fail, "insulin remains the most effective drug to treat type 2 diabetes," Dr. David M ....
Diabetics Benefit From Rehab After Amputation, Too.
Mar 01, 2000; ... WASHINGTON -- Among patients who undergo lower extremity amputation, those with diabetes benefit from intensive rehabilitation just as much as do nondiabetic patients, Dr. David L. Ripley said at the annual meeting of the American Academy of Physical Medicine and Rehabilitation. ...
Low-Dose Nicotinic Acid for Type 2 Diabetics.
Mar 01, 2000; ... SNOWMASS, COLO -- Low-dose nicotinic acid can safely be used to improve the lipid profile of type 2 diabetic patients, Dr. H. Robert Superko asserted at a conference sponsored by the American College of Cardiology. Many physicians have steered clear of this agent in type 2 ...
Chronic Abdominal Compartment Syndrome.(Brief Article)(Statistical Data Included)
Mar 01, 2000; ... SAN FRANCISCO -- Chronic abdominal compartment syndrome may account for many of the comorbidities that resolve after weight loss in the extremely obese, according to the results of a small study. Obesity hypoventilation syndrome, urinary stress incontinence, venous stasis ...
Many Obese Would Risk Death To Lose Weight.(Brief Article)(Statistical Data Included)
Mar 01, 2000; ... SAN FRANCISCO -- Many obese people are willing to accept extreme risks, including the risk of death, to lose weight, according to the results of a small study. A survey of 72 obese patients at Washington University, St. Louis, showed that on average, patients would accept a 6% ...
Support Vital Before and After Weight Loss Surgery.(Brief Article)(Statistical Data Included)
Mar 01, 2000; ... PHOENIX ARIZ. -- After surgery for morbid obesity, patients require adjunctive support to have continued successful weight loss, Dr. Lee M. Kaplan said at the annual meeting of the American College of Gastroenterology. Dr. Kaplan, director of the weight center at Massachusetts ...
High BMI After Coronary Event Predicts a Shorter Life Span.(Brief Article)(Statistical Data Included)
Mar 01, 2000; ... ATLANTA -- Obese individuals who develop an acute coronary syndrome do so at a younger age and have a briefer life expectancy than do leaner patients with heart disease, according to Eric L. Eisenstein, D.B.A. Obese individuals also spend more years living with significant ...
Side Effects Limit Effectiveness Of Drug Treatment of Obesity.(Brief Article)(Statistical Data Included)
Mar 01, 2000; ... SEATTLE -- Side effects continue to limit pharmacologic treatments for obesity, Dr. Jonathan Purnell said at a meeting on drug therapy sponsored by the University of Washington. Dr. Purnell, director of the weight regulation disorders clinic at Harborview Medical Center in ...
Adenosine Limits Infarct Size.(Brief Article)(Statistical Data Included)
Mar 01, 2000 ... Adding adenosine to thrombolytic therapy reduced the size of anterior myocardial infarctions by 67%, compared with placebo, said Dr. Kenneth Mahaffey of Duke Clinical Research Institute, Durham, N.C., and his associates. They studied 236 patients in a prospective study of the ...
Sudden Death, Mitral Valves.(Brief Article)(Statistical Data Included)
Mar 01, 2000 ... The incidence of sudden death is surprisingly high in patients with mitral regurgitation due to flail leaflet, even in those with no symptoms, sinus rhythm, and normal left ventricular function, reported Dr. Francesco Grigioni and his associates at the Mayo Clinic, Rochester, Minn. ...
Stents Avoid Repeat Surgery.(Brief Article)(Statistical Data Included)
Mar 01, 2000 ... The need for repeat revascularization 1 year after percutaneous coronary intervention dropped 28% in one population after the advent of coronary stenting, according to researchers who reviewed the records of all such procedures in British Columbia between 1994 and 1997. Analysis ...
Treating CNS Infections.(central nervous system)
Mar 01, 2000 ... Outpatient parenteral antimicrobial therapy can be used to treat selected patients with central nervous system infections, said Dr. Alan D. Tice and his colleagues in Tacoma, Wash. All 68 patients with CNS infections--including meningitis and brain abscesses--were cured with a ...
No Blood Cultures in Cellulitis.
Mar 01, 2000 ... Blood cultures are not cost effective in managing cellulitis, said Dr. Bezalel Perl and associates at Hadassah-Hebrew University, Jerusalem. In a chart review of 757 adults admitted for cellulitis, 553 underwent routine blood cultures. A patient-specific microbial isolate was ...
Bicillin Confusion.(Brief Article)(Statistical Data Included)
Mar 01, 2000 ... Patients with syphilis may be inadvertently treated with Bicillin C-R more often than providers realize, according to the Centers for Disease Control. The Maryland Department of Health investigated a clinic in which 63 patients might have received Bicillin C-R, a low-dose ...
Tender Is the Liver.(Brief Article)(Statistical Data Included)
Mar 01, 2000 ... A hepatic hematoma developed in an otherwise healthy woman following the increasingly popular practice of therapeutic body massage, said Dr. James F. Trotter of the University of Colorado, Denver. The 39-year-old patient developed abdominal discomfort, right shoulder pain, and ...
Nonulcer Dyspepsia.(Brief Article)(Statistical Data Included)
Mar 01, 2000 ... The symptoms of nonulcer dyspepsia do not abate with treatment of a concurrent Helicobacter pylori infection, reported Dr. Nicholas J. Talley of the University of Sydney Nepean Hospital in Penrith, Australia, and his associates. About 30% of patients with nonulcer dyspepsia have ...
Panel Conditionally Backs Fetal Pulse Oximeter.(Brief Article)(Statistical Data Included)
Mar 01, 2000; ... GAITHERSBURG, MD. - A fetal pulse oximeter that measures fetal oxygen saturation during labor was recommended for approval "with conditions" by a Food and Drug Administration advisory panel. In a 10-1 vote, the FDA's ob.gyn. devices panel recommended that the agency approve the ...
Computer More Accurate Than Humans at Fetal Monitoring.(Brief Article)(Statistical Data Included)
Mar 01, 2000; ... ST. PETERSBURG, FLA. -- Practice will never make perfect when it comes to clinicians reading fetal heart rate tracings, according to Dr. Lawrence Devoe. Even when following the latest guidelines on fetal heart monitoring, physicians and other observers have not improved the ...
Physicians Too Aggressive on ASCUS Follow-Up.(Brief Article)(Statistical Data Included)
Mar 01, 2000; ... SAN FRANCISCO -- Physicians are too quick to order repeat Pap smears when an initial Pap test comes back with a reading of atypical squamous cells of undetermined significance, results of two studies suggest. Guidelines issued by the National Cancer Institute in 1994 recommend ...
New Pap Methods Not Yet Supplanting Standard Smears.(Brief Article)(Statistical Data Included)
Mar 01, 2000; ... WAIKOLOA VILLAGE, HAWAII -- New Pap smear methods are unlikely to supersede the conventional Pap smear for widespread cervical cancer screening any time soon, Dr. Stephen C. Rubin said at a conference on obstetrics, gynecology, perinatal medicine, neonatology, and the law. The ...
Soy Phytoestrogens Linked to Lipid Improvements.(Brief Article)(Statistical Data Included)
Mar 01, 2000; ... ATLANTA - High blood levels of the soy phytoestrogen daidzen are associated with favorable lipid levels in women with suspected myocardial ischemia, Dr. C. Noel Bairey Merz reported at the annual scientific sessions of the American Heart Association. These effects appear to be ...
Adding Androgen To Estrogen Helps Strengthen Bone.(Brief Article)(Statistical Data Included)
Mar 01, 2000; ... Low-dose estrogen-androgen therapy is safe and more effective than estrogen alone in building bone mineral density among surgically menopausal women, said Dr. Elizabeth Barrett-Connor of the University of California, San Diego, and her associates. In a study involving 311 ...
Trichomonas Detection.
Mar 01, 2000 ... Examining a spun urine specimen in addition to a vaginal fluid specimen improves detection of Trichomonas vaginalis infection by 12% in young women, said Dr. Diane R. Blake of the department of pediatrics, University of Massachusetts Medical Center, Worcester, and her associates. ...
Copper IUDs and Menses.(Brief Article)(Statistical Data Included)
Mar 01, 2000 ... Insertion of copper IUDs can restore regular menses in women who have developed secondary amenorrhea, reported Dr. Fortunato Vesce and associates at the University of Ferrara (Italy). In an observational study, regular menses resumed in 40 out of 48 women with secondary ...
Oil Change for PMS.(Brief Article)(Statistical Data Included)
Mar 01, 2000 ... Evening primrose oil seems to reduce some symptoms of premenstrual syndrome, especially cyclical mastalgia, Dr. Ellen Hughes said at a meeting in San Francisco on women's health sponsored by the University of California, San Francisco. Study data on the oil's performance have ...
Anemic Fetuses.(Brief Article)(Statistical Data Included)
Mar 01, 2000 ... Doppler ultrasonography accurately and noninvasively identifies fetuses at risk for severe anemia due to maternal red-cell alloimmunization, said Dr. Giancarlo Mari of Yale University, New Haven, and other members of the Collaborative Group for Doppler Assessment of the Blood Velocity in ...
Nipple Aspirate Fluid May Screen for Breast Cancer.(Brief Article)(Statistical Data Included)
Mar 01, 2000; ... SAN ANTONIO - Recent refinements in nipple aspirate fluid collection may finally render this a useful screening technique for breast cancer. The advantages of using nipple fluid aspiration as a screening tool for early detection of breast cancer are that it's safe, simple to ...
HRT Does More Good Than Harm in Breast Ca Survivors.(Brief Article)(Statistical Data Included)
Mar 01, 2000; ... SAN ANTONIO -- Hormone replacement therapy in long-term breast cancer survivors is likely to have a net overall mortality benefit in addition to substantially improving the quality of life, Dr. Joseph Ragaz said at a breast cancer symposium sponsored by the San Antonio Cancer Institute. ...
Breast Cancer Survivors Often Turn to Alternative Therapies.(Brief Article)(Statistical Data Included)
Mar 01, 2000; ... SAN DIEGO - Breast cancer survivors have reactive as well as proactive reasons for using complementary and alternative medicine, Heather Boon, Ph.D., reported at the annual meeting of the North American Primary Care Research Group. "Women are using these therapies either because ...
Meaning Behind Cafe-au-Lait Macules.(Brief Article)(Statistical Data Included)
Mar 01, 2000; ... MONTEREY, CALIF. -- Cafe-au-lait macules can be the tip-off to a diagnosis of neurofibromatosis in a young child but only if the patient has more than five macules that are greater than 5 mm in diameter, Dr. Sheila Fallon Friedlander noted at the annual meeting of the Pacific Dermatologic ...
Atopic Dermatitis Often Ends in Childhood.(Brief Article)(Statistical Data Included)
Mar 01, 2000; ... BOSTON -- Atopic dermatitis is a common skin condition that usually begins and often resolves in childhood. About 60% of cases start by 1 year of age, and 90% begin before a child turns 5, Dr. Candace S. Lapidus said at a conference on clinical issues in primary care sponsored ...
Herpes Gladitorium Spread by Direct Contact.(Brief Article)(Statistical Data Included)
Mar 01, 2000; ... Of four confirmed outbreaks of herpes simplex virus type 1 infections in wrestlers in a five-county region in Washington state, three involved different strains of the virus. Finding three unrelated outbreaks points to the increased risk of herpes gladitorium in wrestlers and ...
Gingivostomatitis In Children With HSV Type 1.(Brief Article)(Statistical Data Included)
Mar 01, 2000; ... Gingivostomatitis occurs in up to 30% of children with herpes simplex virus type 1 and can cause extreme discomfort. To help physicians recognize the condition earlier and prevent complications like dehydration and bacteremia, Dr. J. Amir of C. Schneider Children's Medical ...
Parents Need Information About Febrile Seizures.(Brief Article)(Statistical Data Included)
Mar 01, 2000; ... BALTIMORE -- Parents of children with febrile seizures are not given enough information about them, Dr. Eileen P.G. Vining said at a pediatric meeting sponsored by Johns Hopkins University "It worries and bothers me that parents are still frightened a month or two after the ...
Midazolam Superior to Lorazepam for Status Epilepticus.(Brief Article)(Statistical Data Included)
Mar 01, 2000; ... ORLANDO, FLA. -- Intravenous midazolam was more effective than intravenous lorazepam for initial management of status epilepticus in pediatric patients in a prospective, randomized study comparing the two benzodiazepines. There are scant data comparing the ability of ...
Benzodiazepine May Prevent Recurrent Febrile Seizures.(Brief Article)(Statistical Data Included)
Mar 01, 2000; ... LAS VEGAS -- Benzodiazepine therapy to prevent recurrent febrile seizures is worth seriously considering in selected patients, Dr. O. Carter Snead III said at a pediatric update sponsored by California chapters 1, 2, 3, and 4 of the American Academy of Pediatrics. The goal is ...
Pertussis Rings Up to $145,903 for 87 Cases Treated.(Brief Article)(Statistical Data Included)
Mar 01, 2000; ... PHILADELPHIA -- Pertussis is expensive: 87 cases in one New York county had a total price tag of $145,903. A number of factors were evaluated, including medical costs, additional child care, household prophylaxis, lost workdays, and lost work productivity due to pertussis, Dr ....
Vaccinations Often Incorrectly Timed by Doctors.(Brief Article)(Statistical Data Included)
Mar 01, 2000; ... Taking into account the timing of immunizations can have a substantial impact on vaccine coverage rates, a study of Medicaid children has found. Among 591 children enrolled in Rhode Island Medicaid, the overall rate of coverage for the basic immunization series was reduced from ...