Family Practice News back issues from April 2000:
Hydration Reduces Prolonged Labor.
Apr 01, 2000; ... MIAMI BEACH -- Hiking up the amount of maternal hydration during labor cut the incidence of prolonged labor by half in a randomized trial of 195 laboring women, Dr. Thomas Garite said at the annual meeting of the Society for Maternal-Fetal Medicine. In a study that challenges ...
Task Force Issues Guide to Common Allergic Disorders.
Apr 01, 2000; ... 'This is not a report written by specialists for specialists,' a task force cochair said. SAN DIEGO -- A national task force has designed a single resource for primary care physicians seeking evidence-based diagnostic and treatment information on the 13 most common allergic ...
Guidelines Target Rise in Type 2 Diabetes in Children.
Apr 01, 2000; ... Obesity blamed for 'emerging epidemic.' Mitchel L. Zoler, Philadelphia Bureau, contributed to this report. New guidelines are designed to help physicians manage children who have a condition that until recently has been viewed only as an adult problem: type 2 ...
Many Americans Are Willing to Pay to Insure the Uninsured [*].
Apr 01, 2000 ... <Pre>Many Americans Are Willing to Pay to Insure the Uninsured [*] Willing to Pay $50 40% Not Willing to Pay More 24% Willing to Pay $5 20% Willing to Pay $30 13% Don't know 3% ...
FDA Panel Okays Two Saline Implants, Rejects One.
Apr 01, 2000; ... GAITHERSBURG, MD. -- Two brands of saline-filled breast implants are likely to stay on the market if the Food and Drug Administration follows the recommendations of one of its expert panels. At a recent hearing the FDA's general and plastic surgery devices panel voted that the ...
Surge in Psychotropics Prescribed to Preschoolers.
Apr 01, 2000; ... Physicians are reacting with concern, but not necessarily surprise, to a study documenting steep increases in prescriptions for psychotropic drugs in preschool-aged children in three large health systems. Prescriptions for stimulants, antidepressants, and the hypertension drug ...
ADHD Underdiagnosed in Girls.
Apr 01, 2000; ... Despite the media frenzy focused on attention-deficit hyperactivity disorder, it's clear that we've done an inadequate job educating teachers, parents, and others about this diagnosis among girls. Girls with the condition are dramatically underdiagnosed and untreated. In fact, ...
Getting a Grip.
Apr 01, 2000; ... "A drink from the fire hose" was how the state medical society lobbyist described his speech on the medical practice environment. As a first-year medical student I had heard of the American Medical Association, but I was ignorant about medicine's political side. As the ...
LETTERS.(Statistical Data Included)(Letter to the Editor)
Apr 01, 2000; ... Health Is Not a Commodity The guest editorial by physician/congressman Ron Paul is an almost total misreading of what is wrong with health care in America today ("Patient Bill of Wrongs," Jan. 15, 2000, p. 13). Although his opposition to managed care and the ...
Correction.(To: "Distinguishing Orbital Cellulitis From Preseptal Cellulitis" in February 15, 2000 issue, p. 47)(Correction Notice)(Statistical Data Included)
Apr 01, 2000 ... The two photographs that accompanied "Distinguishing Orbital Cellulitis From Preseptal ...
PRO & CON.(Statistical Data Included)
Apr 01, 2000 ... Do residents work too many hours? Dr. Maher Roman is an internist with the Jerry L. Pettis Memorial Veterans Medical Center, Loma Linda, Calif. YES It is simply not human to be able to function adequately while working sometimes 40 or more continuous hours ...
Instant Thrombolysis With Lasers.(Statistical Data Included)
Apr 01, 2000; ... NEW ORLEANS -- A bright red laser light--one that promises immediate thrombolysis--is shining in the realm of acute ischemic stroke management. At a press conference during the 25th International Stroke Conference sponsored by the American Stroke Association, Dr. Wayne Clark ...
Poststroke Rehab After Cardiac Surgery.(Statistical Data Included)
Apr 01, 2000; ... WASHINGTON -- The benefits of poststroke rehabilitation are the same for patients whose stoke was due to cardiac surgery as for those whose stroke was due to other causes, Dr. Gagan Mahajan said at the annual meeting of the American Academy of Physical Medicine and Rehabilitation. ...
New Prognosis Tool for Acute Stroke Patients.(Statistical Data Included)
Apr 01, 2000; ... NEW ORLEANS -- A new tool simplifies the prediction of outcomes in acute stroke patients. The prognostic tool synthesizes time variables, clinical information, and diffusion-weighted imaging into a single 12-point scale, Dr. Alison Elizabeth Baird said at the 25th International ...
Imaging Is Defining Stroke Treatment Categories.(Statistical Data Included)
Apr 01, 2000; ... NEW ORLEANS -- The future of stroke management belongs to the "stroke splitters," Dr. Anthony Furlan predicted at the 25th International Stroke Conference sponsored by the American Stroke Association. Equipped with powerful new diagnostic techniques, such as diffusion-weighted ...
Hypertension's Duration Key Factor in Stroke Risk.(Statistical Data Included)
Apr 01, 2000; ... NEW ORLEANS -- How long a patient has been hypertensive is more important than the patient's current blood pressure in estimating the risk of stroke, Dr. Sudha Seshadri said at the 25th International Stroke Conference sponsored by the American Stroke Association. "If you had to ...
Diastolics Below 80 mm Hg Lower Stroke Risk.(Statistical Data Included)
Apr 01, 2000; ... NEW ORLEANS -- How low can you go in reducing blood pressure after a patient has had a stroke? It is still a subject of considerable controversy, but the answer may be lower than previously thought, Dr. Gary Friday said at the 25th International Stroke Conference sponsored by ...
[beta]-Blockers Reshape Treatment Choices in CHF.(Statistical Data Included)
Apr 01, 2000; ... COLORADO SPRINGS - [beta]-blockers offer the first realistic hope of arresting the progressive downhill course of congestive heart failure, Dr. JoAnn Lindenfeld said at a meeting of the Colorado chapter of the American College of Physicians-American society of Internal Medicine. ...
What to Do When Left Ventricular Ejection Fraction Climbs to 60%.(Statistical Data Included)
Apr 01, 2000; ... SNOWMASS, CoLo. -- The unprecedented efficacy of [beta]-blockers in congestive heart failure has spawned a new dilemma: What do you do when the left ventricular ejection fraction of a formerly failing heart climbs to 60%? This is becoming a not uncommon occurrence in clinical ...
Value of [beta]-Blockers for CHF Subgroups Questioned.(Statistical Data Included)
Apr 01, 2000; ... ATLANTA -- The value of [beta]-blocker therapy for heart failure patients who are African American or who have severe disease was thrown into doubt by the negative results of a large, controlled trial. But even the directors of the trial hesitated to make treatment ...
Warfarin Home Self-Monitoring.(Statistical Data Included)
Apr 01, 2000; ... COLORADO SPRINGS - Home self-monitoring of prothrombin time is a highly attractive and underutilized option for selected patients on warfatin, Dr. Alan Jacobson said at the annual meeting of the Colorado chapter of the American College of Physicians-American Society of Internal Medicine. ...
Oral Anticoagulation: Easy on the Vitamin K.(Statistical Data Included)
Apr 01, 2000; ... COLORADO SPRINGS -- Don't be too quick to reach for the vitamin K when a patient on warfarin develops elevated international normalized ratio values without clinically evident bleeding, Daniel M. Witt, Pharm.D., cautioned at the annual meeting of the Colorado chapter of the American ...
New Coronary Bypass Option Under Development.(Statistical Data Included)
Apr 01, 2000; ... SNOWMASS, COLO. -- There may be a new option for the severe ischemic heart disease patient with no options: percutaneous in-situ coronary venous arterialization. "This has the potential to totally revolutionize the way we take care of patients," Dr. Stephen N. Oesterle said at a ...
Start Statin Therapy Before Hospital Discharge.(coronary event treatment with hypercholesteremic drugs)(Brief Article)
Apr 01, 2000; ... COLORADO SPRINGS -- All patients hospitalized for a coronary event ought to be placed on a moderate-dose statin before discharge, Dr. John A. Merenich said at a meeting of the Colorado chapter of the American College of Physicians-American Society of Internal Medicine. Making ...
Antiarrhythmic Drugs Distant Second to Implantable Cardioverter Defibrillators.(Statistical Data Included)
Apr 01, 2000; ... SNOWMASS, COLO. -- Antiarrhythmic agents no longer have any role as primary therapy in patients with low ejection fraction and clinical or inducible ventricular tachycardia, Dr. Roger A. Winkle declared at a conference sponsored by the American College of Cardiology. The ...
Second-Generation ACE Inhibitors Work Best for Cardiovascular Disease.(Statistical Data Included)
Apr 01, 2000; ... LAKE BUENA VISTA, FLA. -- Second-generation angiotensin converting enzyme inhibitors have supplanted the first-generation drugs for treating cardiovascular diseases. The first-generation ACE inhibitors include captopril, enalapril, and lisinopril. The second-generation drugs ...
Bone Densitometry: Peripheral vs. Central Measures.(Brief Article)
Apr 01, 2000; ... COLORADO SPRINGS -- Peripheral bone densitometry is a problematic and overused test, Dr. Michael T. McDermott asserted at a meeting of the Colorado chapter of the American College of Physicians-American Society of Internal Medicine. "I'm not particularly fond of peripheral bone ...
Alternative to Oral Bisphosphonates.(pamidronate)(Brief Article)
Apr 01, 2000; ... COLORADO SPRINGS -- Intravenous pamidronate is a good alternative in osteoporotic women who can't take oral bisphosphonates, estrogen, or calcitonin, Dr. Michael T. McDermott said at a meeting of the Colorado chapter of the American College of Physicians-American Society of Internal ...
Calcium Supplements Not Always Absorbed.(Brief Article)
Apr 01, 2000; ... SEATTLE -- Many patients who rely on calcium supplements as a way to treat and prevent osteoporosis may be throwing their money away X-ray studies of the intestinal tract suggest that only a handful of over-the-counter calcium supplement products are actually broken down and ...
Adults Treated for ADHD Show Dramatic Response.(attention-deficit hyperactivity disorder)(Brief Article)
Apr 01, 2000; ... PHOENIX, ARIZ. -- Adults treated for attention-deficit hyperactivity disorder with stimulants generally have dramatic responses to medication, Dr. Paul H. Wender said at the annual meeting of the American Society for Adolescent Psychiatry. "We are not talking about what happens ...
EEG Biofeedback Helped Patients With ADHD.(attention-deficit hyperactivity disorder)(Brief Article)
Apr 01, 2000; ... WASHINGTON -- Impulse control and attentiveness improved after 20 sessions of EEG biofeedback in 85% of 1,089 children and adults with attention-deficit hyperactivity disorder and other attentional and behavioral disorders, Siegfried Othmer, Ph.D., said in a poster presentation at the ...
Consider Duration, Onset of Action When Choosing an Insomnia Agent.(benzodiazepine receptors)(Brief Article)
Apr 01, 2000; ... SEATTLE -- Duration and onset of action are the most important considerations in choosing a benzodiazepine receptor agonist to treat acute insomnia, Dr. Vishesh Kapur said at a meeting on drug therapy sponsored by the University of Washington. "A rational approach to using these ...
E. coli O157:H7 in Beef.(pathogen found in 89% of grinder loads)(Brief Article)
Apr 01, 2000 ... Raw beef destined to be ground into patties may be tainted with small amounts of Escherichia coli O157:H7, according to the Agriculture Department. The pathogen was found in 89% of grinder loads--huge batches of raw beef of 3,000 pounds or more. But hamburger lovers need not ...
Lyme Disease Outcomes.(antimicrobial agents evaluated)(Brief Article)
Apr 01, 2000 ... Patients treated with antimicrobial therapy for Lyme disease are as healthy as people who were never infected. In a study involving 678 people with suspected Lyme disease in Connecticut, 86% of whom had received standard antimicrobial therapy, 212 subjects were compared with 212 ...
Laxatives on the Loose.(Duke Established Populations for Epidemiologic Studies of the Elderly)(Brief Article)
Apr 01, 2000 ... Laxative use is common among community-dwelling elderly people but is not associated with use of constipating drugs, Christine Ruby, Pharm.D., said in a poster presentation at the annual meeting of the Gerontological Society of America. She and her associates looked at laxative ...
IBS Is Not a Mental Dx.(irritable bowel syndrome)(Brief Article)
Apr 01, 2000 ... Patients with irritable bowel syndrome want physicians to take their disease seriously and offer more help, Dr. Barbara Yawn said in a poster session at the annual meeting of the North American Primary Care Research Group. These patients aren't any more likely to have ...
Latest Hypertension Figures.(according to the National Health and Nutrition Examination Study)(Brief Article)
Apr 01, 2000 ... About 50 million American adults have hypertension, according to the latest data from the third National Health and Nutrition Examination Survey. A total of 42.3 million adults have high blood pressure, defined as systolic blood pressure of 140 mm Hg or greater, diastolic blood ...
Topicals Offer Pain Relief for Postherpetic Neuralgia Patients.(analgesia administration)(Brief Article)
Apr 01, 2000; ... FORT LAUDERDALE, FLA. -- Growing clinical evidence supports the use of topical analgesics in postherpetic neuralgia. It's becoming clear that irritable nociceptors are at work in postherpetic neuralgia and that a lidocaine patch can safely and effectively relieve the pain, ...
Cognitive-Behavioral Tx for Chronic Pain.(Brief Article)
Apr 01, 2000; ... FORT LAUDERDALE, FLA. -- Cognitive-behavioral therapy benefits chronic pain patients long after completion of the program. Improvement in pain intensity and depression is significantly related to self-efficacy--the belief in one's own ability to function despite the persistence ...
Proper Planning Can Facilitate In-Office Conscious Sedation.(and prevent adverse effects)(Brief Article)
Apr 01, 2000; ... SAN FRANCISCO -- Physicians need to exercise care in using in-office conscious sedation, but proper planning can protect against adverse effects, according to Dr. David Berman, assistant chief of the department of emergency medicine at Kaiser Permanente, Sacramento. The basic ...
Expanding Treatment Options in Osteoarthritis.(Brief Article)
Apr 01, 2000; ... COLORADO SPRINGS -- Beyond the workhorse conventional NSAIDs and the newer cyclooxygenase-2 inhibitors, there is a growing array of options for managing osteoarthritis, Dr. David H. Collier said at the annual meeting of the Colorado chapter of the American College of Physicians-American ...
COX-2 Inhibitors Are 'Safer Aspirins,' Not 'Superaspirins'.(Brief Article)
Apr 01, 2000; ... COLORADO SPRINGS -- The cyclooxygenase-2 inhibitors are not "superaspirins," but they are "safer aspirins," Dr. David H. Collier said at the annual meeting of the Colorado chapter of the American College of Physicians--American Society of Internal Medicine. The selective COX-2 ...
Celecoxib Doesn't Inhibit the Healing of Upper GI Lesions.(gastrointestinal)(Brief Article)
Apr 01, 2000; ... PHOENIX, ARIZ. -- The selective cydooxygenase-2 inhibitor celecoxib had no adverse effect on the healing of upper gastrointestinal lesions, based on a meta-analysis of results from four controlled trials with a total of 4,000 patients. Celecoxib's neutral effect on ulcer healing ...
Depression: Differentiate Unipolar From Bipolar.
Apr 01, 2000; ... VAIL, COLO. -- Premenstrual and postpartum depression can be either unipolar or bipolar in nature, and it's vital to recognize the difference, Dr. Steven Dubovsky warned at a conference on obstetrics and gynecology sponsored by the University of Colorado. In fact, ...
Psychiatric Dx Precludes Prenatal Care.(Brief Article)
Apr 01, 2000; ... More than one out of every three pregnant women with a psychiatric or substance abuse diagnosis don't receive adequate prenatal care, according to Dr. Rosemary H. Kelly of the University of California, Davis, and her associates. In a retrospective study of California birth ...
Women Who Have Miscarried Are at Increased Risk of OCD.(obsessive-compulsive disorder)(Brief Article)
Apr 01, 2000; ... TORONTO -- Women who have had a miscarriage are eight times more likely to develop an episode of obsessive-compulsive disorder in the following 6 months than are women in the general population, Pamela A. Geller, Ph.D., reported at the annual meeting of the Association for Advancement of ...
Get Expert Advice on Drugs in Pregnancy, Lactation.
Apr 01, 2000 ... FAMILY PRACTICE NEWS is pleased to announce the debut of a new column that is aimed at helping you to better manage medical problems in pregnant and lactating women. The first installment of "Drugs, Pregnancy, and Lactation" appears on the opposite page. This monthly column will ...
Caffeine.
Apr 01, 2000; ... The use of caffeine in pregnancy has been widely studied. What appears clear from retrospective studies is that caffeine consumption at any level during pregnancy is not associated with an increased risk of birth defects. Research also suggests that limited caffeine consumption during ...
Triptans Not Advised for Migraines in Pregnancy.
Apr 01, 2000; ... RANCHO MIRAGE, CALIF. -- The triptans are best avoided for treating migrainesduring pregnancy, Dr. Dawn A. Marcus advised at a meeting on treating the difficult headache patient. So far, these serotonin agonists have not been associated with teratogenic effects in ...
Biophysical Profile Cuts ADD Risk.(attention-deficit disorder )
Apr 01, 2000; ... MIAMI BEACH -- Use of biophysical profiling to enable swift delivery at the first sign of fetal asphyxia appears to be associated with a reduced risk of attention-deficit disorder and several other disorders later in life. In fact, in a study of 153,593 children, those born to ...
Hypoxic Ischemia Increases Risk of Later Psychosis.
Apr 01, 2000; ... The occurrence of fetal and neonatal complications that are related to hypoxic ischemia doubles the risk that the neonate will develop schizophrenia or other psychoses later in life, according to Dr. Gwen L. Zornberg and her associates at the Harvard School of Public Health, Boston. ...
Cocaine, Cigarettes Linked to Postnatal Language Delay.
Apr 01, 2000; ... MIAMI BEACH -- Children who were prenatally exposed to cocaine are more than twice as likely as unexposed children to have language development problems by age 6, according to data presented at the annual meeting of the Society for Maternal-Fetal Medicine. In a study involving ...
Cerebral Palsy Tied To Prolonged Latency Period After PPROM.(preterm premature rupture of the membranes )
Apr 01, 2000; ... MIAMI BEACH -- Latency periods of 7 days or longer after preterm premature rupture of the membranes appear to be associated with a significantly elevated risk of cerebral palsy, according to a study that casts doubt on the routine practice of prolonging latency. Of 78 mothers ...
Membrane Rupture Raises Fetal HIV Risk.(Statistical Data Included)
Apr 01, 2000; ... SAN FRANCISCO -- The risk that an HIV-infected mother will transmit the virus to her infant rises by about 2% each hour after her membranes rupture and before she delivers her infant. The results of a metaanalysis of studies involving more than 4,700 mother-infant pairs confirm ...
More Vaginal Infections in HIV+ Women.(Brief Article)
Apr 01, 2000; ... ST. PETERSBURG, FLA. -- Women infected with HIV have much higher rates of vaginal infection, according to data presented by Dr. Andrew Helfgott. Physicians should be looking for vaginal infections in HIV-positive women and treating them aggressively to decrease the transmission ...
Vaginal Prolapse: Surprisingly Common Condition.(Brief Article)
Apr 01, 2000; ... ST. PETERSBURG, FLA. -- "Is this normal?" That's what one of Dr. Steven Swift's patients asked him when he examined her cystocele. She was referred to him for correction of this common condition, but it didn't bother her at all. He wasn't able to give her a good answer to her ...
Data Deficit Clouds Incontinence Surgery Options.(stress incontinence surgical therapeutics)(Brief Article)
Apr 01, 2000; ... SAN FRANCISCO -- The National Institutes of Health is committing $1 million to conduct a large multicenter study comparing stress incontinence surgeries in at least 1,000-1,500 women. The data are desperately needed in a field plagued by a dearth of good surgical studies, Dr ....
Prenatal Antihypertensives.(Statistical Data Included)
Apr 01, 2000 ... Taking high blood pressure medication during pregnancy may lead to lower birth weights, said Dr. P. von Dadelszen and colleagues at the University of Toronto. In a metaanalysis of 45 randomized trials following up 3,773 women, a medication-induced fall of 10 mm Hg in mean ...
Poor PKU Control Harms Child.(Statistical Data Included)
Apr 01, 2000 ... Poor metabolic control before conception and early in pregnancy causes cognitive impairment and developmental delay in the children of women with phenylketonuria, said Susan B. Waisbren, Ph.D., of Children's Hospital in Boston and her associates. They assessed 253 4-year-olds; ...
Ocular Toxicity of Tamoxifen.(Statistical Data Included)
Apr 01, 2000 ... Women with breast cancer should have a detailed ophthalmic assessment when starting low-dose tamoxifen, said Dr. Baha N. Noureddin and associates at the American University of Beirut, Lebanon. Patients should report even subtle visual symptoms and have yearly eye exams because ...
Chemotherapy-Related Colitis.(Statistical Data Included)
Apr 01, 2000 ... Taxane-based chemotherapy for metastatic breast cancer has been linked with fatal, colitislike complications, reported Dr. Nuhad K. Ibrahim and associates of the University of Texas M.D. Anderson Cancer Center in Houston. So far, six women have developed colitis while receiving ...
Lung Ca in Women With HIV.(Statistical Data Included)
Apr 01, 2000 ... The risk of lung cancer is twice as high in HIV-infected women as in seronegative women who are at risk for HIV, based on the results of a small prospective study presented at a conference on Retroviruses and Opportunistic Infections. Ruby Phelps of the Centers for Disease ...
Ultrasound Screening for Ovarian Ca Is Promising.(Statistical Data Included)
Apr 01, 2000; ... SAN DIEGO -- Annual transvaginal ultrasound screening detected ovarian cancer at an early stage in a study of more than 14,000 women at high risk for the disease. But it's still too soon for widespread adoption of annual ultrasound screening for this purpose. Larger studies are ...
Molecular Markers Can Predict Endometrial Ca Prognosis.(Statistical Data Included)
Apr 01, 2000; ... MAUI, HAWAII -- Molecular markers can be added to the traditional factors of histologic grade and depth of invasion to predict the prognosis of women with endometrial cancer, according to Dr. Andrea Mariani. Patients whose tumors are made up of nondiploid cells and who have ...
Female Hair Loss: Don't Delay Search for Cause.(Brief Article)
Apr 01, 2000; ... NAPLES, FLA. -- When a woman has hair loss, don't wait to start the search for the cause, Dr. Lynn Drake advised at the annual meeting of the Florida Society of Dermatology. Early diagnosis is particularly important when hair loss is associated with endocrine disease. Even when ...