Family Practice News back issues from December 2001:
FP donates skills at N.Y recovery site. (Physical, Emotional Support).(Brief Article)
Dec 01, 2001; ... The Sept. 11 terrorist assault and the subsequent anthrax attacks left many physicians searching for ways to help the survivors and volunteers who were affected by the violent events. After a month of wishing that he could help, family physician David Abend finally got a chance ...
Fee-based E-mail consultations get tested in california: A major barrier to greater use of 'e-visits' has been the lack of reimbursement. (Doctors Paid $20 Per 'E-Visit').(Brief Article)
Dec 01, 2001; ... About 200 physicians in California are being paid $20 each time they electronically consult with patients in an ongoing study. If such communication proves cost effective and keeps doctors and patients satisfied, Blue Shield of California plans to expand the service. ...
Diagnostic rule may flag UTIs without culturing: This strategy allows for telephone triage. (Avoiding Uuneeded Antiobiotics).(Brief Article)
Dec 01, 2001; ... HALIFAX, N.S. -- A simple diagnostic rule for managing uncomplicated urinary tract infections in female patients shows promise as a way to cut unnecessary antibiotic use and the volume of urine cultures. The rule focuses on testing for pyuria, the presence of dysuria, and the ...
Antibiotics overprescribed for upper respiratory infections. (Family Physicians Batting .200).(Brief Article)
Dec 01, 2001; ... HALIFAX, N.S. -- Family physicians had a batting average of .200 when prescribing antibiotics to patients with an upper respiratory infection, in a study with more than 50 physicians and 298 patients. Among more than 200 patients who were prescribed an antibiotic for their ...
Watch terrorism survivors for signs of avoidance, numbing. (Lessons Learned From Oklahoma City).(Brief Article)
Dec 01, 2001; ... Avoidance and numbing symptoms, which are relatively uncommon manifestations of posttraumatic stress disorder, singled out some of the most troubled survivors of the 1995 bombing of the Alfred P. Murrah Federal Building in Oklahoma City, according to a study of 182 adult survivors of the ...
Peer review groups enlisted to educate doctors on bioterrorism. (Delivering 'Special Alerts').(Brief Article)
Dec 01, 2001; ... WASHINGTON -- The Centers for Disease Control and Prevention is enlisting the aid of peer review organizations to speed the delivery of accurate clinical information on bioterrorism. "Special Alert" is the insignia of the new rapid distribution network by which PROs will help ...
Letters.(Brief Article)
Dec 01, 2001 ... Let's Adjust to Alternatives As both an osteopathic family physician and doctor of chiropractic, I find it depressing that FAMILY PRACTICE NEWS would publish such vitriolic diatribes as the letters from Dr. Tad Lonergan ("Chiropractic's Gain, FP's Loss") and Dr. Hasan A. Benler ...
Corrections. (Opinion).(CDC Offers Clinicians Help in Dealing With Anthrax" (Nov. 15, 2001, p. 1)(Cost and Inconvenience Undercutting Mifepristone" (Aug. 15, 2001, p. 14)(Brief Article)
Dec 01, 2001 ... A dosage error appeared in "CDC Offers Clinicians Help in Dealing With Anthrax" (Nov. 15, 2001, p. 1). For initial treatment of cutaneous or inhalation anthrax, the correct dose of doxycycline is 100 mg every 12 hours for children older than 8 years who weigh more than 45 ...
Hawthorn extract may benefit aging hearts. (Adjunctive Therapy).(Brief Article)
Dec 01, 2001; ... NEW YORK -- Extracts of the leaves and fruit of the hawthorn plant (Crataegus laevigata) confer a range of benefits on the aging heart, Dr. Tieraona Low Dog said at a meeting on botanical medicine sponsored by the Columbia-Presbyterian Medical Center. Used for centuries as a ...
Saw palmetto for benign prostatic hyperplasia. (Alternative Medicine).(Brief Article)
Dec 01, 2001; ... * Saw palmetto has long been used to relieve symptoms of benign prostatic hyperplasia (BPH), and it has a good safety record. * A careful physical examination by a physician should always precede herbal treatment for urinary symptoms. History of Use The ...
Rapid flu test's clinical utility questioned. (More Useful During Epidemic).(Brief Article)
Dec 01, 2001; ... HALIFAX, N.S. -- Rapid influenza antigen tests may have a limited clinical role. The positive predictive value of these tests is probably the most clinically relevant measure of their efficacy, and by this measure the tests are "really only good during an epidemic," Dr. Jonathan ...
Flu vaccination needs a push to reach 2010 goals. (High-Risk Adults, Elderly).(Brief Article)
Dec 01, 2001; ... ATLANTA -- Little recent progress has been made at improving influenza vaccination rates in elderly and high-risk adults, particularly among minorities, James Singleton reported in a poster at the National Immunization Conference sponsored by the Centers for Disease Control and Prevention ....
Phone support helps manage depressed patients. (Pilot Test Results).(Brief Article)
Dec 01, 2001; ... HALIFAX, N.S. -- A telephone-support program for patients with depression enhanced patient management in a pilot program involving five primary care practices with a total of 18 physicians. The program proved so successful that two of the five practices decided to continue ...
One question can rule out depression. (Primary Care Screening).(Brief Article)
Dec 01, 2001; ... HALIFAX, N.S. -- Asking patients a single question--"Do you often feel sad or depressed?"--can rule out depression with 93% accuracy Dr. Cristen Wall reported at the annual meeting of the North American Primary Care Research Group. When tested on 97 patients seen in two ...
Remicade warnings. (Clinical Capsules).(Brief Article)
Dec 01, 2001 ... Remicade, a biologic agent for rheumatoid arthritis and Crohn's disease, has been linked to tuberculosis and other opportunistic infections, including histoplasmosis, listeriosis, and pneumocystosis, according to an Oct. 5 "Dear Healthcare Professional" letter from Centocor, the drug's ...
Missed appendicitis. (Clinical Capsules).(Brief Article)
Dec 01, 2001 ... The misdiagnosis of appendicitis has increased in the elderly and in women of childbearing age, reported Dr. David R. Flum and his associates at the University of Washington, Seattle. They reviewed 85,790 appendectomies done in Washington state between 1987 and 1998. Among the ...
High-normal BP raises CV risks. (Clinical Capsules).(Brief Article)
Dec 01, 2001 ... High-normal blood pressure raises the risk of myocardial infarction, stroke, and heart failure in men and women of all ages, but the elderly are particularly at risk, said Dr. Ramachandran S. Vasan of Boston University and associates. They followed 6,859 participants in the ...
Antimicrobials in animal feed. (Clinical Capsules).(Brief Article)
Dec 01, 2001 ... Three studies found evidence that antimicrobials in animal feed promote emergence of resistant strains of bacteria. In a randomized study 18 healthy volunteers ingested glycopeptide- or streptogramin-resistant strains of Enterococcus faecium, or susceptible strains of E. faecium ...
What's your diagnosis? An elderly white male patient presented with a red, swollen, bulbous nose. (Derm Diagnosis).(Brief Article)
Dec 01, 2001; ... ANAHEIM, CALIF -- At first glance, this patient appears to have rhinophyma, a spontaneous swelling of the soft tissues of the nose associated with rosacea and most often seen in white men over the age of 60. But in this case, Dr. Joseph B. Bikowski of Sewickley, Pa., noted that ...
Target individual elements of rosacea to get better outcomes. (Dermatitis, Flush, Fibrosis).(Brief Article)
Dec 01, 2001; ... SANDESTIN, FLA. -- Targeting the distinct elements of rosacea may lead to a more successful outcome, Dr. Mark V. Dahl said at a meeting of the Alabama Dermatology Society. That's because the condition acts more like a syndrome than a disease, with individual aspects that, while ...
Diagnostic criteria for eczema updated. (Necessary Features Simplified).(Brief Article)
Dec 01, 2001; ... PORTLAND, ORE. -- New criteria will make it simpler to diagnose atopic dermatitis, Dr. Jon Hanifin said at an international symposium on atopic dermatitis. These criteria, which were unveiled at the meeting, are set to be published soon, said Dr. Hanifin, a professor of ...
Drug update: Outpatient treatment of deep vein thrombosis.(Brief Article)
Dec 01, 2001; ... Outpatient management with a low-molecular-weight heparin is the wave of the future for treating deep vein thrombosis. Already prevalent in Europe and Canada, a surge of outpatient programs in the United States is expected in the next 5 years. Low-molecular-weight heparin (LMWH) ...
What to ask when you're the interviewee. (Practice Trends).(Brief Article)
Dec 01, 2001; ... You may be a seasoned pro at interviewing patients and asking them pointed questions about their health. But during interviews for a practice opportunity, many family physicians lack the skills to ask the right questions, says Dr. Rebecca Ann Beach, a family physician with Union Hospital ...
AAFP leads effort to reassess and renew family practice. (Future of Family Medicine Project).(Brief Article)
Dec 01, 2001; ... ATLANTA -- The family practice profession is due for a complete overhaul. That, at least, is what family medicine leaders are convinced is needed to help the specialty thrive in the years ahead. Responding to growing discontent among family physicians, the American ...
Regulatory relief ahead? (Policy & Practice).(Brief Article)
Dec 01, 2001; ... Physicians remain hopeful that Congress will pass Medicare regulatory relief, even as Congress focuses on war and homeland security issues in response to terrorism. "We hope [regulatory relief] will be resolved very shortly," Dr. Donald Palmisano, secretary-treasurer for the American ...
Medicare simplified. (Policy & Practice).(Brief Article)
Dec 01, 2001; ... On Nov. 1, the Centers for Medicare and Medicaid Services (CMS) rolled out a streamlined, "user-friendly" enrollment form in an effort to make it easier for physicians and other health care providers to become eligible for Medicare reimbursement. In developing the new form, CMS analyzed ...
Emergency contraception. (Policy & Practice).(Brief Article)
Dec 01, 2001; ... California Gay. Gray Davis has signed legislation authorizing pharmacists to dispense emergency contraception without a prescription. Washington is the only other state that allows this, says a spokeswoman for the legislation's author, state Sen. Dede Alpert, a California Democrat. New ...
Wal-mart lawsuit. (Policy & Practice).(Brief Article)
Dec 01, 2001; ... Wal-Mart Stores Inc., the largest U.S. private sector employer, has been sued in a class action lawsuit alleging sex discrimination for denying employees insurance coverage of prescription contraceptives and devices. The suit was filed in the U.S. District Court for the Northern District ...
Retiree benefits erosion. (Policy & Practice).(Brief Article)
Dec 01, 2001; ... Fewer employers are providing retiree health care coverage, and alternative sources of coverage have become costly or limited, the General Accounting Office reports. William Scanlon, GAO's director for health care issues, told a House subcommittee that only one-third of large employers and ...
Unapproved drug seized. (Policy & Practice).(Brief Article)
Dec 01, 2001; ... U.S. marshals seized close to $3 million worth of dietary supplements that were unlawfully produced with ephedrine; During inspection of Biogenics Inc., a Utah drug company doing business as E'ola International, the Food and Drug Administration discovered that the company was manufacturing ...
French firm guilty of felony. (Policy & Practice).(Brief Article)
Dec 01, 2001; ... The French corporation Roussel Uclaf has pleaded guilty to felony charges of conspiracy and defrauding the Food and Drug Administration and will pay more than $33 million in penalties. This constitutes one of the largest monetary penalties ever imposed in a criminal pharmaceutical ...
Acupuncture: It's no gag. (Indications).(Brief Article)
Dec 01, 2001; ... Patients who dread dental visits because they have a strong gag reflex may get relief from a few well-placed needles. In a British study of 10 patients with the problem, a dentist trained in acupuncture inserted needles into an "antigagging point" on each ear, manipulated them briefly, and ...
Heading off alzheimer's. (Indications).(Brief Article)
Dec 01, 2001; ... A small head might be a big risk factor for Alzheimer's disease, which is 14 times more likely in people with a small head and the apolipoprotein E e4 gene, compared with people without those two factors, researchers found. They studied 1,869 healthy Japanese Americans aged 65 years and ...
Voice of experience. (Indications).(Brief Article)
Dec 01, 2001; ... Dr. Yashashri Choudhari was not enthusiastic about having to perform an emergency C-section at the end of a long and busy on-call shift, But the exhausted ob.gyn.in Belfast, Ireland, received effusive praise from the patient's husband, who was in the operating room during the early morning ...
Erectile disability? (Indications).(Brief Article)
Dec 01, 2001; ... An employer does not have to make special accommodations if an occupational injury prevents a worker from having sex five times a week, the U.S. Supreme Court ruled. Antonio Contreras, a forklift operator, was injured in 1995 while working at an Illinois garden equipment plant run by ...
Doctor UFO. (Indications).(Brief Article)
Dec 01, 2001; ... The Disclosure Project, a group devoted to the release of secret government information on unidentified flying objects, believes that if alien messages had been heeded, the Sept. 11 tragedy could have been prevented. "There exist the technologies to monitor, intercept, and penetrate the ...
The heart of family practice: Captain of a sinking ship. (Opinion).(Brief Article)
Dec 01, 2001; ... Freddy and Rose were two of my first patients as a resident. I learned more from them about family medicine than from any other educational experience, even 10 years later. Freddy had deep brown skin and jaundiced eyes. I diagnosed him with cirrhosis, only to observe the natural ...
Should patients with stable angina be managed conservatively? (PRO & CON).(Brief Article)
Dec 01, 2001 ... [YES] About 25%-50% of patients with exertional angina should be managed with medical therapy only. This therapy must be optimal, and include all of the drugs that are known to be effective. Revascularization therapy is clearly needed with triple-vessel disease or left main ...
The heart of family practice: Being a friend. (Opinion).(Brief Article)
Dec 01, 2001; ... Recently, in the middle of a busy day, I found myself frustrated by a patient's blood pressure that I could not seem to bring under control easily. I mentioned to the patient that she was not being as compliant as I would like. The patient admitted that on most days, she was ...
DTaP, Prevnar Vaccine Shortages. (New Interim Recommendations).(Brief Article)
Dec 15, 2001; ... ATLANTA -- Shortages of two routine childhood vaccines have prompted new interim recommendations from the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices. Shortages of both the conjugate pneumococcal and the diphtheria-tetanus-acellular ...
Aggressive Statin Use Benefits All High-Risk Patients: The treatment reduced vascular events regardless of baseline LDL levels. (Heart Protection Study).(Brief Article)
Dec 15, 2001; ... ANAHEIM, CALIF. -- Results of the Heart Protection Study, the latest blockbuster statin trial, will likely transform the landscape of medical practice, observers agreed after initial presentation of the British megatrial at the annual scientific sessions of the American Heart Association. ...
Infant GBS Risk Halved With Universal Screenings: Related rise in antibiotic use a drawback. (Compared With Risk-Based Approach).
Dec 15, 2001; ... QUEBEC CITY -- Universal culture screening of all pregnant women for group B streptococcus cuts by half the risk of a newborn developing early-onset group B streptococcal disease, compared with screening based on a riskbased approach, according to data presented at the annual meeting of ...
CDC Protocol On GBS Testing Proves Effective. (Perianal Cultures).(Brief Article)
Dec 15, 2001; ... PALM BEACH, FLA. -- The anorectal sampling that the American College of Obstetricians and Gynecologists recommends for group B streptococcus screening late in pregnancy is not necessary for accuracy-- but the lab procedure recommended by the Centers for Disease Control and Prevention to ...
New CDC Guidelines Are Coming on Hepatitis B Vaccine. (Stronger Birth Dose Recommendation).(Brief Article)
Dec 15, 2001; ... ATLANTA -- New hepatitis B immunization guidelines from the Centers for Disease Control and Prevention will more strongly recommend the birth dose. The new document, addressing both pediatric and adult hepatitis B immunization, will replace the last one issued in November 1991 ....
Anakinra Gets FDA's Okay For Rheumatoid Arthritis. (Interleukin-1 Blocker).(Brief Article)
Dec 15, 2001; ... SAN FRANCISCO -- Anakinra, the third biologic therapy to be approved for moderate to severely active rheumatoid arthritis, may prove to have some cost and therapeutic advantages over competing drugs. The Food and Drug Administration's approval of anakinra (Kineret) coincided ...
Infliximab Maker Warns Doctors of New TB Cases. (Rheumatoid Arthritis, Crohn's).(Brief Article)
Dec 15, 2001; ... The manufacturer of influximab, one of the two currently available tumor necrosis factor-[alpha] antagonists, has issued a "Dear Doctor" letter warning about continued case reports of tuberculosis and other opportunistic infections in patients receiving the biologic agent for rheumatoid ...
Vitamin D Lowered Risk of Falling in Nursing Homes by 49%. (Randomized Study).(Brief Article)
Dec 15, 2001; ... PHOENIX -- Vitamin D supplementation can reduce the risk of falling in the elderly by 49%, Dr. Heike A. Bischoff said at the annual meeting of the American Society for Bone and Mineral Research. In a randomized study of 122 women in geriatric homes in Basel, Switzerland, those ...
Letters.
Dec 15, 2001 ... AAFP Concerned About HIPAA Although the recent article on a lawsuit brought by the Association of American Physicians and Surgeons stated that the American Academy of Family Physicians declined to comment, the AAFP does have concerns about the Health Insurance Portability and ...
Correction.("FP (Family Practice) Charts Path of New Med School" in November 15, 2001 issue, p. 1)(Brief Article)(Correction Notice)
Dec 15, 2001 ... The article "FP Charts Path of New Med School" (Nov. 15, p. 1) included an incorrect statement about the number of medical schools in Florida. In addition to the new Florida State University College of Medicine, Tallahassee, the state has four other medical ...
'Could You Sit 30 Minutes Less?'. (Guest Editorial).(Brief Article)
Dec 15, 2001; ... The benefits of exercise are indisputable, and patients want advice on exercise, yet most physicians do not routinely counsel patients to become more active. If you doubt the impact of encouraging exercise, you should take to heart the findings from the Activity Counseling Trial (ACT) ....
Should men be encouraged to have PSA testing for prostate cancer screening? (Pro & Con).(Brief Article)
Dec 15, 2001 ... YES The availability of prostate-specific antigen screening has led to a tremendous increase in prostate cancer screening. The result has been a "natural experiment" on a national and global scale in prostate-specific--based screening. No definitive data show that ...
CDC Teams Readied to Fight Possible Smallpox. (Bioterrorism Preparedness).(Brief Article)
Dec 15, 2001; ... Teams of specialists from the Centers for Disease Control and Prevention have been vaccinated against smallpox and began training in November to prepare for rapid deployment in the event a suspected case of smallpox is reported. "There has been no credible threat [of smallpox ...
Distinguishing Smallpox From Chickenpox: An Unpleasant Primer. (Initial Lesions Resemble Chickenpox).(Brief Article)
Dec 15, 2001; ... Unless you've got your radar way up, smallpox early in its course is easy to confuse with other things, according to Dr. Christopher J. Harrison of the University of Louisville (Ky.). The incubation period for smallpox averages 10-14 days but can be as short as a week or as long ...
Drop in Blood Pressure Cuts Second Stroke Risk. (Normotensive Patients Also Benefit).(Brief Article)
Dec 15, 2001; ... STOCKHOLM -- Blood pressure reduction cut the risk of a second stroke by 28% over 4 years in a trial that enrolled more than 6,000 patients. Regardless of starting blood pressure, the blood pressure decrease was associated with similar reductions in stroke risk in normotensive ...
Standard Thrombolytic Cocktail Challenged for Acute MI. (Patient Selection is Critical).
Dec 15, 2001; ... STOCKHOLM -- The recipe for thrombolytic therapy in myocardial infarction has changed. The standard thrombolytic-drug cocktail should no longer simply be the thrombolytic drug (usually a plasminogen activator) and unfractionated heparin. Results of three major trials reported at ...
USDA Panel Skeptical About Milk's Health Claims. (Criticism of 'Milk Mustache' ADS).(Brief Article)
Dec 15, 2001; ... A scientific review released by the U.S. Department of Agriculture offers support for critics who claim that the dairy industry has overstated milk's nutritional merits. A panel appointed by the USDA concluded that milk cannot be considered a "sports drink," does not ...
COPD Patients Can Benefit From Exercise. (Customized Regimen is Key).(Brief Article)
Dec 15, 2001; ... Aerobic exercise using the large muscle groups in the legs can help patients with chronic obstructive pulmonary disease improve their lung function, said Dr. Christopher B. Cooper of the University of California, Los Angeles. Breathlessness tends to make exercise difficult for ...
Internet Ciprofloxacin. (Clinical Capsules).(Brief Article)
Dec 15, 2001 ... The U.S. Food and Drug Administration has issued warnings to 11 foreign Internet vendors attempting to capitalize on anthrax fears by offering ciprofloxacin to American consumers. The FDA said the letters were sent because it has been unable to determine if the products were ...
New HIV Guidelines. (Clinical Capsules).(Brief Article)
Dec 15, 2001 ... The recently updated HIV Counseling, Testing, and Referral Standards and Guidelines place more emphasis on early knowledge of HIV status and on making testing more accessible. The guidelines from the Centers for Disease Control and Prevention also address ways to improve the quality and ...
Transfuse Elderly MI Patients. (Clinical Capsules).(Brief Article)
Dec 15, 2001 ... More aggressive use of transfusion is warranted in elderly patients with acute MI who are found to be anemic, according to Dr. Wen-Chih Wu of Brown University Providence, R.I., and associates. Existing transfusion guidelines do not give specific hematocrit values at which to ...
Depression, Erectile Dysfunction. (Clinical Capsules).(Brief Article)
Dec 15, 2001 ... Sildenafil is significantly more effective than placebo in treating erectile dysfunction in patients with comorbid untreated depression, said Dr. Stuart N. Seidman of Columbia University, New York, and his associates. Erectile dysfunction and depression are often comorbid, but ...
IBS in Twins. (Clinical Capsules).(Brief Article)
Dec 15, 2001 ... The likelihood that someone will develop irritable bowel syndrome is influenced as much by social learning as by genetics, reported Rona L. Levy Ph.D., of the University of Washington, Seattle, and her associates. Irritable bowel syndrome (IBS) was reported by 117 pairs of ...
New & Approved: Coreg Biotronik Home Monitoring System.(Brief Article)
Dec 15, 2001; ... Coreg (carvedilol, GlaxoSmithKline) A [beta]-blocker for severe congestive heart failure. The first drug in its class approved for this indication and the first shown to reduce morbidity and mortality in this population. Approved for mild to moderate CHF in 1997. ...
Program Is Revised For Accutane Patients. (Pregnancy Prevention).(Brief Article)
Dec 15, 2001; ... The risk management program aimed at preventing Accutane-exposed pregnancies has been revised. Announced in October and effective in January, SMART (System to Manage Accutane-Related Teratogenicity) is designed to enhance the safe and appropriate use of Accutane by strengthening ...
Anti-Infectives. (Drugs, Pregnancy, And Lactation).(Brief Article)
Dec 15, 2001; ... This is the second installment of a three-part series of columns on the safety of antibiotics in pregnant and lactating women. * Lincosamides. Clindamycin (Cleocin) has been classified under pregnancy category B. There is no evidence of teratogenicity or embryo-fetotoxicity from ...