Family Practice News back issues from March 2005:
Mobile screening gains acceptance.
Mar 01, 2005; ... Scan in a van? From a country club in Austin, Tex., to an evangelical church in Porterville, Calif., to the community hall in Rutherfordton, N.C., people are lining up to be screened for their stroke risk, and maybe even to have their bone density measured. Mobile ultrasound ...
Vital signs.(Brief Article)(Illustration)
Mar 01, 2005 ... <Pre> VITAL SIGNS Many Americans Don't Want to Pay More for Genetically Personalized Health Care Are you willing to beWould you pay more forgenetically tested? genetically personalized care? No 35% ...
Groups call for 'uncompromising' diabetes care: get them to target and keep them there.
Mar 01, 2005; ... WASHINGTON -- Diabetes must be managed with an "uncompromising insistence to treat to target," according to new guidelines issued by the American College of Endocrinology and the American Association of Clinical Endocrinologists. The document is aimed at putting an stop to the ...
Seniors look to doctors for Medicare drug info.
Mar 01, 2005; ... WASHINGTON -- Older patients are choosing their physician over the phone or electronic resources to help them understand the complexities of the new prescription drug law. Many beneficiaries don't understand what the new law does, and many are not comfortable looking for ...
Treatment of substance abuse and mental illness should occur together.(News)
Mar 01, 2005; ... WASHINGTON -- The Substance Abuse and Mental Health Services Administration is now telling health professionals to expect to see substance use with other mental health disorders and to treat both problems at the same time. The release of "Treatment Improvement Protocol (TIP) 42: ...
Avoid valproate in fertile women, expert panel recommends.(News)
Mar 01, 2005; ... NEW ORLEANS -- Valproate should not be prescribed as first-line therapy for any indication in women of childbearing age because it increases the risk of major malformations in exposed infants, the American Epilepsy Society's pregnancy outcomes forum panel has recommended. ...
Rise in obesity surgery prompts look at standards.(News)
Mar 01, 2005; ... The rush to offer bariatric surgery to the growing number of obese Americans has resulted in a proliferation of procedures performed, sometimes without the necessary experience to manage those high-risk patients. It's unclear if more deaths or complications have resulted from ...
U.S. infant mortality rate rises for the first time since 1958.(News)
Mar 01, 2005; ... The U.S. infant mortality rate rose in 2002, the first such increase since 1958, researchers at the Centers for Disease Control and Prevention reported. The increase, from 6.8 infant deaths per 1,000 live births in 2001 to 7 deaths per 1,000 live births in 2002, was primarily ...
Collaborating to serve.(Editorial)
Mar 01, 2005; ... Cultural rhetoric paints doctors and lawyers as natural enemies. In reality, both share a fundamental mission: to use specialized knowledge of systems to help people. Efforts to join the two professions in the pursuit of a common cause can thus be powerful agents for change. A ...
Should red and processed meats be removed from U.S. dietary guidelines?(Pro & Con)
Mar 01, 2005; ... [YES] The study by Ann Chao, Ph.D., et al. that recently appeared in the Journal of the American Medical Association showing that red and processed meat consumption greatly increases one's risk of colon cancer is but one example of the problems with a meat-based diet. Multiple studies, as ...
Chronic fatigue in adolescents.(Guest Editorial)
Mar 01, 2005; ... For adolescents with chronic fatigue syndrome, one of the most important factors in their successful treatment and recovery is the early recognition of the illness and the support of a caring primary care physician. Chronic fatigue syndrome (CFS) is most easily recognized in adolescents ....
Pulmonary artery catheterization not useful.(Cardiovascular Medicine)
Mar 01, 2005; ... NEW ORLEANS -- Routine use of an indwelling pulmonary artery catheter to guide medical therapy in patients hospitalized for &compensated heart failure can no longer be justified, according to the findings of a National Heart, Lung, and Blood Institute-sponsored randomized trial. ...
Elevated troponin a red flag in heart failure: high serum levels of the protein can identify patients as high risk, data from the ADHERE registry show.(Cardiovascular Medicine)
Mar 01, 2005; ... SAN FRANCISCO -- Patients seen in the emergency department for acute decompensated heart failure fared much worse if they had elevated serum troponin, W. Frank Peacock IV, M.D., said in a poster at the annual meeting of the American College of Emergency Physicians. The results ...
Social factors predict onset of depression in heart failure.(Cardiovascular Medicine)
Mar 01, 2005; ... NEW ORLEANS -- A brief checklist of social and health factors predicts onset of depressive symptoms in heart failure patients, Edward P. Havranek, M.D., said at the annual scientific sessions of the American Heart Association. The four-item checklist consists of living alone, ...
Conivaptan reverses hyponatremia, studies show.(Cardiovascular Medicine)
Mar 01, 2005; ... NEW ORLEANS -- Conivaptan was safe and effective for treating hyponatremia in three phase III studies that together involved about 200 evaluable patients. Based in part on these findings, the Food and Drug Administration issued an approvable letter for conivaptan last December ....
Chronic methamphetamine use appears to be cardiotoxic.(Cardiovascular Medicine)
Mar 01, 2005 ... NEW ORLEANS -- Chronic use of methamphetamine can lead to nonischemic, dilated cardiomyopathy and profound left-ventricular dysfunction, according to a study of 53 methamphetamine users seen at a single medical center in California. "To our knowledge, this is the first study of ...
Low relative lymphocyte count flags cardiomyopathy risk.(Cardiovascular Medicine)
Mar 01, 2005 ... NEW ORLEANS -- A depressed relative lymphocyte count was associated with an increased risk of death in patients with hypertrophic cardiomyopathy in a study with 962 patients. The relative lymphocyte count (RLC) is an inexpensive, universally available test "that may be helpful ...
USPSTF: screen older male smokers for AAA.(Cardiovascular Medicine)(United States. Preventive Services Task Force)(abdominal aortic aneurysms )
Mar 01, 2005; ... The U.S. Preventive Services Task Force is recommending that men between the ages of 65 and 75 years, who are or have been smokers, undergo a one-time ultrasound screening for abdominal aortic aneurysm. The recommendation is based on new evidence that has shown that screening ...
Bare-metal stents match bypass in 5-year mortality.(Cardiovascular Medicine)
Mar 01, 2005; ... MUNICH -- Percutaneous treatment of coronary stenosis with stents carries the same mortality risk as coronary bypass surgery but a significantly higher rate of later revascularization procedures, based on 5-year follow-up results from a randomized study with about 1,200 patients. ...
Prior oxygen boost may aid post-CABG cognition.(Cardiovascular Medicine)(coronary artery bypass graft )(Brief Article)
Mar 01, 2005; ... NEW ORLEANS -- Spending a few hours in a hyperbaric chamber before undergoing on-pump coronary artery bypass graft surgery markedly reduces post-operative neurocognitive dysfunction, according to the findings of a randomized double-blind trial. The trial included 64 patients ...
Cardiovascular risks rising in Native Americans.(Cardiovascular Medicine)
Mar 01, 2005; ... ATLANTA -- The prevalence of cardiovascular risk factors and cardiovascular disease is alarmingly high and continues to rise in Native Americans, according to several reports at a prevention conference on heart disease and stroke sponsored by the Centers for Disease Control and Prevention ....
Low-molecular-weight heparin may aid acute MI: reviparin improved patient outcomes in thrombolysis with streptokinase or urokinase.(Cardiovascular Medicine)
Mar 01, 2005; ... NEW ORLEANS -- Antithrombotic treatment, in the form of the low-molecular-weight heparin reviparin, has been shown for the first time to safely improve the outcomes of patients with an acute myocardial infarction. "Although heparin is often routinely used to treat patients with ...
Heart attack outcomes called 'dismal' in renal disease patients.(Cardiovascular Medicine)
Mar 01, 2005; ... NEW ORLEANS -- Mortality is extra-ordinarily high in the year after acute MI in patients with renal failure--and the explanation may lie largely in their strikingly different clinical characteristics as compared with the general MI population. In this regard, dialysis patients ...
An on-site diabetes educator may boost patient outcomes.(Metabolic Disorders)
Mar 01, 2005; ... WASHINGTON -- A "chronic care model" that includes a diabetes educator actually working in the primary care office can ease the burden on the physician and improve outcomes for patients with diabetes, Linda M. Siminerio, Ph.D., said at a consensus conference organized by the American ...
Better, smaller: the future of continuous monitors.(Metabolic Disorders)(continuous glucose monitoring devices)
Mar 01, 2005; ... KEYSTONE, COLO. -- Look for next-generation continuous glucose monitoring devices to be more accurate, less obtrusive, and easier for diabetic patients and their families to use, according to H. Peter Chase, M.D. Among the numerous devices in development, he singled out two for ...
For type 1 diabetes patients, islet cell transplants are a potential therapy.(Metabolic Disorders)
Mar 01, 2005; ... KEYSTONE, COLO. -- Formidable obstacles continue to prevent pancreatic islet transplantation from having a major impact on type 1 diabetes despite the spectacular technical advances of the past 4 years, Ronald G. Gill, Ph.D., said at a conference on management of diabetes in youth. ...
Mother's pediatric type 2 diabetes affects offspring.(Metabolic Disorders)
Mar 01, 2005; ... QUEBEC CITY -- The long-term complications of childhood type 2 diabetes can stretch beyond the patient and into the next generation, according to new data from the University of Manitoba, Winnipeg. In a cohort of almost 90 children born to mothers diagnosed with childhood type 2 ...
Size doesn't matter most in thyroid nodule malignancy.(Metabolic Disorders)
Mar 01, 2005; ... CHICAGO -- The two most important things to gather from an ultrasound study of thyroid nodules is the solidity and the presence or absence of calcifications, according to one expert. These characteristics, not size, should guide a physician's decision about whether to perform a ...
Surgeon volume affects resection in thyroid ca.(Metabolic Disorders)(cancer)
Mar 01, 2005; ... VANCOUVER, B.C. -- Most thyroid cancer surgery is done by low-volume operators, who are less likely to perform a total thyroidectomy than are high-volume surgeons, Philip I. Haigh, M.D., reported at the annual meeting of the American Thyroid Association. That being said, the ...
Increased risk of low BMD in congenital adrenal hyperplasia.(Metabolic Disorders)(bone mineral density)
Mar 01, 2005; ... LISBON -- Women who receive long-term glucocorticoid treatment for congenital adrenal hyperplasia due to 21-hydroxylase deficiency are at risk for decreased bone mineral density, Jeremy A. King, M.D., reported in a poster presentation at the 12th International Congress of Endocrinology. ...
Pertussis cases show need for adult booster shot.(Infectious Diseases)
Mar 01, 2005; ... Three recent hospital pertussis outbreaks and one infant death from the disease strongly point to the need for improved recognition and protection against transmission, the Centers for Disease Control and Prevention said. The cases, from four states, also illustrate the ...
Transmission of MRSA traced to breast milk.(Infectious Diseases)(Methicillin-resistant Staphylococcus Aureus)
Mar 01, 2005; ... WASHINGTON -- Methicillin-resistant Staphylococcus aureus has been transmitted via breast milk, Dawn Terashita Gastelum, M.D., reported in a poster presentation at the annual Interscience Conference on Antimicrobial Agents and Chemotherapy. The two reported cases, which resulted ...
140 L.A. children hospitalized with MRSA in 6 months.(Infectious Diseases)(methicillin resistant Staphylococcus aureus )(Brief Article)
Mar 01, 2005; ... WASHINGTON -- A clonal outbreak of community-acquired methicillin-resistant Staphylococcus aureus in Los Angeles County led to a high rate of hospitalizations among children in 2003, Elizabeth Bancroft, M.D., reported in a poster at the annual Interscience Conference on Antimicrobial ...
Resistant TB may spur WHO guideline revision: currently recommended first-line TB treatments may be contributing to drug resistance.(Infectious Diseases)(tuberculosis)
Mar 01, 2005; ... MIAMI BEACH -- An effective fight against increasing resistance to tuberculosis treatment worldwide may require rethinking of the World Health Organization's recommended standard treatment regimen, David Olson, M.D., said at the annual meeting of the American Society of Tropical Medicine ...
Many symptoms, long duration: think Lyme disease.(Infectious Diseases)
Mar 01, 2005 ... BOSTON -- Persistent musculoskeletal pain, headache, fatigue, and cognitive dysfunction that occur for no apparent reason over a prolonged period of time are key elements of a clinical diagnosis of chronic Lyme disease in children, results of a retrospective study has shown. ...
Hantavirus survivors have long-term pulmonary, renal complications.(Infectious Diseases)
Mar 01, 2005 ... MIAMI BEACH -- Hantavirus survivors commonly experience fatigue, shortness of breath, and myalgias up to 5 years after infection, according to the final summary of a longitudinal, prospective study. Proteinuria, which may be clinically significant as a predictor of renal ...
In HIV therapy adherence, almost isn't good enough.(Infectious Diseases)
Mar 01, 2005; ... Being almost compliant with antiretroviral therapy was associated with a sharp increase in the risk that HIV-infected patients would develop resistance to one or more of the drugs, P. Richard Harrigan, Ph.D., reported at an American Medical Association press briefing. In a ...
Handheld computers may assist in HIV education.(Infectious Diseases)
Mar 01, 2005; ... SAN FRANCISCO -- Educational videos on handheld computers were a hit with patients learning how to start or switch HIV medications, a preliminary study of 50 patients found. Handheld computers, also called personal digital assistants (PDAs), could be useful tools in educating ...
Pros and cons to testing for HIV-drug resistance.(Infectious Diseases)
Mar 01, 2005; ... SAN FRANCISCO -- All official guidelines on HIV treatment either make blanket recommendations for drug-resistance testing or at least suggest that the clinician consider such testing depending on the patient's circumstances, Brad Hare, M.D., said at a meeting on HIV management sponsored by ...
Metronidazole treats tonsillitis anaerobes.(Infectious Diseases)
Mar 01, 2005; ... WASHINGTON -- Metronidazole is effective in the treatment of non-[beta]-hemolytic streptococcal tonsillitis, Itzhak Brook, M.D., reported in a poster presentation at the annual Interscience Conference on Antimicrobial Agents and Chemotherapy. Although group A [beta]-hemolytic ...
Neuropathy case linked to metronidazole.(Infectious Diseases)
Mar 01, 2005; ... SAVANNAPI, GA. -- Brief metronidazole treatment has been associated with a case of reversible autonomic neuropathy in a 15-year-old girl, Lisa Hobson-Webb, M.D., reported in a poster at the annual meeting of the American Association of Electrodiagnostic Medicine. "This has never ...
Strep throat: cephalosporin beat penicillin.(Infectious Diseases)
Mar 01, 2005; ... WASHINGTON -- A short-course regimen with a cephalosporin was more effective than a 10-day regimen with penicillin for curing strep throat, based on a metaanalysis of 14 studies done in adults and children. A short-course regimen, which usually lasts 5 days, runs counter to what ...
Therapy for acute bacterial sinusitis.(Drug Update)
Mar 01, 2005; ... Acute bacterial sinusitis is usually preceded by a viral infection of the upper respiratory tract. Because experts agree that the indiscriminate use of antibiotics for sinusitis has contributed to the emergence of resistant organisms, antibiotic therapy should be reserved for patients who ...
Recognizing deadly anticonvulsant side effects.(Skin Disorders)
Mar 01, 2005; ... STOWE, VT. -- "Tell me you have a patient with a rash who also happens to have a seizure disorder [and it's] enough to make me stop what I'm doing and get right over," Dirk M. Elston, M.D., said at a dermatology conference sponsored by the University of Vermont. The patient ...
Corticosteroids may promote favorable outcome in SJS, TEN.(Skin Disorders)(Stevens-Johnson syndrome)(toxic epidermal necrolysis)
Mar 01, 2005; ... VIENNA -- Corticosteroid therapy for Stevens-Johnson syndrome and toxic epidermal necrolysis received a big boost from two observational studies presented at the annual meeting of the European Society for Dermatological Research. Juergen Schlingman, M.D., reported on 281 ...
Endogenous protein protects skin from E. coli.(Skin Disorders)
Mar 01, 2005; ... VIENNA -- Healthy skin secretes an antimicrobial protein called psoriasin that is a potent Escherichia coli-killing compound, Regine Glaser, M.D., said at the annual meeting of the European Society for Dermatological Research. Psoriasin appears to be the principal reason that ...
Atopic dermatitis more common in very clean home.(Skin Disorders)(Brief Article)
Mar 01, 2005; ... FLORENCE, ITALY -- A case-control study conducted in Greece lends support to the theory that a "superclean" environment during infancy and early childhood may predispose children to atopic dermatitis. Penny Emmanouil, M.D., and associates in the department of dermatology at ...
5-year survival has improved for invasive melanoma.(Skin Disoders)
Mar 01, 2005; ... SANDIEGO -- Over the next 15 years, 5-year survivors of melanoma have a 91.5% chance of having achieved cure, Duane C. Whitaker, M.D., reported at a melanoma update sponsored by the Scripps Clinic. "Stated another way, all comers with an invasive melanoma--regardless of ...
Fast and effective: full-body examinations uncover otherwise missed skin lesions.(Skin Disorders)
Mar 01, 2005; ... KEY BISCAYNE, FLA. -- A full-body examination is a quick and useful tool to screen patients and uncover benign and cancerous lesions that would otherwise remain undetected, according to a study presented at the annual meeting of the Noah Worcester Dermatological Society. Kenneth ...
The eyes have it: look for periocular melanoma.(Skin Disorders)
Mar 01, 2005; ... SAN DIEGO -- Ocular and periocular melanoma will occur in fewer than 2,900 people in the United States in 2005, Geva Mannor, M.D., said at a melanoma update sponsored by the Scripps Clinic. Despite the rare prevalence of these lesions, it's important to understand who is at risk ...
Sun protection factor rating is ideal, not actual, protection.(Skin Disorders)(Brief Article)
Mar 01, 2005; ... SAN DIEGO -- No matter what sun protection factor sunscreen you recommend, remember that the SPF system has its limitations, Shanna Meads, M.D., advised at a melanoma update sponsored by the Scripps Clinic. For one thing, SPF measures only UVB protection, not protection from ...
Derm DX.(Skin Disorders)
Mar 01, 2005; ... A 71-year-old woman presented with expanding necrolytic erythema on her tongue and perineum. Her history was remarkable for eczema, anemia, and painful glossitis during the previous year. She had experienced nausea and vomiting for 6 months and "striking" 20 kg weight loss during the ...
Identify, eliminate triggers to reduce hair shedding.(Skin Disorders)
Mar 01, 2005; ... STOWE, VT. -- Getting to the root of diffuse hair shedding requires uncovering and eliminating or treating the possible triggers, said Wilma E Bergfeld, M.D. "The key to optimal management of shedding, or telogen effluvium, is detective work," Dr. Bergfeld said at a dermatology ...
Treatment of lice requires specificity.(Skin Disorders)
Mar 01, 2005; ... STOWE, VT. -- Location, location, location. Where lice live on the body and how they got there are important considerations for optimal diagnosis and therapy, according to Dirk M. Elston, M.D. While much attention is given to the identification and treatment of head lice because ...
Psoriasis responds to intermittent etanercept.(Skin Disorders)
Mar 01, 2005; ... KOHALA COAST, HAWAII -- New data suggest that etanercept can be given intermittently like other psoriasis treatments, according to a poster that Alice B. Gottlieb, M.D., presented at a conference on clinical dermatology sponsored by the Center for Bio-Medical Communication Inc. ...
Balance SSRI benefits with risks for children.(Mental Health)(selective serotonin reuptake inhibitor)
Mar 01, 2005; ... WASHINGTON -- It is important to balance risks with benefits when considering a selective serotonin reuptake inhibitor to treat a child or adolescent, several experts said at the annual meeting of the American Academy of Child and Adolescent Psychiatry. Among other things, ...
Depression does not predict mortality.(Mental Health)
Mar 01, 2005; ... Depressive symptoms are not independent predictors of mortality, according to data from a national sample of 3,617 adults. The findings of previous studies of associations between depressive symptoms and mortality have been inconsistent, and few of these studies have used ...
Genetic defect may raise risk of depression.(Mental Health)(Brief Article)
Mar 01, 2005; ... A recently discovered genetic mutation that causes dysfunction in the synthesizing of serotonin might explain why some depressed patients are resistant to drug treatment, researchers say. Xiaodong Zhang, M.D., and colleagues at Duke University, Durham, N.C., screened 87 adults ...
Stalking may be linked to right brain dysfunction.(Mental Health)
Mar 01, 2005; ... SCOTTSDALE, ARIZ. -- Some paraphilic stalking behaviors may be associated with right-hemispheric brain dysfunction, Montgomery Brower, M.D., said at the annual meeting of the American Academy of Psychiatry and the Law. The brain's right hemisphere deals with visual-spatial ...
Drug abuse in gay men linked to other issues: depression, partner abuse, and childhood sexual abuse are often intertwined with drug abuse.(Mental Health)
Mar 01, 2005; ... ATLANTA -- Substance abuse is pervasive among gay men and is so intricately intertwined with epidemics of depression, partner abuse, and childhood sexual abuse that adequately addressing one issue requires attention to the others as well, said Ronald Stall, Ph.D., chief of prevention ...
Naltrexone depot formulation increases adherence for alcoholism.(Mental Health)
Mar 01, 2005; ... NEW YORK -- An injectable depot formulation of naltrexone, now in phase III trials, may help overcome the adherence problems that have compromised the drug's efficacy in the treatment of alcohol dependence, Helen M. Pettinati, Ph.D., said at the annual conference of the Association for ...
Antiseizure drug reduces frequency of binge eating.(Mental Health)
Mar 01, 2005; ... Obese patients with binge-eating disorder treated with topiramate in an open-label study binged significantly less often and lost weight, according to a study by Susan L. McElroy, M.D., and her colleagues. A previous, randomized, placebo-controlled trial of 61 patients conducted ...
Question culls child's school problems.(Mental Health)
Mar 01, 2005; ... CHICAGO -- Physicians can screen for academic problems in school-age children by asking parents a simple question, Jeffrey P. Brosco, M.D., said at the annual meeting of the Society for Developmental and Behavioral Pediatrics. Asking parents explicitly, "Do you have any concerns ...
Checklist finds high rates of child PTSD.(Mental Health)(posttraumatic stress disorder )
Mar 01, 2005; ... CHICAGO -- Preliminary findings suggest that the Pediatric Symptom Checklist can identify high rates of posttraumatic stress disorder among children, but that results vary depending on whether a child or parent completes the checklist. Based upon parental responses to the ...
New schizophrenia algorithm being developed.(Mental Health)
Mar 01, 2005; ... STOCKHOLM -- An interactive, online schizophrenia treatment algorithm provides a decision tree complete with graded supporting evidence and special clinical considerations for patients with comorbid or pre-existing conditions, Herbert Meltzer, M.D., said at the annual meeting of the ...