Family Practice News back issues from September 2005:
Clinical trials: minorities needed.(News)
Sep 01, 2005; ... NEW YORK -- Racial disparities in access to health care will disappear only when adequate and representative samples of minorities participate in clinical trials, Winston Price, M.D., said at the annual meeting of the National Medical Association. That disparities in delivery of ...
Doctor pay under Medicare to drop 4.3% next year: docs to Congress: you gotta fix the SGR.(News)(sustainable growth rate formula)
Sep 01, 2005; ... Physicians face a 4.3% cut to Medicare reimbursements next year unless Congress takes action to change the sustainable growth rate formula. The reduction was announced in a proposed rule that would update payment rates and revise payment policies under the program's fee ...
Guidelines aim to offer VBAC to more women.(News)(vaginal birth after cesarean section)
Sep 01, 2005; ... A trial of labor after cesarean section should be offered to all appropriate candidates, and not restricted to those in facilities with surgical teams that are immediately available and present throughout labor, according to new clinical guidelines issued by the American Academy of Family ...
Information technology used mostly for electronic billing in 2003.(VITAL SIGNS)(Brief Article)(Illustration)
Sep 01, 2005 ... <Pre> Information Technology Used Mostly For Electronic Billing in 2003 Electronic billing 73% Electronic medical records 17% Computerized prescription order entry 8% ...
Consumer ad guidelines criticized.(News)(prescription drug advertising)
Sep 01, 2005; ... New voluntary guidelines for direct-to-consumer prescription drug advertising released by the Pharmaceutical Research and Manufacturers of America have drawn criticism from politicians and consumer groups who say they don't go far enough. "While I wish the PhRMA guidelines would ...
Term 'metabolic syndrome' called into question.(News)
Sep 01, 2005; ... Avoid labeling patients with the term "metabolic syndrome," at east until its meaning and medical usefulness can be further clarified, the American Diabetes Association and the European Association for the Study of Diabetes said in a joint statement. The metabolic syndrome, also ...
Metabolic syndrome diagnostic code rarely used in practice.(News)
Sep 01, 2005; ... Despite America's obesity epidemic, use of the diagnostic code for metabolic syndrome in U.S. clinical practice is "rarer than a blue moon," according to Earl S. Ford, M.D. In 2001, the National Cholesterol Education Program (NCEP) established a definition for the metabolic ...
Say goodbye to paper, noncompliant Medicare claims Oct. 1.(News)
Sep 01, 2005; ... Hello, October--goodbye, paper Medicare claims. Oct. 1 marks the date that physicians and other providers may no longer submit any paper Medicare claims; electronically filed claims not in compliance with federal regulations are also prohibited. The rules are part of ...
Adult circumcision may protect against HIV.(News)
Sep 01, 2005; ... RIO DE JANEIRO -- Adult circumcision may protect against infection with HIV, according to the first randomized controlled trial to test the procedure. After 21 months of follow-up, "circumcision prevented 6-7 out of 10 potential HIV infections" in heterosexual South African men ...
Fears of new virulent HIV strain assuaged.(News)(Brief Article)
Sep 01, 2005; ... RIO DE JANEIRO -- Fears that a new, multidrug-resistant, rapidly progressing strain of HIV-1 had surfaced in New York City have been alleviated. Concerns have existed since February, when officials from the New York City Department of Health and Mental Hygiene announced that a ...
Reverset active in patients failing current regimens.(News)
Sep 01, 2005; ... Rio DE JANEIRO -- The novel nucleoside reverse transcriptase inhibitor Reverset is poised to become the newest member of the oldest class of antiretroviral agents, with researchers reporting its promise for HIV-infected patients for whom current antiretroviral regimens have failed and who ...
Mifepristone warnings updated in wake of deaths.(News)
Sep 01, 2005; ... The maker of the abortion drug mifepristone has again announced it is adding to the warnings section of the product's package insert--less than a year after a previous revision--to include information on four deaths that have occurred in women using the drug. The previous ...
Panel recommends approval of fetal monitoring device.(News)
Sep 01, 2005; ... GAITHERSBURG, MD. -- Three years after rejecting it, the Food and Drug Administration's Obstetrics and Gynecology Devices Panel recently unanimously recommended approval of a fetal heart monitor that provides an analysis of fetal ECG during labor. The recommendation came after ...
Diabetes tracking: a public health necessity.(Guest Editorial)
Sep 01, 2005; ... Diabetes is epidemic in New York City and throughout the United States. Self-reported diabetes prevalence among New York City adults has more than doubled in the past decade, from less than 4% to almost 10%. Diabetes is now the fourth leading cause of death and ninth leading ...
Cholesterol wars: how many wins does it take?(Guest Editorial)
Sep 01, 2005; ... For many years, naysayers have questioned the rationale that total or LDL cholesterol plays a role in vascular disease. It was only 11 years ago that results of the landmark Scandinavian Simvastatin Survival Study (4S) exploded into the medical consciousness, showing a remarkable decrease ...
Pay for performance and better care.(Letters)(Letter to the Editor)
Sep 01, 2005; ... I am at a loss regarding Dr. Charles K. Francis' "pro" comments in a recent issue ("Would pay for performance result in better care?" Pro & Con, March 15, 2005, p. 15). Dr. Francis made the case for performance measures potentially being an opportunity to improve the quality of ...
Provisions for marijuana Rx.(Letters)(Letter to the Editor)
Sep 01, 2005; ... The issue of "medical" marijuana, which is not going to go away soon despite its debatable benefits, must be addressed in a reasonable manner, preferably by the medical community first ("Medical Marijuana," Guest Editorial, July 1, 2005, p. 10). While it is probably not ...
Correction.(Correction Notice)
Sep 01, 2005 ... In "Aldosterone Can Play Role in Refractory Hypertension" (June 15, 2005, p. 15), a statement regarding the diagnosis of ...
Medicaid cuts would hurt mentally ill.(Guest Editorial)(Editorial)
Sep 01, 2005; ... Medicaid faces new threats that would undoubtedly harm millions of people with mental disorders and other chronic illnesses. This program comprises more than half of all state and local mental health spending, and without sustained funding, millions of low-income adults and children would ...
Should we screen for Barrett's esophagus?(Pro & Con)
Sep 01, 2005; ... YES Barrett's esophagus seems to be the primary risk factor for development of adenocarcinoma of the esophagus. The disease progresses through a well-defined histologic pathway of metaplasia, low-grade dysplasia, high-grade dysplasia, and ultimately, adenocarcinoma. ...
Rosiglitazone: at 10 years, no liver toxicity seen: experience in more than 7,000 patients shows the agent to be free of troglitazone's side effect.(Metabolic Disorders)
Sep 01, 2005; ... SAN DIEGO -- Rosiglitazone has shown no hint of excess liver toxicity in 10 years of safety monitoring by GlaxoSmithKline, Alexander R. Cobitz, M.D., Ph.D., reported at the annual scientific sessions of the American Diabetes Association. The withdrawal of the first ...
Novel agent lowers glucose without edema, weight gain.(Metabolic Disorders)(metaglidasen)
Sep 01, 2005 ... SAN DIEGO -- Metaglidasen is a novel insulin sensitizer that appears to lower blood glucose as effectively as the thiazolidinediones without causing weight gain or edema, Julio Rosenstock, M.D., reported at the annual scientific sessions of the American Diabetes Association. The ...
Spironolactone effectively counteracts rosiglitazone-associated edema.(Metabolic Disorders)
Sep 01, 2005 ... SAN DIEGO -- Spironolactone appears to be the most effective antidiuretic for the management of rosiglitazone-associated fluid retention, Janaka Karalliedde, M.D., reported at the annual scientific sessions of the American Diabetes Association. Edema is a common side effect of ...
Retinopathy found prior to diabetes development.(Metabolic Disorders)
Sep 01, 2005; ... SAN DIEGO -- Diabetic retinopathy can occur in people who do not yet have diabetes, Richard Hamman, M.D., reported at the annual scientific sessions of the American Diabetes Association. The incongruous finding, among patients with impaired glucose tolerance (IGT) or impaired ...
Coalition reduces amputations in 2 communities: education effort proves 'hard-to-reach' patients can be reached through family, friends, and local leaders.(Metabolic Disorders)
Sep 01, 2005; ... SAN DIEGO -- A community-based education effort to improve foot care among African American males with diabetes in the communities of Charleston and Georgetown, S.C., resulted in a sharp decline in amputation rates, from 79.1 per 1,000 diabetes hospitalizations in 1999 to 31.7 per 1,000 in ...
Infected or not?--Managing lesions of the diabetic foot.(Metabolic Disorders)
Sep 01, 2005; ... CHICAGO -- Clinical symptoms are critical when distinguishing between uninfected and mildly infected diabetic foot lesions, Warren S. Joseph, D.P.M., reported at the Vascular Annual Meeting. For instance, lack of cellulitis indicates lack of infection, as does good granulation ....
Ablation improves drug refactory atrial fib.(Cardiovascular Medicine)(Catheter Ablation for the Cure of Atrial Fibrillation study)
Sep 01, 2005; ... ORLANDO -- A single session of catheter ablation of atrial fibrillation backed up by antiarrhythmic drug therapy proved markedly more effective than antiarrhythmic drugs alone at preventing atrial arrhythmia recurrences in the first-ever randomized multicenter trial of this percutaneous ...
Gender gap in AF recurrence after cardioversion.(Cardiovascular Medicine)(atrial fibrillation)
Sep 01, 2005; ... NEW ORLEANS -- The recurrence rate of persistent atrial fibrillation following cardioversion is significantly higher in women than men, Osnat Gurevitz, M.D., reported at the annual meeting of the Heart Rhythm Society. The mechanism underlying this gender difference is unclear ....
Pipeline for heart failure drugs is chock full.(Cardiovascular Medicine)
Sep 01, 2005; ... VANCOUVER, B.C. -- The recent big therapeutic successes in heart failure have come from implantable electrophysiologic devices--cardiac resynchronization therapy, implantable cardioverter defibrillators--and surgical advances, such as ventricular reduction procedures. Although ...
[beta]-blockers for heart failure.(Drug Update)
Sep 01, 2005; ... Since the late 1990s, [beta]-blockers have been part of the standard regimen for reducing mortality and hospitalizations among patients with heart failure. Results from several clinical trials showed that [beta]-blocker treatment produces about a 35% reduction in mortality in patients with ...
Counterpulsation therapy benefits heart failure.(Cardiovascular Medicine)
Sep 01, 2005; ... ORLANDO -- A standard 7week course of enhanced external counterpulsation therapy in patients with heart failure who are on optimal pharmacotherapy improves their exercise duration, quality of life, and New York Heart Association class for at least 6 months afterward, according to the ...
FDA panel narrowly votes down AbioCor artificial heart.(Cardiovascular Medicine)
Sep 01, 2005; ... GAITHERSBURG, MD. -- The AbioCor total artificial heart did not meet the Food and Drug Administration's humanitarian-device exemption requirements, according to the FDA's Circulatory Systems Devices Panel. The vote was 7-6 against, with one abstention. The committee determined ...
MRSA eyed as pathogen in girls' genital abscesses.(Infectious Diseases)
Sep 01, 2005; ... NEW ORLEANS -- A recent series of "curious" cases of large vulvar or labial abscesses in previously healthy children were associated with methicillin-resistant Staphylococcus aureus and represent the first reported cases of such abscesses in the pediatric and adolescent population, S ....
Community-acquired MRSA expands range.(Infectious Diseases)(methicillin-resistant Staphylococcus aureus)(Brief Article)
Sep 01, 2005; ... BETHESDA, MD. -- Community-acquired methicillin-resistant Staphylococcus aureus was three times more prevalent than nosocomial MRSA in a small, non-teaching community hospital, reported Ananthakrishnan Ramini, M.D., at the annual conference on antimicrobial resistance sponsored by the ...
Rotavirus ups enteric gram-negative sepsis risk.(Infectious Diseases)
Sep 01, 2005; ... Children with rotavirus gastroenteritis face a small but real risk of developing enteric gram-negative sepsis, investigators have reported. Be aware of the possibility of this complication, especially when a child is developing a high fever and lethargy several days after the ...
Don't culture for community-acquired pneumonia.(Infectious Diseases)
Sep 01, 2005; ... SAN FRANCISCO -- Physicians who forgo obtaining cultures from patients who come in with possible community-acquired bacterial pneumonia are probably practicing wisely, John G. Bartlett, M.D., said at the annual meeting of the American College of Physicians. It has been reported ...
Pneumonia hospitalization rule endorsed.(Infectious Diseases)(CURB-65)(Brief Article)
Sep 01, 2005; ... SAN FRANCISCO -- A simple clinical rule known as the CURB-65 can be a big help in identifying those patients with community-acquired pneumonia who need to be hospitalized, Michael S. Niederman, M.D., said at the annual meeting of the American College of Physicians. Unlike the ...
Fed purchase of avian flu vaccine suggested: advisors want the government to purchase all doses and prioritize their use in a pandemic.(Infectious Diseases)
Sep 01, 2005; ... ROCKVILLE, MD. -- Should the United States face an influenza pandemic, the federal government should buy all the vaccine, members of the National Vaccine Advisory Committee agreed at a joint meeting with the Advisory Committee on Immunization Practices. The committees met to ...
U.S. government requests 22 million avian flu vaccine doses.(Infectious Diseases)(Sanofi-Pasteur to supply initial order)
Sep 01, 2005; ... The U.S. government aims to buy millions of doses of avian influenza vaccine, which preliminary data have shown produces a robust immune response against the A (H5N1) virus in some doses. "We have been asked to provide up to 20 million doses of the vaccine, in addition to the 2 ...
Immunization info lags for children under 6.(Infectious Diseases)
Sep 01, 2005; ... Fewer than half of U.S. children under 6 years of age participated in an immunization information system in 2003, the Centers for Disease Control and Prevention reported. One of the Healthy People 2010 goals is to increase to at least 95% the proportion of children under 6 years ...
Federal officials aim to boost confidence in childhood vaccines.(Infectious Diseases)
Sep 01, 2005; ... Federal health officials called a press conference to try to restore public confidence in childhood vaccines despite the charge by some parents that there is a connection between the vaccines and autism. Several autism advocacy groups rallied on Capitol Hill recently to protest ...
Combination shot found as safe as its five components.(Infectious Diseases)(diphtheria, tetanus, polio, and Haemophilus influenzae type b vaccine )
Sep 01, 2005; ... WASHINGTON -- Children who received a combined pertussis, diphtheria, tetanus, polio, and Haemophilus influenzae type b vaccine experienced fever and injection site reactions at rates similar to, or less than, those seen in children who received the component vaccines, Arnd Herz, M.D., ...
Varicella vaccine found effective in outbreak at an elementary school.(Infectious Diseases)
Sep 01, 2005; ... Varicella vaccination was found to be highly effective during an outbreak of varicella among elementary school children in Utah, reported Maryam B. Haddad of the Centers for Disease Control and Prevention, Atlanta, and associates. The outbreak occurred from October 2002 until ...
Echinacea update.(Alternative Medicine: AN EVIDENCE-BASED APPROACH)
Sep 01, 2005; ... The Trial The study, sponsored by the National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (NIH), included a 7-day prophylaxis phase prior to challenge with rhinovirus type 39, followed by a 5-day treatment phase. A ...
In AOM, combo curbs resistant pathogens.(Infectious Diseases)(acute otitis media)
Sep 01, 2005; ... An amoxicillm/clavulanate combination was significantly more effective than azithromycin in eliminating bacterial acute otitis media, including penicillin-resistant strains, reported Alejandro Hoberman, M.D., of the Children's Hospital of Pittsburgh, and his colleagues. In a ...
Glove choice crucial in job-related dermatitis.(Skin Disorders)
Sep 01, 2005; ... HERSHEY, PA. -- The right pair of gloves can make all the difference to patients who develop contact dermatitis from the chemicals they are exposed to on the job, Matthew J. Zirwas, M.D., said at a meeting on contact dermatitis sponsored by Pennsylvania State University. ...
Contact dermatitis in auto mechanic? Think isothiazolinones.(Skin Disorders)
Sep 01, 2005; ... HERSHEY, PA. -- A new onset of dermatitis in an auto mechanic should raise clinical suspicion for contact allergy to isothiazolinone preservatives found in many car repair and maintenance products, Bruce A. Brod, M.D., said at a meeting on contact dermatitis sponsored by Pennsylvania State ...
Infliximab benefits lasting in plaque psoriasis: visible psoriasis was absent in 26% of patients; 47% had no significant impact on social life or activities.(Skin Disorders)
Sep 01, 2005; ... GLASGOW, SCOTLAND -- In the first phase III trial evaluating infliximab for plaque psoriasis, substantial improvements were achieved by week 10 and sustained through week 50 in the majority of patients, Kristian Reich, M.D., reported at the annual meeting of the British Association of ...
Development pipeline filled with oral psoriasis therapies.(Skin Disorders)
Sep 01, 2005; ... CHICAGO -- The future of psoriasis therapy lies in oral therapies now in development, Neil J. Korman, M.D., reported at the 11th International Psoriasis Symposium sponsored by the Skin Disease Education Foundation. "Biologics have made an enormous difference in people's lives, ...
Fumaric acid esters appear to help some patients with severe psoriasis.(Skin Disorders)
Sep 01, 2005; ... GLASGOW, SCOTLAND -- A proprietary formulation of fumaric acid esters has proved, during decades of use in Germany, to be a useful option for some patients with severe, recalcitrant psoriasis. Although the therapy is less than perfect--with gastrointestinal side effects, slow ...
Complex aphthosis easily mistaken for Behcet's.(Skin Disorders)
Sep 01, 2005; ... HOUSTON -- Strict adherence to diagnostic criteria for Behcet's disease can lead physicians to misdiagnose patients who actually have complex aphthosis, Peter J. Lynch, M.D., warned at a conference on vulvovaginal diseases sponsored by Baylor College of Medicine. Oral and ...
Derm Dx.(Skin Disorders)(Letterer-Siwe disease)
Sep 01, 2005; ... A girl born at 41 weeks' gestation was apneic upon delivery and had a rash from head to toe. She was intubated and sent to the NICU. Skin exam showed erythematous papules with purpura, crusting, and ulceration that involved the face, trunk, arms, legs, palms, and soles. The mother had a ...
Low-dose flutamide may help treat female refractory acne.(Skin Disorders)
Sep 01, 2005; ... QUEBEC CITY -- Dosages of the androgen receptor blocker flutamide at 125 mg/day appear to be effective in treating acne in women who have not responded to other medications, James C. Shaw, M.D., reported at the annual conference of the Canadian Dermatology Association. Flutamide ...
Tips for improving teenagers' adherence to acne treatment.(Skin Disorders)
Sep 01, 2005; ... SAN FRANCISCO -- Lack of treatment efficacy is only one of the reasons that acne therapy often fails in teenagers, Lee T. Zane, M.D., reported at a meeting on clinical pediatrics sponsored by the University of California, San Francisco. Poor adherence is also a factor, said Dr ....
Early pimecrolimus reduces AD flares in children.(Skin Disorders)(atopic dermatitis)
Sep 01, 2005; ... SAN DIEGO -- Initiating treatment with pimecrolimus cream 1% during the early signs of atopic dermatitis in infants and children significantly reduced the incidence of flares, prolonged flare-free intervals, and reduced the need for a topical corticosteroid, Elaine Siegfried, M.D., ...
Apligraf matches standard Tx of excision wounds.(Skin Disorders)
Sep 01, 2005; ... CHICAGO -- The quality of healed wounds treated with bilayered cell therapy equaled that of wounds treated with a standard dressing in a randomized, multicenter study of 172 patients, Vincent Falanga, M.D., reported at the annual meeting of the Wound Healing Society. Apligraf, a ...
Tool assesses depression in primary care settings.(Mental Health)(Hamilton Depression Rating Scale)
Sep 01, 2005; ... Boca RATON, FLA. -- An abbreviated Hamilton Depression Rating Scale can quickly assess depression severity and monitor patient response to treatment in a primary care setting, according to a multicenter study. Complete remission of symptoms is the optimal outcome with ...
Target patient's physical symptoms of depression.(Mental Health)
Sep 01, 2005; ... Boca RATON, FLA. -- Targeting physical symptoms of depression in a primary care setting increases the likelihood of treatment response and remission, according to a multicenter study. Somatic symptoms of depression are getting increased attention as part of a drive to achieve ...
Depression common in teen mothers.(Mental Health)(Brief Article)
Sep 01, 2005; ... LOS ANGELES -- Half of adolescent mothers experience significant depression in the first year after giving birth, according to a study of 417 young mothers followed for 48 months. The study included roughly equal numbers of Mexican American, African American, and Caucasian ...
Mental illness flares for some patients in rehab: symptoms worsened in 13% of patients undergoing substance abuse treatment, a VA study showed.(Mental Health)
Sep 01, 2005; ... SANTA BARBARA, CALIF. -- Psychiatric symptoms are common among people with substance abuse disorders, but in most patients those symptoms improve over the course of residential substance abuse treatment. A recent Veterans Affairs study sheds light on patients whose psychiatric ...
Alcoholism study: combo Tx boosts medication compliance.(Mental Health)
Sep 01, 2005; ... SAN JUAN, P.R. -- Patients struggling with medication compliance for alcohol dependence may benefit from a clinical intervention combining medical management and brief counseling sessions, Helen M. Pettinati, Ph.D., said at the annual meeting of the American Academy of Addiction ...
Quality of life scores are poor in kleptomania, pathological gambling.(Mental Health)(Brief Article)
Sep 01, 2005; ... People with symptoms of pathological gambling and kleptomania, regardless of severity, seem to have a very poor quality of life, reported Jon Grant, M.D., of Brown University, Providence, R.I., and Suck-Won Kim, M.D., of the University of Minnesota, Minneapolis. Their study ...
New Orleans leads nation with the most drug-related emergency department visits.(DATA WATCH)(Brief Article)(Illustration)
Sep 01, 2005 ... <Pre> New Orleans Leads Nation With the Most Drug-Related Emergency Department Visits (per 100,000 population) New Orleans 56 Newark 47 Baltimore 46 Boston 46 New York46 Philadelphia42 St. Louis 41 Chicago 40 Detroit ...
Gum disease again tied to pregnancy outcomes: some women with periodontal disease in the study had low-birth-weight babies or preterm babies.(Women's Health)
Sep 01, 2005; ... LOS ANGELES -- A small study adds to the growing body of evidence implicating periodontal disease in poor pregnancy outcomes. Twelve percent of the women with periodontal disease had low-birth-weight babies in a 277-patient observational study. In comparison, only 2% ...
Eclampsia usually occurs late in pregnancy.(Women's Health)
Sep 01, 2005; ... NEW YORK -- Eclampsia has become increasingly rare in Western countries, but it still occurs in 1 in 2,000-3,500 pregnancies--and obstetric clinics must be prepared to treat it, Baha M. Sibai, M.D., said at an obstetrics symposium sponsored by Columbia University and New York Presbyterian ...