Family Practice News back issues from November 2005:
Primary care can do syndrome surveillance.
Nov 01, 2005; ... SAN FRANCISCO -- Primary care practices could provide timely illness information as part of a coordinated syndromic surveillance network for detecting emerging infections or bioterrorism, Philip D. Sloane, M.D., said at the annual meeting of the American Academy of Family Physicians. ...
Drug order shown to be irrelevant for heart failure: [beta]-blocker can be effective when used first.
Nov 01, 2005; ... STOCKHOLM -- A [beta]-blocker and an ACE inhibitor, the two mainstays of heart failure treatment, can be started in either order and be safe and effective, according to results from more than 1,000 patients. Until now, treatment of patients with heart failure usually began with ...
HPV vaccine prevents early cervical cancer.(human papillomavirus )
Nov 01, 2005; ... SAN FRANCISCO -- A multinational study of 11,502 young women showed for the first time that a vaccine for human papillomavirus can prevent precancerous cervical lesions and early in situ cervical cancers, Laura A. Koutsky, Ph.D., reported. The recombinant vaccine against HPV ...
Vital signs.(Brief Article)
Nov 01, 2005 ... <Pre> VITAL SIGNS More Than Half of Patients Discussed Health Information Found Online With Their Physician in the Past Year Never 43% Sometimes 25% Once or twice 18% ...
Study results may lead payers to challenge atypical antipsychotic Rx.(News)
Nov 01, 2005; ... A landmark study of antipsychotics won't dramatically alter prescribing patterns, but could be used by payers to limit access to more expensive atypical antipsychotics, an expert predicted. State Medicaid programs spend more on antipsychotics than for any other drug class, and ...
Atomoxetine given black box warning by FDA.(News)
Nov 01, 2005; ... The Food and Drug Administration's public health advisory on a potential increased risk of suicidal ideation in children and adolescents taking atomoxetine is a cautious move, given the paucity of data. But the data should not be ignored, several experts told FAMILY PRACTICE NEWS. ...
Testosterone may help some post menopause.(News)
Nov 01, 2005; ... Postmenopausal women with symptoms of decreased sexual desire may be candidates for testosterone therapy, according to a position statement from the North American Menopause Society. The group did not recommend testosterone without concomitant estrogen therapy because there are ...
AAFP starts push for hard cap on noneconomic damages.(News)
Nov 01, 2005; ... SAN FRANCISCO -- The best mechanism to hold down increases in medical liability insurance premiums is a hard cap on noneconomic damages of not more than $500,000, according to a report from the American Academy of Family Physicians. "Nothing else has any conclusive data to show ...
Guillain-Barre cases prompt alert on meningococcal shot.(News)
Nov 01, 2005; ... Any physician with a patient who develops Guillain-Barre syndrome after receiving the meningococcal conjugate vaccine should report the case to the Vaccine Adverse Event Reporting System, according to an alert issued by the Food and Drug Administration and the Centers for Disease Control ...
Adult immunization comes of age.(Guest Editorial)(Editorial)
Nov 01, 2005; ... The era of adult immunization is here. Publication of the adult immunization schedule by the Centers for Disease Control and Prevention marks the fourth year in a row that physicians who treat adults get a vaccine chart to post on their walls, just as physicians who treat children and ...
Is Medicare coverage for ICD implants in patients meeting MADIT-II/SCD-HeFT criteria unaffordable?(Pro & Con)(Multicenter Automatic Defibrillator Implantation Trial-II )
Nov 01, 2005; ... YES The government cannot afford to pay for implantable cardioverter defibrillators in all Medicare patients who meet the criteria established in the Multicenter Automatic Defibrillator Implantation Trial-II (MADIT-II) and Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) ....
Putting patients' interests first.(Letters)
Nov 01, 2005; ... The article about concierge medicine raises--albeit tangentially--the age-old question of what to do when the health insurance plan's interests run contrary to the patient's ("Physicians Tailor Their Concierge Care Practices," Sept. 1, 2005, p. 84). Since every U.S. health ...
Concierge care is better for patients.(Letter to the Editor)
Nov 01, 2005; ... I would like to congratulate Dr. Garrison Bliss on recreating the doctor-patient relationship that third-party payers have degraded ("Physicians Tailor Their Concierge Care Practices," Sept. 1, 2005, p. 84). In my retainer practice, my only concern and loyalty is to the ...
From 'assembly line' to concierge joy.(Letters)(Letter to the Editor)
Nov 01, 2005; ... I converted to a "concierge" practice with the aid of MDVIP just over a year ago, and it was the best move I ever made ("Physicians Tailor Their Concierge Care Practices," Sept. 1, 2005, p. 84, and "Legal Risk Seen With Some Retainer-Fee Model Practices," July 15, 2005, p. 66). ...
Parity is good, but not enough.(Letters)
Nov 01, 2005; ... I was both heartened and disappointed by the recent article about the effort by many organizations to push for mental health parity--as well as other issues ("Groups Join Forces in Fight for Mental Health Reform," September 2005, p. 1). In the article, Sen. Edward M. Kennedy was ...
Addition of C-reactive protein levels to Framingham proposed.(Cardiovascular Medicine)
Nov 01, 2005; ... NEW YORK -- The predictive value of the Framingham risk score could change substantially if serum C-reactive protein levels were included in the calculation. An analysis of data collected on more than 15,000 women in the Women's Health Study showed that incorporating C-reactive ...
Teen hypertension often seen but not addressed.(Cardiovascular Medicine)
Nov 01, 2005; ... SAN FRANCISCO -- Physicians may be failing to address abnormal blood pressure levels among adolescents, according to a study presented at the annual meeting of the American Academy of Family Physicians. The study analyzed blood pressure levels recorded on preparticipation sports ...
New scan gives rapid diagnosis of chest pain: a single 15-second scan may replace a battery of tests for serious conditions in emergency situations.(Cardiovascular Medicine)
Nov 01, 2005; ... SAN FRANCISCO -- Chest pain represents one of the most common presenting symptoms in an emergent situation, and it also represents a diagnostic challenge: Is it a pulmonary embolism? Is it an aortic dissection? Is it coronary artery disease? Or is it nothing? Now, new CT ...
Device may improve outcomes of in-hospital cardiac arrest.(Cardiovascular Medicine)
Nov 01, 2005; ... VANCOUVER, B.C. -- The traditional "code blue" strategy of handling in-hospital cardiac arrests has remained essentially unchanged for about 30 years, a period during which--in sharp contrast--massive resources have been devoted to improving public access defibrillation for out-of-hospital ...
Stent patients need to take their aspirin daily.(Cardiovascular Medicine)
Nov 01, 2005; ... STOCKHOLM -- Less than 1% of patients who receive a drug-eluting coronary stent develop late stent thrombosis during the first 1.5 years after implantation, on the basis of a study in more than 2,000 patients. While these and earlier findings showed that drug-eluting stents are ...
Fondaparinux betters enoxaparin in acute coronary syndrome.(Cardiovascular Medicine)
Nov 01, 2005; ... STOCKHOLM -- The antithrombotic agent fondaparinux provided similar short-term efficacy compared with enoxaparin, but dramatically greater safety and superior long-term outcomes in the largest-ever clinical trial involving patients with acute coronary syndrome. Key findings in ...
New drugs aim to raise HDL in short, long term.(Cardiovascular Medicine)(High density lipoprotein cholesterol)
Nov 01, 2005; ... NEW YORK -- Although drug treatments that raise serum levels of HDL cholesterol are already available, several potentially better, more targeted treatments are moving through the development pipeline, H. Bryan Brewer Jr., M.D., said at an international symposium on triglycerides and HDL. ...
Pandemic influenza? Physicians calmly prepare: for now, doctors can just watch and wait. In fact, the only panic that's occurring is among the media.(Infectious Diseases)
Nov 01, 2005; ... Warnings of a potential avian influenza pandemic have the nation and medical community on--alert but those who would be on the front lines appear to be taking the threat in stride. "Everyone I know is fatalistic about it. Everyone knows it's coming, but it's difficult to prepare ...
Most measles cases in 2001-2004 were preventable.(Infectious Diseases)
Nov 01, 2005; ... More than half of all the measles cases reported among United States residents during 2001-2004 were preventable, according to the Centers for Disease Control and Prevention. Although endemic measles has been eliminated from the United States, cases continue to be imported from ...
Prevnar: invasive pneumococcal disease at bay.(Infectious Diseases)(Brief Article)
Nov 01, 2005; ... Routine use of seven-valent pneumooccal conjugate vaccine in young children has dramatically reduced the incidence of vaccine-type and overall invasive pneumococcal disease in children and adults, the Centers for Disease Control and Prevention reported. The most substantial ...
HSV-2 shedding upped by some contraceptives: genital tract shedding of the virus was not associated with vaginal intercourse, new partner, or douching.(Infectious Diseases)
Nov 01, 2005; ... Bacterial vaginosis, high-density group B streptococcus colonization, and the use of hormonal contraceptives each is independently associated with an increased risk of genital tract shedding of herpes simplex virus type 2, Thomas L. Cherpes, M.D., and his colleagues at the University of ...
Valacyclovir cheapest way to prevent neonatal herpes.(Infectious Diseases)(Brief Article)
Nov 01, 2005; ... CHARLESTON, S.C. -- Oral valacyclovir was the most economically favorable treatment choice for the prevention of intrapartum herpes transmission in a recent analysis. The clinical outcomes and costs of the three strategies, including oral valacyclovir, oral acyclovir, and no ...
Valacyclovir proves safe for the long-term suppression of HSV-2.(Infectious Diseases)
Nov 01, 2005; ... CHARLESTON, S.C. -- Once-daily treatment with valacydovir for the suppression of genital herpes caused by herpes simplex virus type-2 was well-tolerated for up to 20 months in a recent study. Previously, data were available only for up to 12 months of daily valacyclovir use, ...
Death rates for diabetic ketoacidosis decline overall.(Metabolic Disorders)
Nov 01, 2005; ... SAN DIEGO -- Deaths from diabetic ketoacidosis among adults in the United States decreased by one-third between 1984 and 2002, Jing Wang and her associates reported in a poster at the annual scientific sessions of the American Diabetes Association. There was no decline, however, ...
One-quarter of diabetic children present with DKA.(Metabolic Disorders)
Nov 01, 2005; ... SAN DIEGO -- One-fourth of children with diabetes present with ketoacidosis at onset, and a majority are hospitalized, Arleta B. Rowers, M.D., reported at the annual scientific sessions of the American Diabetes Association. Younger and poorer children are more likely to present ...
ARBs improve endothelial function, findings show: for patients with impaired glucose intolerance, angiotensin II receptor-1 blockade helps significantly.(Metabolic Disorders)(ACE inhibitors and angiotensin receptor blockers)
Nov 01, 2005; ... TORONTO -- Endothelial function improves significantly with angiotensin II receptor-1 blockade in patients with impaired glucose tolerance, and quickly reverts to baseline after discontinuation of therapy, Thomas H. Schindler, M.D., reported at the annual meeting of the Society of Nuclear ...
Better glucose control in those who know [A.sub.1c] goal.(Metabolic Disorders)
Nov 01, 2005; ... SAN DIEGO -- Nearly half of adult patients who received care at a municipal hospital diabetes clinic did not recognize the term [A.sub.1c], and fewer than one-quarter knew what their hemoglobin Axe level should be, Mary K. Rhee, M.D., reported at the annual scientific sessions of the ...
Glycemic control unchanged despite changes in Tx strategies.(Metabolic Disorders)
Nov 01, 2005; ... SAN DIEGO -- Despite a rise in the number of treatment regimens for adults with type 2 diabetes during the 1990s, national surveys showed no improvement in the number of adults who achieved glycemic control, Tao Fan reported in a poster session at the annual scientific sessions of the ...
Very-low-carb diet curbed metabolic syndrome.(Metabolic Disorders)
Nov 01, 2005; ... NEW YORK -- A very-low-carbohydrate diet was effective at raising serum levels of HDL cholesterol, lowering triglyceride levels, and producing weight loss in overweight patients with metabolic syndrome in a controlled study with 27 patients. The beneficial effects on lipid ...
Studies finally link tanning beds to melanoma.(Skin Disorders)
Nov 01, 2005; ... VANCOUVER, B.C. -- Two new studies presented at the Sixth World Congress on Melanoma have linked tanning bed use and melanoma. "The year 2005 sees the first real, indisputable evidence that tanning bed use contributes to melanoma risk," said Philippe Autier, M.D., of the Jules ...
Extending higher dosage of etanercept found safe: some prescribers may keep patients on a regimen in order to maintain insurance coverage of the drug.(Skin Disorders)
Nov 01, 2005; ... CHICAGO -- Maintaining patients with moderate to severe psoriasis on a higher than recommended dose of etanercept is safe, according to new long-term multicenter phase III data. Although the recommended dosing in the United States is for 3 months of 50 mg etanercept twice ...
Biologic therapies tackle palmoplantar pustulosis.(Skin Disorders)
Nov 01, 2005; ... CHICAGO -- Evidence is mounting that biologic therapies such as alefacept and efallzumab can successfully treat palmoplantar pustular psoriasis. Preliminary data from a pilot study of 15 patients at two sites showed a 16-week course of alefacept (Amevive), including 8 weeks of ...
Prescribers fume over new isotretinoin program.(Skin Disorders)
Nov 01, 2005; ... SANTA BARBARA, CALIF. -- Who's responsible for iPLEDGE, the new, highly restrictive, mandatory registry for isotretinoin prescriptions? A Vioxx-jittery Food and Drug Administration, noncompliant pharmacists, the American Academy of Dermatology, dermatologists, and other ...
Shrink-wrapped lice may have met their match.(Skin Disorders)
Nov 01, 2005; ... SANTA BARBARA, CALIF. -- A suffocation-based pediculicide developed by a dermatologist in his office may offer hope for regaining control over head lice, the bane of elementary school morns and the physicians they hound for a cure. That was the word at the annual meeting of the ...
Combing beats insecticides for lice, study shows.(Skin Disorders)(Brief Article)
Nov 01, 2005; ... Combing wet hair with conditioner and a free-tooth comb is four times more effective at curing pediculosis than water-based, over-the-counter pediculicide shampoos, Nigel Hill, Ph.D., and colleagues reported. The study contradicts others that have found pediculicides more ...
Head lice.(Drug Update)
Nov 01, 2005; ... Infestation with head lice is primarily a problem among healthy school-age children. However, adults can occasionally become infested with--and require treatment for--lice that their children bring home. Lice usually spread by person-to-person contact. Fomite transmission via sharing hats ...
Patch test series may miss cosmetic allergens.(Skin Disorders)
Nov 01, 2005; ... HERSHEY, PA. -- Patch testing with personal cosmetic products or topical prescriptions may identify allergens that are not found on common series in patients with suspected allergic contact dermatitis to cosmetics, Erin M. Warshaw, M.D., said at a meeting on contact dermatitis sponsored by ...
Clinical pearls for diagnosing, treating dermatitis.(Skin Disorders)
Nov 01, 2005; ... BLAINE, WASH. -- Skin disorders such as dermatitis can be vexing to parents and children alike, often out of proportion to their seriousness, Marvin J. Scotvold, M.D., said at a conference sponsored by the North Pacific Pediatric Society. In other instances, "I've had pediatric ...
Adult ADHD prescriptions doubled in 4 years.(Skin Disorders)
Nov 01, 2005; ... The number of young adults, aged 20-44 years, receiving prescriptions for adult attention-deficit hyperactivity disorder has more than doubled in just 4 years, according to an analysis by Medco Health Solutions Inc. And the increase in prescriptions for adult ADHD is likely to ...
Birth defect risk leads to Paxil label change.(Mental Health)
Nov 01, 2005; ... New data linking paroxetine use during the first trimester of pregnancy with increased risk of major congenital malformations has prompted changes to the drug's label. Preliminary results of a retrospective epidemiologic study sponsored by GlaxoSmithKline Inc., the drug's maker, ...
Zoloft was the leading SSRI/SNRI in 2004.(DATA WATCH)(Brief Article)
Nov 01, 2005 ... <Pre> Zoloft Was the Leading SSRI/SNRI in 2004 All Others 16% Paxil CR 8% Celexa9% Lexapro 16% Zoloft 28% Effexor XR 23% Note: Based on share of ...
Reviewing the safety of SSRIs.(Drugs, Pregnancy, And Lactation)
Nov 01, 2005; ... Over the past few years, several published studies have addressed the reproductive safety of the selective serotonin reuptake inhibitors. Recent studies have focused on the risk for neonatal discontinuation syndrome or symptoms of perinatal jitteriness associated with use of SSRIs during ...
Screen helps detect global developmental delay: child-development professionals advocate an in-depth process called developmental surveillance.(Mental Health)
Nov 01, 2005; ... BLAINE, WASH. -- Pediatricians and family physicians need to be alert for the signs of global developmental delay in young children. And when these signs are found they must be carefully followed up, Forrest C. Bennett, M.D., said at a conference sponsored by the North Pacific ...
Home visits fail to identify childhood language delays.(Mental Health)
Nov 01, 2005; ... A home visit program designed to identify early childhood language delays not only failed to spot most delayed children, but also failed to refer the vast majority of identified children for further evaluation or intervention. The results suggest the home visitors didn't get ...
E-mail therapy effectively treats eating disorders.(Mental Health)
Nov 01, 2005; ... MONTREAL -- Psychotherapy for eating disorders can be delivered effectively by e-mail and can reach a segment of the population that might otherwise decline treatment, Paul Robinson, M.D., said at an international conference sponsored by the Academy for Eating Disorders. He ...
Expert sees possible link between strep, anorexia: rarely, group A [beta]-hemolytic streptococcal infection can lead to sudden onset of psychiatric symptoms.(Mental Health)
Nov 01, 2005; ... MONTREAL -- Streptococcal pharyngitis may be a very occasional trigger for anorexia nervosa and other neuropsychiatric conditions and should be investigated in patients with sudden onset of psychiatric symptoms, Mae S. Sokol, M.D., said at an international conference sponsored by the ...
Depression common in eating disorders, complicates Tx.(Mental Health)
Nov 01, 2005; ... BALTIMORE -- Depression frequently co-occurs with eating disorders, making treatment challenging, Graham W. Redgrave, M.D., said at a symposium on mood disorders sponsored by Johns Hopkins University. "There are high rates of concurrent major depressive disorder in anorexia," ...
Refeeding syndrome risk hard to predict with eating disorders.(Mental Health)
Nov 01, 2005; ... MONTREAL -- Refeeding syndrome is a potential problem for all eating-disordered patients who are reintroducing fluids and food, but it is difficult to predict which patients are at greatest risk, Ovidio Bermudez, M.D., said at an international conference sponsored by the Academy for Eating ...
Vaginal delivery linked to high incontinence risk: odds of pelvic floor disorders are increased nearly twofold, compared with cesarean delivery, nulliparity.(Women's Health)
Nov 01, 2005; ... MONTREAL -- Vaginal delivery is associated with a near twofold increased odds of pelvic floor disorders, compared with cesarean delivery and nulliparity, according to results of a large epidemiologic study. "This study finally gives us some numbers to hang our hat on, with ...
Postpartum endoanal scan helps project incontinence risk.(Women's Health)
Nov 01, 2005; ... MONTREAL -- Endoanal ultrasound performed immediately postpartum can identify clinically occult anal sphincter defects, which are linked to an increased risk of anal incontinence, according to a British study. "This technology can improve our prediction of incontinence and has ...
Botox shots may help with resistant incontinence.(Women's Health)
Nov 01, 2005; ... ATLANTA -- Botox may be the answer for women with detrusor overactivity incontinence who have failed to respond to conservative therapy. A cystoscopic technique that uses intradetrusor injections of botulinum toxin A injections to decrease bladder muscle overactivity associated ...
Make discussing exercise in pregnancy a priority: ample evidence shows that regular, moderate exercise in healthy pregnancies has no adverse effects.(Women's Health)
Nov 01, 2005; ... Although exercise is promoted to the general population for its well-recognized benefits, it is still not adequately accepted or recommended during pregnancy, according to Raul Artal, M.D., professor and chair of obstetrics, gynecology, and women's health at St. Louis University. ...
Gastric bypass cuts cardiac risk in morbidly obese: both traditional and emerging biochemical markers improved after surgery, compared with preop values.(Obesity)
Nov 01, 2005; ... ORLANDO -- The clinical benefits of gastric bypass surgery go beyond weight loss and include lowering the risk of coronary artery disease, according to the results of a study presented by D. Brandon Williams, M.D., at the annual meeting of the American Society for Bariatric Surgery. ...
Look beyond BMI in gauging cardiovascular risk for obese.(Obesity)
Nov 01, 2005; ... ORLANDO -- Body mass index alone is not a good indicator of cardiovascular risk in the morbidly obese and should be supplemented with body habitus measures for screening bariatric surgery candidates, Edward H. Livingston, M.D., said at the annual meeting of the American Society for ...
Teen girls' activity levels drop.(Clinical Capsules)(Brief Article)
Nov 01, 2005; ... A steep decrease in activity levels among teen girls as they age has led to increases in body mass index and adiposity, particularly in black girls, reported Sue Y.S. Kimm, M.D., of the University of New Mexico in Albuquerque. Dr. Kimm and her associates assessed body mass index ...
Binge eating disorder.(Clinical Capsules)(Brief Article)
Nov 01, 2005; ... Guided self-help cognitive-behavioral therapy was associated with a significantly higher remission rate for binge eating disorder than was guided self-help behavioral weight loss treatment, but weight loss was minimal among both groups, reported Carlos M. Grilo, Ph.D., and Robin M. Masheb, ...
Managing gastrogastric fistulas.(Clinical Capsules)(Brief Article)
Nov 01, 2005; ... Gastrogastric fistulas are a rare but serious complication of Roux-en-Y gastric bypass, often marked by unresponsive marginal ulcers, failure of weight loss, nausea, and/or vomiting, reported Lester Carrodeguas, M.D., and his associates at the Bariatric Institute and Division of Minimally ...
Antipsychotic-related weight gain.(Clinical Capsules)(Brief Article)
Nov 01, 2005; ... A behavioral weight control program was associated with modest improvements in obese patients taking antipsychotic medications, but longer and more robust interventions are necessary, reported Melissa A. Kalarchian, Ph.D., of the University of Pittsburgh Medical Center, and her associates ....
Payment system thwarts efforts to treat obesity: many physicians try to get counseling paid for by coding for a related comorbidity, such as diabetes.(Obesity)
Nov 01, 2005; ... With the obesity epidemic growing, physicians are facing a payment system that hasn't caught up. Although coverage varies by payer, most Medicare carriers do not pay for office visits coded only for obesity and the same is true for most private payers, physicians told FAMILY ...
Less than half of overweight youth are diagnosed by doctor.(Obesity)
Nov 01, 2005; ... Less than half of overweight children in the United States are told that they are overweight by their physicians, the Centers for Disease Control and Prevention reported. The percentage of children and teens aged 6-19 years who are overweight tripled to 16% during the period ...