Family Practice News back issues from March 2006:
Palliative care gets to a 'tipping point'.
Mar 01, 2006; ... The number of palliative care programs in U.S. hospitals grew from 632 in 2000 to 1,027 in 2003, an increase of 63%, according to results from a large study. The study "demonstrates the increasing recognition by hospitals in the United States and those providing primary care for ...
FDA panel backs stronger warnings on ADHD drugs; voted 8-7 to add black box on cardio risks.(attention-deficit hyperactivity disorder)
Mar 01, 2006; ... GAITHERSBURG, MD. -- The best way to inform physicians, adults with attention-deficit hyperactivity disorder, and parents of children with ADHD about the potential cardiovascular risks of the drugs used to treat the disorder is under consideration at the Food and Drug Administration. ...
ABFM tweaks certification rules, starts 10-year cycle.(American Board of Family Medicine)
Mar 01, 2006; ... A 10-year cycle and off-line self-assessment module options are two of the changes the American Board of Family Medicine has made in its maintenance of certification process--changes that drew praise from some critics who were upset by its original program. "I'm pleased that the ...
Colon cancer regimens extend survival.(News)
Mar 01, 2006; ... SAN FRANCISCO -- Patients with advanced colorectal cancer clearly live longer if they receive three chemotherapeutic drugs during the course of their treatment. Moreover, the addition of a biologic agent holds the promise of even longer survival for many patients, said Dr. Alex ...
Approved, Rotateq awaits nod from ACIP, AAP.(News)(Advisory Committee on Immunization Practices)(American Academy of Pediatrics)
Mar 01, 2006; ... ROCKVILLE, MD. -- The Food and Drug Administration has approved the first oral vaccine against rotavirus, and the first since a previous vaccine was withdrawn from the market in 1999. Merck & Co. said it is already taking orders for its Rotateq vaccine, but the product has not ...
Low-fat diet fails to cut cancer, CVD risk.(News)
Mar 01, 2006; ... Eating a low-fat diet did not affect rates of cardiovascular disease, coronary heart disease, stroke, or colorectal cancer in the largest-ever long-term randomized trial of a dietary intervention in postmenopausal women. The study showed a small reduction in the rate of invasive ...
AHRQ report casts doubt on diagnosing breast ca noninvasively.(News)(Agency for Healthcare Research and Quality)
Mar 01, 2006; ... Noninvasive techniques should not be used to avoid a biopsy for patients in whom mammography has identified a suspicious growth, according to a new report from the Agency for Healthcare Research and Quality. In a review of the relevant scientific literature similar to the ...
CDC-developed rapid avian flu detection test gets FDA nod.(News)(Centers for Disease Control and Prevention)(Brief article)
Mar 01, 2006; ... A rapid test to detect human infection with avian influenza provides preliminary results in just 4 hours instead of the standard 23 days, according to officials with the Food and Drug Administration and the Centers for Disease Control and Prevention. The test is being made ...
Slashing accounts receivable, Part II.(Guest Editorial)
Mar 01, 2006; ... I knew my December 2005 column, which suggested asking each patient for a credit card number and billing balances to the card account as they come in, was an idea whose time had come. But I was quite unprepared for the huge volume of feedback. Questions and requests for copies of my credit ...
Putting: herbal therapies to the test.(Guest Editorial)(Editorial)
Mar 01, 2006; ... As interest in herbs and phytomedicines continues to grow, physicians and patients alike may wonder which products can be considered reliable, based on their quality and/or their clinical efficacy. At least four organizations have established third-party programs to test and ...
The crux of clinical trials.(Brief article)
Mar 01, 2006; ... Dr. David Orentlicher and Dr. Thomas Kintanar tackled a provocative topic, but missed some important points ("Should patients be required to take part in comparative clinical trials?" Pro & Con, Dec. 1, 2005, p. 12). Refusal by eligible subjects to participate is only one ...
Pill splitting means irregular dosing.(Letters)(Letter to the editor)
Mar 01, 2006; ... Both Dr. Michael P. Cecil and Dr. Paul Antony missed the point in their discussion of pill splitting ("Should physicians encourage pill splitting as a way to help patients save money?" Pro 84 Con, Jan. 15, 2006, p. 15). Pills do not split 50:50, even if they are scored and ...
Bypass grafting trumps PCI for coronary disease.(Cardiovascular Medicine)
Mar 01, 2006; ... CHICAGO -- Bypass grafting is superior to percutaneous intervention for the treatment of severe coronary artery disease, according to a large retrospective study presented at the annual meeting of the Society of Thoracic Surgeons. The study, prompted in part by what the authors ...
Manage statin-associated myopathy concerns.(Cardiovascular Medicine)
Mar 01, 2006; ... SNOWMASS, COLO. -- When starting patients on statin therapy, it's important to acquaint them with the characteristic ways in which statin-associated myopathy differs from everyday aches and pains, Dr. Robert A. Vogel said at conference sponsored by the Society for Cardiac Angiography and ...
Time to rethink adult congenital heart disease.(Cardiovascular Medicine)
Mar 01, 2006; ... One morning a few months ago, Dr. Dan Murphy was awakened at 3 a.m. with news of a tragic case. The patient, a 38-year-old man, had been operated on twice during childhood for a heart defect--once to get him stable and then again to fix the defect. Once he reached adolescence, ...
Dyspnea in diabetics should trigger close CVD work-up.(Metabolic Disorders)(cardiovascular diseases)
Mar 01, 2006; ... SNOWMASS, COLO. -- The complaint of shortness of breath in a diabetic patient without known coronary artery disease is a red flag that should trigger an extensive cardiovascular work-up including stress myocardial perfusion imaging, Dr. George A. Beller said at a conference sponsored by ...
Intensive insulin control cut morbidity, not death in ICU.(Metabolic Disorders)
Mar 01, 2006; ... Targeting blood glucose levels to below 110 mg/dL with insulin therapy prevented morbidity but did not significantly reduce mortality among patients in a medical intensive care unit, said Dr. Greet Van den Berghe and her associates, of Catholic University of Leuven, Belgium. A ...
Rapid glycemic control may complicate cataract surgery.(Metabolic Disoders)
Mar 01, 2006; ... Rapid glycemic correction before cataract surgery should be avoided in patients with moderate to severe diabetic retinopathy because it might increase the risk of retinopathy or maculopathy progression. Blood glucose levels that are quickly corrected in the 3 months before ...
Morbid obesity complicates intubation.(Clinical Capsules)(Brief article)
Mar 01, 2006 ... Despite attempts at optimal positioning, it's significantly more difficult to intubate patients who are morbidly obese than those of normal weight, according to a poster presentation by Dr. Thomas C. Mort at the annual congress of the Society of Critical Care Medicine. In a ...
Birth control and weight gain.(Clinical Capsules)(Brief article)
Mar 01, 2006 ... Use of depot medroxyprogesterone acetate was associated with increasing weight gain in obese girls during an 18-month prospective study, reported Dr. Andrea E. Bonny of Case Western Reserve University, Cleveland. Of 450 girls aged 12-18 years, most of whom were using hormonal ...
Obesity and IUI outcomes.(Clinical Capsules)(intrauterine insemination)(Brief article)
Mar 01, 2006 ... Obese, ovulatory women can achieve similar pregnancy rates with intrauterine insemination, compared with women of normal weight, but obese women require higher doses of gonadotropins for adequate ovarian stimulation, according to Dr. William C. Dodson of Pennsylvania State University in ...
Alendronate increases bone density, trial confirms.(Metabolic Disorders)
Mar 01, 2006; ... SAN DIEGO -- Postmenopausal women with low bone density who received once-weekly alendronate 70 mg had significantly greater increases in bone mineral density and reductions in markers of bone turnover over a 2-year period, compared with those who received once-weekly risedronate 35 mg, ...
Counsel select travelers on malaria prevention.(Infectious Diseases)
Mar 01, 2006; ... WASHINGTON -- Long-term travelers to countries with high risk for malaria should use personal protective measures and chemoprophylactic regimens based on the risk factors they are likely to encounter, Patricia Schlagenhauf-Lawlor, Ph.D., said at the annual meeting of the American Society ...
Few American travelers bother with hepatitis B prevention.(Infectious Diseases)
Mar 01, 2006; ... WASHINGTON -- Most American travelers to regions endemic for hepatitis B do not receive pretravel health advice and are underimmunized, according to an anonymous survey of 618 adult travelers to such areas. In the survey of people who traveled to countries with moderate to high ...
Value of early meningococcal symptoms debated.(Infectious Diseases)
Mar 01, 2006; ... Recognition of the early meningococcal disease features of leg pain, old hands and feet, and abnormal skin color may help get children to the hospital faster than classic symptoms that occur later in the illness, reported Dr. Matthew J. Thompson of the University of Oxford (England) and ...
MRSA colonization may affect up to 2.3 million: the CDC recommends not just antimicrobials, but a 'multipronged" strategy.(Infectious Diseases)
Mar 01, 2006; ... WASHINGTON -- As many as 2.3 million people in the United States carry methicillin resistant Staphylococcus aureus, Dr. Daniel B. Jernigan reported at the annual Interscience Conference on Antimicrobial Agents and Chemotherapy. The estimate comes from a recent study in which ...
Skin lesions rare in neonatal herpes, assess activity levels.(Infectious Diseases)(Brief article)
Mar 01, 2006; ... LAS VEGAS -- Most cases of disseminated neonatal herpes and CNS neonatal herpes do not present with skin lesions, Dr. M. Jeffrey Maisels noted at a meeting sponsored by the American Academy of Pediatrics" California Chapters 1, 2, 3, and 4 and the AAP. "You can't rely on seeing ...
'When in doubt, biopsy' nail pigment streaks.(Skin Disorders)
Mar 01, 2006; ... SAN DIEGO -- A longitudinal pigmented streak beneath the nail could either be a benign melanonychia striata or a far-from-benign subungual melanoma, but despite the vast difference in prognosis, the two conditions are very difficult to tell apart clinically, Dr. Constance Nagi said at a ...
Don't ignore changing skin lesions during pregnancy.(Skin Disorders)
Mar 01, 2006; ... SAN DIEGO -- A pregnant patient's suspicious or changing skin lesion should be investigated as promptly and as thoroughly as the same lesion in a nonpregnant patient, Dr. Dina Massry said at a melanoma update sponsored by the Scripps Clinic. Studies pointing to delayed diagnosis ...
FDA approves once-daily topical combo of steroid, vitamin D for psoriasis Tx.(Skin Disorders)(Brief article)
Mar 01, 2006; ... The Food and Drug Administration in January approved Taclonex, a new topical therapy for psoriasis. The combined steroid and vitamin D3 analogue ointment adds both choice and convenience to the currently available first-line treatments for the disease, Dr. Alan Menter said in an ...
Derm Dx.(Skin Disorders)(eosinophilic fasciitis )
Mar 01, 2006; ... 56-year-old woman presented with a 7-month history of discolored, painful, tender round marks on her legs and neck that rapidly increased in size to cover large areas of her trunk and legs. Arthralgias and diffuse hair loss ensued. What's your diagnosis? When the woman was ...
Viewing addiction as a syndrome will open doors.(Mental Health)
Mar 01, 2006; ... COLORADO SPRINGS -- All addictions, whether chemical or behavioral, should be viewed as different manifestations of an underlying addiction syndrome-and addiction recovery programs will fail to achieve optimal outcomes until their protocols reflect this view, Howard J. Shaffer, Ph.D., said ...
Alcohol dependence.(Drug Update)
Mar 01, 2006; ... The medications approved to treat alcohol dependence are severely underused despite evidence of their efficacy. It's estimated that less than 1% of people with alcohol dependence and abuse receive medication as part of their treatment. That's despite a call by the National Institute on ...
U.S. surveys show paths to addiction treatment.(Mental Health)
Mar 01, 2006; ... BETHESDA, MD. -- Treatment for substance use disorders continues to be out of reach for many people who need it at a time in which funding for treatment and health plan coverage of substance abuse remains stagnate, Constance M. Horgan, Sc.D., said at the annual conference of the ...
Consider ethnicity when screening for depression.(Mental Health)(Brief article)
Mar 01, 2006; ... SANTA ANA PUEBLO, N.M. -- Different populations may require different screening instruments for depression, according to investigators who compared the accuracy of methods for detecting depression in 209 terminally ill cancer patients in Japan. The patients' total score on the ...
Watch for growth slowdown with stimulants.(Mental Health)(Brief article)
Mar 01, 2006; ... NEW YORK -- Significant growth slowdown during treatment with stimulants may occur in a small subset of children who require closer monitoring and referral, Dr. Harold E. Carlson said at a psychopharmacology update sponsored by the American Academy of Child and Adolescent Psychiatry. ...
Fetal pulse oximetry fails to lower C-section rate.(Women's Health)
Mar 01, 2006; ... MIAMI -- Fetal pulse oximetry failed to significantly decrease the cesarean delivery rate or to improve neonatal outcomes in a randomized, multicenter study of more than 5,000 women, Dr. Steven L. Bloom said at the annual meeting of the Society for Maternal-Fetal Medicine. ...
New sterilization device nears market.(Women's Health)
Mar 01, 2006; ... The Adiana transcervical sterilization system appears to be easy to use, safe, and effective, according to phase III data, Dr. Alan Johns reported at the annual meeting of the AAGL (formerly the American Association of Gynecologic Laparoscopists). The Adiana Complete system is ...
GI Agents: Part II.(Drugs, Pregnancy, And Lactation)
Mar 01, 2006; ... The second part of this three-part series examines the safety of drugs used to treat several gastrointestinal diseases that cause significant morbidity in pregnant women. * Helicobacter pylori infection: The bacteria H. pylori are associated with chronic active antral gastritis, ...
Strength training slows knee osteoarthritis.(Musculoskeletal Disorders)
Mar 01, 2006; ... BOSTON -- Lower-extremity strength training may do more to stave off the incidence and progression of knee osteoarthritis symptoms in older individuals than do conventional range-of-motion exercises, said Steven A. Mazzuca, Ph.D., at the 10th World Congress on Osteoarthritis, sponsored by ...
Bisphosphonate shown to ease some knee OA.(Musculoskeletal Disorders)(Brief article)
Mar 01, 2006; ... SAN DIEGO -- Risedronate treatment preserved trabecular bone in patients with advanced medial compartment knee osteoarthritis, and at a high dose even appeared to build it, Christopher Buckland-Wright, Ph.D., said at the annual meeting of the American College of Rheumatology. ...
Seniors need strong abdominal muscles.(Exercise Rx)
Mar 01, 2006; ... Abdominal strength is important for everyone, but especially for older patients. The abdominal muscles consist of several layers of overlapping fibers: the rectus abdominus, which runs from the ribs to the pelvis, the internal and external obliques, which weave diagonally along ...
How to help parents prevent obesity in toddlers.(Obesity)
Mar 01, 2006; ... WASHINGTON -- Recognize parenting strategies that hinder or support the development of healthy eating patterns, and you can help prevent obesity in toddlers, Jennifer Orlet Fisher, Ph.D., and Susan L. Johnson, Ph.D., said in a presentation at the annual meeting of the American Academy of ...
Six tips for averting obesity in youngsters.(Obesity)
Mar 01, 2006; ... LAS VEGAS -- There are at least six behavior change strategies physicians can recommend to prevent child and adolescent obesity, Dr. William H. Dietz said at a meeting sponsored by the American Academy of Pediatrics" California Chapters 1, 2, 3, and 4 and the AAR "Reasonable ...
Tap self management to help youths fight obesity.(Obesity)
Mar 01, 2006; ... LAS VEGAS -- Posing an open-ended question is the best way to approach the topic of treatment options when talking with an obese child or adolescent and the patient's family, Dr. William H. Dietz advised at a meeting sponsored by the American Academy of Pediatrics" California Chapters 1, ...
Study exonerates high carbs, low fats as weight gain cause.(Obesity)
Mar 01, 2006; ... Diets that are low in fat and high in carbohydrates from vegetables, fruits, and whole grains do not cause weight gain in postmenopausal women, reported Barbara V. Howard, Ph.D., and her associates in the Women's Health Initiative Dietary Modification Trial. These results ...
Think 'bronchiectasis' in frequent antibiotic users.(Pulmonary Medicine)
Mar 01, 2006; ... KEYSTONE, COLO. -- Anybody who needs two or more courses of antibiotics within a year for respiratory tract infections deserves to be evaluated for bronchiectasis, Dr. Gwen A. Huitt asserted at a meeting sponsored by the National Jewish Medical and Research Center. "It's not ...
Ralstonia found in more Vapotherm devices, recall launched.(Pulmonary Medicine)
Mar 01, 2006; ... Vapotherm respiratory gas administration devices are being voluntarily recalled, following federal government reports that twenty-nine hospitals in 16 states found Ralstonia organisms colonizing the devices, and cultures from approximately 40 pediatric patients also yielded the bacteria. ...
Direct low-literacy patients to cancer screening.(Clinical Rounds)
Mar 01, 2006; ... WASHINGTON -- Physician-directed interventions can increase rates of colorectal cancer screening in patients with low literacy skills, Dr. Charles Bennett reported at a conference on health literacy sponsored by the American College of Physicians Foundation. Patients with ...
Drug adds 6 months to colorectal cancer survival.(Clinical Rounds)
Mar 01, 2006; ... SAN FRANCISCO -- Adding oxaliplatin to a standard, two-drug chemotherapy regimen led to a 30% improvement in median survival among patients with metastatic colorectal cancer, according to early results from an Italian study. Furthermore, patients who received oxaliplatin along ...
Evaluate apnea patients for coexisting rhinitis.(Clinical Rounds)
Mar 01, 2006; ... KEYSTONE, COLO. -- All patients with obstructive sleep apnea should be evaluated and treated for rhinitis, an extremely common coexisting condition, Dr. Robert Ballard said at a meeting sponsored by the National Jewish Medical and Research Center. Several recent studies indicate ...
Age doesn't play into cochlear implant outcomes.(Clinical Rounds)
Mar 01, 2006; ... Patient age has little effect on postoperative outcomes for recipients of cochlear implants, reported Janice Leung and her associates at Johns Hopkins Hospital, Baltimore. In their study of 749 patients with profound hearing loss, patients older than 65 years attained the same ...
Stuffy noses in infants are not always benign.(Clinical Rounds)(Brief article)
Mar 01, 2006; ... RANCHO MIRAGE, CALIF. -- Infants with nasal obstructions due to upper airway infections tend to experience frequent oxygen desaturations during sleep, according to a poster presented by Dr. Henning Wulbrand at a conference on sleep disorders in infancy and childhood sponsored by the ...
'Back to sleep' doesn't apply in presence of apnea.(Clinical Rounds)(Brief article)
Mar 01, 2006; ... Young children with sleep apnea showed more respiratory disturbance when they slept on their backs than in all other positions combined, according to new findings from a chart review. Dr. Kevin D. Pereira and his associates at the University of Texas Health Science Center at ...
Headache, sleep disturbance comorbid in kids.(Clinical Rounds)(Brief article)
Mar 01, 2006; ... RANCHO MIRAGE, CALIF. -- Twenty percent of children with episodic headaches have at least one symptom of sleep disturbance, according to a poster presented by Dr. Lenora M. Lehwald at a conference on sleep disorders in infancy and childhood, sponsored by the Annenberg Center for Health ...
CIND estimated in 23% of U.S. elderly.(Clinical Rounds)(cognitive impairment not classified as dementia)
Mar 01, 2006; ... ORLANDO -- Preliminary findings suggest a 23% prevalence of cognitive impairment not classified as dementia in the U.S. population older than 70, according to results presented at the annual meeting of the Gerontological Society of America. This is a group that could potentially ...
Aspirin cuts first stroke risk by 17%, but for female patients only.(Clinical Rounds)
Mar 01, 2006; ... DALLAS -- Aspirin appears to be effective for primary prevention of stroke in women, but not in men, according to the findings of a metaanalysis presented by Dr. David L. Brown, at the annual scientific sessions of the American Heart Association. "For women with no history of ...
Warfarin, monitoring still top choice for stroke prevention.(Clinical Rounds)
Mar 01, 2006; ... DALLAS -- Oral anticoagulation with warfarin proved superior to clopidogrel plus aspirin for prevention of stroke and other vascular events in patients with atrial fibrillation in the massive Atrial Fibrillation Clopidogrel Trial With Irbesartan for Prevention of Vascular Events, Dr ....
Data back supplements for pediatric ailments.(Clinical Rounds)
Mar 01, 2006; ... LA JOLLA, CALIF. -- Interest in natural supplements is just as strong in pediatrics as it is in adult medicine, Dr. Paula Gardiner said a meeting on natural supplements in evidence-based practice sponsored by the Scripps Clinic. "Kids are being exposed to natural supplements in ...
PPIs vs. peptic ulcer bleeding.(Clinical Capsules)(proton pump inhibitors)(Brief article)
Mar 01, 2006 ... Treatment with proton pump inhibitors reduces the risk of bleeding and abdominal surgery in patients with peptic ulcers, and also reduces mortality among Asian patients with peptic ulcers, according to an updated metaanalysis of 24 randomized controlled trials. Dr. Grigoris ...
Manometry makes all the difference.(Clinical Capsules)(Brief article)
Mar 01, 2006 ... Esophageal manometry provided new information leading to a change in patient management in up to 60% of cases in a prospective study, Dr. Brian E. Lacy said at the annual meeting of the American College of Gastroenterology. The study showed that esophageal manometry (EM) has a ...
Girth predicts CVD risk in women.(Clinical Capsules)(cardiovascular diseases)(Brief article)
Mar 01, 2006 ... Waist circumference of at least 35 inches correlated with several major cardiovascular and metabolic risk factors in a nationwide screening program for women, reported Dr. Lori Mosca, director of preventive cardiology at New York-Presbyterian Hospital/Columbia University Medical Center, ...
Program helps hospitals launch palliative care.(Practice Trends)(Brief article)
Mar 01, 2006; ... A California program has helped hospitals establish palliative care services, according to a recent study evaluating the program 1 year after its completion. Given that more than half of people in the United States die in a hospital, end-of-life care is an important part of ...
Malpractice concerns eat up 10% of premiums.(Practice Trends)
Mar 01, 2006; ... WASHINGTON -- The costs of malpractice insurance and defensive medicine account for about 10 cents of every dollar spent on health care premiums, several speakers said at a press briefing sponsored by America's Health Insurance Plans. Medical liability and defensive medicine ...
Bill halts 4.4% cut.(Policy & Practice)(Brief article)
Mar 01, 2006; ... Congress' long-awaited passage of the budget reconciliation package (also called the Deficit Reduction Act) put a freeze on a 4.4% Medicare pay cut that physicians experienced in the month of January. The congressional action stopped any further reductions but did not increase Medicare ...