Family Practice News back issues from August 2006:
Steroid injections backed for hip OA.(Musculoskeletal Disorders)
Aug 01, 2006; ... AMSTERDAM -- Radiologically guided corticosteroid injections brought marked symptomatic improvement to patients with advanced hip osteoarthritis in a double-blind placebo-controlled randomized trial, Dr. Walter P. Maksymowych reported at the annual European Congress of Rheumatology. ...
Early pregnancy NSAID use tied to malformation risk: cardiac defects are 3.3 times more likely.(Women's Health)
Aug 01, 2006; ... TUCSON, ARIZ. -- Mothers who take NSAIDs during the first trimester of pregnancy face a 2.2-fold increased risk of giving birth to infants with congenital malformations, results from a large, long-term population study show. In addition, subset analysis revealed a 3.3-fold ...
Guidelines: hit type 2 diabetes hard and early.(News)(Disease/Disorder overview)
Aug 01, 2006; ... Metformin therapy should be prescribed along with lifestyle intervention as soon as patients are diagnosed with type 2 diabetes, according to the authors of a new consensus algorithm endorsed by the American Diabetes Association. Based on evidence gleaned from well-controlled ...
Lipitor tops list of branded drugs prescribed by family physicians in 2005.(VITAL SIGNS)(Brief article)
Aug 01, 2006 ... <Pre> VITAL SIGNS Lipitor Tops List of Branded Drugs Prescribed By Family Physicians in 2005 Millions Lipitor 21,714 Synthroid 10,574 Norvasc 10,258 Toprol-XL 10,231 Zoloft 8,531 Zithromax Z-Pak...
Rx error costs exceed $3.5 billion a year.(News)
Aug 01, 2006; ... Each year, patients in the United States experience at least 1.5 million preventable injuries due to medication errors, according to the findings of an Institute of Medicine analysis. The report, released in July, estimated that these preventable adverse drug events would add up ...
Antiseizure drug reduces chronic headache days.(News)
Aug 01, 2006; ... LOS ANGELES -- The anticonvulsant drug topiramate significantly eased chronic daily headaches, one of the most intractable forms of headache to treat, in a randomized, placebo-controlled trial conducted at 46 U.S. centers. Although subjects continued to experience headaches on ...
One question opens doors in migraine treatment.(News)(Disease/Disorder overview)
Aug 01, 2006; ... Los ANGELES -- Health care providers asked lots of questions during videotaped, real-life office visits with migraineurs, but almost always failed to ask the one question that would indicate whether they should prescribe a preventive medication. That question: "Can you tell me ...
ACIP: second varicella vaccine dose advised.(News)(Disease/Disorder overview)
Aug 01, 2006; ... ATLANTA -- A second dose of varicella vaccine should be given to all children at ages 4-6 years, the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention voted at its June meeting. The second dose of varicella vaccine can be given ...
Drug, behavior therapy combat teen obesity.(News)(Disease/Disorder overview)
Aug 01, 2006; ... A Yearlong study of nearly 500 obese adolescents found that combining the weight loss drug sibutramine with behavioral therapy resulted in statistically significant improvements in body mass index and several metabolic risk factors, compared with behavioral therapy alone. In ...
No smoke is 'safe' smoke, says surgeon general.(News)
Aug 01, 2006; ... The science is now anything but hazy: Secondhand tobacco smoke causes premature death and disease in children and adults who don't smoke--and there is no safe exposure level, the U.S. surgeon general warned in a comprehensive report released in June. In a return to a public ...
Vitamins tied to gestational events.(News)(Disease/Disorder overview)
Aug 01, 2006; ... LISBON -- A metaanalysis of results from two major trials of prenatal supplementation with high dosages of vitamins C and E has raised concern about possible adverse effects, such as an increased risk of stillbirths and of gestational hypertension. More stillbirths are "a worry, ...
What is the most appropriate surgery for obese adolescents?(Point/Counterpoint)(Disease/Disorder overview)
Aug 01, 2006; ... Gastric banding is reversible and safer. Laparoscopic placement of an adjustable gastric band is a safe and effective alternative to laparoscopic gastric bypass surgery in the obese adolescent. The vast adult experience in gastric bypass surgery has been excellent, ...
HT report based on 'flawed study'.(Letters)
Aug 01, 2006; ... Imagine my consternation at your advising against hormone therapy on your front page, based on the Women's Health Initiative now discredited as a flawed study ("Risks of Hormone Therapy Dwarfed Benefits in WHI," March 15, 2006, p. 1). A recent study from Brigham and Women's ...
Aspirin may offset NSAID-related heart risks.(Cardiovascular Medicine)(Drug overview)
Aug 01, 2006; ... AMSTERDAM -- Concomitant aspirin use may fully reverse the increased atherothrombotic risk associated with cyclooxygenase-2 selective NSAIDs, Dr. Gurkirpal Singh reported at the annual European Congress of Rheumatology. In addition, aspirin may also reduce--if only partially in ...
Obstructive sleep apnea found a cardiac arrhythmia risk factor.(Cardiovascular Medicine)(Disease/Disorder overview)
Aug 01, 2006; ... BOSTON -- Obstructive sleep apnea is a risk factor for cardiac arrhythmias, and cardiologists should consider the diagnosis and treatment of this sleep disorder in terms of cardioprotective benefit, according to Dr. Maria Teresa La Rovere. In a study she presented in a poster at ...
Bypass patients are at increased risk of AAA.(Cardiovascular Medicine)(abdominal aortic aneurysm)(Disease/Disorder overview)
Aug 01, 2006; ... PHILADELPHIA -- Patients who have undergone coronary bypass surgery have an increased risk of also having an abdominal aortic aneurysm, according to results from a single-center study with 752 patients. Based on this finding, screening for an abdominal aortic aneurysm (AAA) in ...
CPAP lowers blood pressure in patients with sleep apnea.(Cardiovascular Medicine)(continuous positive airway pressure)(Disease/Disorder overview)
Aug 01, 2006; ... SAN DIEGO -- Two weeks of continuous positive airway pressure significantly reduced the blood pressure of hypertensive obstructive sleep apnea patients in a small randomized controlled trial presented in a poster at the International Conference of the American Thoracic Society. ...
Delays can be deadly in young athletes with SCA.(Cardiovascular Medicine)
Aug 01, 2006; ... ATLANTA -- Automated external defibrillators can be a lifesaver in sudden cardiac arrest, the No. 1 cause of death in young athletes, but planning, preparation, and education are essential. "The single most important determinant of survival is the time from cardiac arrest to ...
Imaging methods unveil rupture-prone plaque.(Cardiovascular Medicine)(Disease/Disorder overview)
Aug 01, 2006; ... CHICAGO -- A furiously competitive race is on to develop new imaging methods capable of identifying vulnerable coronary plaques. The first of these technologies to undergo evaluation in prospective clinical trials are virtual histology, palpography, thermography, and multislice ...
Nontraditional plasma markers fill in LDL's predictive gaps.(Cardiovascular Medicine)(Disease/Disorder overview)
Aug 01, 2006; ... SPARKS, NEV. -- Many patients with "normal" levels of LDL cholesterol go on to develop heart disease. "LDL cholesterol is an okay, but not great, predictor of coronary risk," Dr. James A. Underberg said at the annual meeting of the American College of Preventive Medicine. He ...
Test thyroid function in thrombocytopenia.(Metabolic Disorders)(Disease/Disorder overview)
Aug 01, 2006; ... CHICAGO -- Immunologic thrombocytopenia was associated with an increased prevalence of thyroid disease in a retrospective longitudinal study. The finding argues for routine screening for thyroid disease in patients with immunologic thrombocytopenia. The study also indicated ...
Maternal thyroid disease possible risk factor for craniosynostosis.(Metabolic Disorders)(Disease/Disorder overview)
Aug 01, 2006; ... TUCSON, ARIZ. -- Maternal thyroid disease or its treatment may increase the risk of craniosynostosis in offspring by nearly threefold, preliminary results from an ongoing study suggest. The finding is important because thyroid disease is the second most common endocrinopathy, ...
IV ibandronate rivals oral drug on BMD improvement.(Metabolic Disorders)(body mass index)(Disease/Disorder overview)
Aug 01, 2006; ... BOSTON -- Intermittent intravenous ibandronate is at least as effective as daily oral ibandronate for increasing bone mineral density and may be preferable to oral dosing in patients with esophageal disease or compliance problems. There are no fracture data for the intravenous ...
Hormone elevated in daughters of PCOS patients.(Metabolic Disorders)(polycystic ovary syndrome)(Disease/Disorder overview)
Aug 01, 2006; ... BOSTON -- The daughters of women with polycystic ovary syndrome have elevated levels of antimullerian hormone from infancy to the perimenarchal period, suggesting that the underpinnings of PCOS may be present long before clinical symptoms develop. Folliculogenesis may be altered ...
PCOS symptoms may resolve with gastric bypass.(Metabolic Disorders)(polycystic ovary syndrome)(Disease/Disorder overview)
Aug 01, 2006; ... BOSTON -- Bariatric surgery may resolve symptoms of polycystic ovary syndrome in obese women with the condition, Dr. Hector Escobar-Morreale reported at the annual meeting of the Androgen Excess Society. "In some women, the syndrome is so driven by insulin resistance that it ...
Metformin urged for PCOS, despite lack of data: current knowledge of the risks of insulin resistance and the disadvantages of OCs deemed convincing.(Metabolic Disorders)(Disease/Disorder overview)
Aug 01, 2006; ... WASHINGTON -- Insulin resistance is such an integral and dangerous feature of polycystic ovary syndrome that metformin should be favored over oral contraceptive pills for treatment of the syndrome, said physicians in annual scientific sessions of the American Diabetes Association meeting. ...
Liver disease may accompany polycystic ovary syndrome.(Metabolic Disorders)(Disease/Disorder overview)
Aug 01, 2006; ... CHICACO -- Women with polycystic ovary syndrome can have fairly advanced liver disease, Dr. Tracy L. Setji of Duke University, Durham, N.C., and colleagues said in a poster presentation at the annual meeting of the American Association of Clinical Endocrinologists. At a ...
Some turning to gastric bypass in adolescents.(Metabolic Disorders)
Aug 01, 2006; ... WASHINGTON -- Early evidence suggests that the health benefits of bariatric surgery offset the risks for severely obese adolescents, according to the results of small studies reported at the annual scientific sessions of the American Diabetes Association. Significant metabolic ...
Weight loss after banding varies among ethnic groups.(Metabolic Disorders)
Aug 01, 2006; ... SAN FRANCISCO -- Affican American patients, especially women, appear to lose a smaller percentage of excess weight after laparoscopic adjustable gastric banding than their white counterparts, despite similar resolution of comorbidities, Dr. Manish S. Parikh reported at the annual meeting ...
Hybrid type diabetes found in 18% of obese kids.(Metabolic Disorders)
Aug 01, 2006; ... WASHINGTON -- A preliminary look at the children referred for participation in a large treatment trial of type 2 diabetes in overweight and obese youth shows that the children not only have a high prevalence of hypertension and dyslipidemia, but a high incidence of autoantibody positivity ...
Shorter, simpler TB regimen considered a priority.(Infectious Diseases)(Tuberculosis)
Aug 01, 2006; ... LISBON -- Tuberculosis experts now generally agree that the main priority for improving TB therapy is to shorten and simplify the regimen for active disease, Dr. Ann Ginsberg said at the 12th International Congress on Infectious Diseases. "This will have the greatest impact on ...
Jury out on West Nile's possible role as a teratogen.(Infectious Diseases)
Aug 01, 2006; ... TUCSON, ARIZ. -- Recent published data suggest a risk of birth defects among live-born infants of mothers infected with West Nile virus, but much more work is needed to confirm the association, Dr. Dawn M. Wesson said at the annual meeting of the Teratology Society. "There ...
Steroids gain traction for severe pneumonia.(Infectious Diseases)(Clinical report)
Aug 01, 2006; ... LISBON -- The use of corticosteroids to reduce the morbidity and mortality of severe bacterial pneumonia is supported by results from two positive randomized trials, multiple observational studies, and animal models, Dr. Antoni Torres said at the 12th International Congress on Infectious ...
Advise siblings on melanoma.(melanoma patient education has improved rate of self screening)(Clinical report)
Aug 01, 2006; ... Providing telephone counseling and targeted educational materials to the siblings of recently diagnosed melanoma patients can help improve the rate and quality of skin self-screening, according to the results of new research. In a randomized controlled trial that included 494 ...
New topical antifungal roots out onychomycosis.(Skin Disorders)(Brief article)
Aug 01, 2006; ... PHILADELPHIA -- A novel broad-spectrum topical antifungal for the treatment of onychomycosis is now in early-stage clinical trials, and so far the data look favorable. Several papers covering various aspects of the new drug, AN2690, were presented as posters at the annual meeting of the ...
Melanoma care varies by region, insurance type.(Skin Disoders)
Aug 01, 2006; ... ATLANTA -- A review of more than 60,000 melanoma patients found that they were more likely to have a sentinel node biopsy and receive adjuvant therapy with a biologic response modifier if they had commercial insurance and were treated at a teaching hospital in a geographic area where these ...
Telepsychiatry's time has come for rural patients.(Mental Health)
Aug 01, 2006; ... BOCA RATON, FLA. -- Telepsychiatry is a valid and reliable way to extend depression treatment to rural settings, according to a study from researchers at the University of California, Davis. "Telepsychiatry has been hot and cold, hot and cold, and right now it's hot," Dr. Donald ...
Short scale assesses child, adolescent depression.(Mental Health)
Aug 01, 2006; ... BOCA RATON, FLA. -- Major depression in children and adolescents can be assessed quickly using a 10-item scale designed for adults. Results correlate well with a standard 45-minute pediatric measure, according to a study presented at a meeting of the New Clinical Drug Evaluation Unit ...
Web-based therapy for depression will target adolescents.(Mental Health)
Aug 01, 2006; ... SAN ANTONIO -- Primary care physicians may be able to quickly and accurately assess and stratify an adolescent's 1-year risk of developing new-onset major depression using a 20-item checklist, Dr. Benjamin W. Van Voorhees said at the annual meeting of the Society for Prevention Research. ...
Pregnancy doesn't alter breast cancer outcomes.(Women's Health)(Clinical report)
Aug 01, 2006; ... ATLANTA -- Young women who became pregnant after breast cancer treatment were significantly less likely to have a recurrence or to die of the disease than were those who did not become pregnant, according to a French retrospective study presented at the annual meeting of the American ...
HER2+ breast Ca mortality is lowered with trastuzumab.(Women's Health)
Aug 01, 2006; ... ATLANTA -- New results from the international Herceptin Adjuvant (HERA) trial show that taking trastuzumab for 12 months after standard chemotherapy significantly reduced the risk of death for early-stage HER2-positive breast cancer patients. At a median follow-up of 2 years, ...
Early epidurals don't increase risk of operative delivery.(Women's Health)(Brief article)(Clinical report)
Aug 01, 2006; ... HOLLYWOOD, FLA. -- Epidural analgesia given in early labor has been shown to have no significant effect on the risk of operative delivery in patients with spontaneous labor, and the same appears to hold true for patients with induced labor, according to data presented at the annual meeting ...
A clinician's approach to anticonvulsants.(bipolar disorder treatment with lithium)
Aug 01, 2006; ... Historically, lithium has been a mainstay of treatment for bipolar disorder. However, over the last decade, anticonvulsant drugs such as sodium valproate and lamotrigine (Lamictal) have become more widely used to treat this disorder. The use of lithium in the first trimester is ...
Patient selection, patience key to pessary success.(Women's Health)(Clinical report)
Aug 01, 2006; ... TUCSON, ARIZ. -- A randomized crossover trial suggests that symptom relief and satisfaction can be obtained by either of two commonly used pessary types, but that patient selection and patience are both key to success. The multicenter study enrolled 134 women ages 30-89 (mean ...
Familial trend detected in Barrett's esophagus.(Digestive Disorders)
Aug 01, 2006; ... CHICAGO -- Family history plays a larger role in Barrett's esophagus and associated cancers than was previously recognized, according to Dr. Amitabh Chak. "There's clearly an inheritance pattern that suggests an autosomal dominant disease," said Dr. Chak at the annual Midwestern ...
In-office, unsedated transnasal esophagoscopy shows promise.(Digestive Disorders)
Aug 01, 2006; ... CHICAGO -- Transnasal esophagoscopy easily identified esophageal abnormalities without sedation in an office-based setting during a small, prospective study. The procedure, which allows endoscopic visualization of the aerodigestive tract from the nasal vestibule to the gastric ...
Ethnicity matters in GI lesions with iron-deficiency anemia.(gastrointestinal)(Clinical report)
Aug 01, 2006; ... LOS ANGELES -- In patients with iron-deficiency anemia, significant ethnic differences were found in the frequency, type, and distribution of clinically important gastrointestinal lesions, Dr. Bani Chander reported during a poster session at the annual Digestive Disease Week. In ...
Half of elderly may have prescription errors.(Geriatric Medicine)
Aug 01, 2006; ... SEATTLE -- Nearly half of a sample of elderly persons in Los Angeles were taking medications that they probably should not have been, and the likelihood of such a problem rose sharply with the number of medications they were taking, Gretchen E. Alkema said at the annual research meeting of ...
Elective, major bowel surgery well tolerated.(Geriatric Medicine)(Brief article)
Aug 01, 2006; ... SEATTLE -- Elderly persons who undergo major bowel operations on an elective basis fare much better than those who have emergency surgery, Dr. Demetrios J. Louis said at the annual meeting of the American Society of Colon and Rectal Surgeons. Dr. Louis reviewed 138 patients over ...
Fatty liver is underdiagnosed in obese children.(Obesity)(Disease/Disorder overview)
Aug 01, 2006; ... ATLANTA -- Obese children are at risk for developing nonalcoholic fatty liver disease and nonalcoholic steatohepatitis, which can lead to fibrosis and cirrhosis, speakers said at a meeting sponsored by the American Association for the Study of Liver Diseases. A significant ...
Overweight, obese teens are not being screened for comorbidities.(Obesity)(Disease/Disorder overview)
Aug 01, 2006; ... BOSTON -- Overweight and obese adolescents are not being sufficiently screened for weight-related comorbid conditions, and the failure to do so can have enduring health implications, Dr. Margaret Stager said at the annual meeting of the Society for Adolescent Medicine. Despite ...
Breakfast-obesity link is stronger than thought.(Obesity)(Disease/Disorder overview)
Aug 01, 2006; ... WASHINGTON -- Patients who regularly skip breakfast have as high a risk of obesity as patients who have a family history of type 2 diabetes, a cross-sectional study of adolescents has shown. Regularly skipping breakfast has been linked to obesity before, but Alison Okada ...
Nighttime device eases rotator cuff tendinopathy.(Musculoskeletal Disorders)
Aug 01, 2006; ... DENVER -- Asimple device seems to ease nighttime shoulder pain, according to study findings presented at the annual meeting of the American College of Sports Medicine. Dr. Michael Carroll, a Traverse City, Mich.-based family physician in private practice, presented independent ...
Shoulder pain unappreciated in ankylosing spondylitis.(Musculoskeletal Disorders)(Disease/Disorder overview)
Aug 01, 2006; ... GLASGOW, SCOTLAND -- Shoulder involvement is often overlooked in ankylosing spondylitis, despite patients' reports that upper body pain interferes with their daily activities, Dr. Charlotte E. Page reported in a poster session at the annual meeting of the British Society for Rheumatology. ...
Punch biopsies flag those at risk for neuropathy.(Clinical Rounds)(Disease/Disorder overview)
Aug 01, 2006; ... WASHINGTON -- Analysis of skin punch biopsy specimens may help predict diabetic neuropathy in at-risk patients, diagnose the condition earlier, and assess treatment response, Dr. Michael Polydefkis said at the annual scientific sessions of the American Diabetes Association. ...
Sleep apnea's effects on brain activation worsen with age.(Clinical Rounds)(Disease/Disorder overview)(Brief article)
Aug 01, 2006; ... SALT LAKE CITY -- The combination of obstructive sleep apnea and advanced age may have an overwhelming effect on the brain's compensatory mechanisms, and early diagnosis and treatment of OSA in older patients may be important for preserving brain function, reported Liat Ayalon, Ph.D., at ...
Structured sleep eases transformed migraines.(Clinical Rounds)
Aug 01, 2006; ... Los Angeles -- A structured sleep modification program significantly reduced the frequency and intensity of headaches in women with transformed migraines, University of North Carolina researchers reported at the annual meeting of the American Headache Society. The strength of ...
Foot procedure gets diabetics back on their feet.(Clinical Rounds)(Disease/Disorder overview)
Aug 01, 2006; ... SCOTTSDALE, ARIZ. -- Amputation of the diabetic foot can be avoided by surgical reconstruction using an anterolateral thigh perforator flap, according to a 4-year retrospective study reported by Dr. Joon pio Hong at the annual meeting of the Wound Healing Society. "[The ...
Fitness measures identify candidates for aneurysm repair.(Clinical Rounds)(Disease/Disorder overview)
Aug 01, 2006; ... PHILADELPHIA -- Some patients with abdominal aortic aneurysms are too sick to safely undergo aneurysm repair, by open surgery or with an endovascular procedure, and new methods are emerging to identify such patients. A small percentage of patients, perhaps less than 3%, fall ...
ACIP: postpartum Tdap vaccine recommended.(Disease/Disorder overview)
Aug 01, 2006; ... ATLANTA -- The recently licensed adolescent/adult formulation of tetanus-diphtheria acellular pertussis vaccine should be given routinely to women after delivery and before hospital discharge if they haven't already received a dose of that vaccine and if at least 2 years have elapsed since ...
Digital rectal exam key to early prostate diagnosis.(Clinical Rounds)(Disease/Disorder overview)(Brief article)
Aug 01, 2006; ... ATLANTA -- Omitting a digital rectal exam from prostate cancer screening can compromise treatment outcomes because many of the cancers detected by the exam alone are potentially curable, but may not remain so by the time PSA levels are high enough to warrant biopsy, investigators warned at ...
Zoledronic acid slows bone loss in prostate cancer.(Clinical Rounds)(Disease/Disorder overview)
Aug 01, 2006; ... ATLANTA -- An annual dose of zoledronic acid can prevent bone loss in men who may be at risk of osteoporosis and who undergo androgen-deprivation therapy for nonmetastatic prostate cancer, Dr. M. Dror Michaelson reported at the annual meeting of the American Society of Clinical Oncology. ...
Suspected child abuse goes unreported by MDs.(Clinical Rounds)(Brief article)
Aug 01, 2006; ... SAN FRANCISCO -- Primary care physicians frequently fail to report possible child abuse, even when they strongly suspect that an injury may have been caused by abuse, Dr. Emalee Flaherty reported at the annual meeting of the Pediatric Academic Societies. Among 15,003 patient ...
Atripla, Lucentis.(New & Approved)
Aug 01, 2006; ... Atripla (efavirenz 600 mg/emtricitabine 200 mg/tenofovir disoproxil fumarate 300 mg, GlaxoSmithKline and Gilead Sciences) A fixed-dose antiretroviral drug combination pill for use alone or with other antiretroviral agents for treating HIV-1 infection in adults, the ...
Pay for performance hits pay dirt ... sometimes: New York's program paid off, but in California and Massachusetts, clinical outcomes have yet to improve.(Practice Trends)
Aug 01, 2006; ... SEATTLE -- When the physicians of Rochester, N.Y., first had a pay-for-performance program imposed on them, they ignored it. "At the beginning of our program, most people would not acknowledge it existed," said Dr. Howard B. Beckman, the medical director of the Rochester ...