Family Practice News back issues from February 2007:
Coalition kickstarts free ePrescribing.(Practice Trends)
Feb 01, 2007; ... WASHINGTON -- Doctors who have yet to get on the health information technology bandwagon no longer have any excuses, according to members of the National ePrescribing Patient Safety Initiative, a coalition of health insurers and software companies. The initiative--called ...
Average physician fee for the five most popular minimally invasive cosmetic procedures.(VITAL SIGNS)(Brief article)
Feb 01, 2007 ... <Pre> VITAL SIGNS Average Physician Fee for the Five Most Popular Minimally Invasive Cosmetic Procedures Chemical peel$628 Laser hair removal $406 Botox$363 Sclerotherapy$311 Microdermabrasion$177 ...
Cancer Society backs HPV shot for middle school girls: no hard advice given for ages 19-26 years.(News)
Feb 01, 2007; ... The American Cancer Society advocated routine vaccination against human papillomavirus for 11- and 12-year-old girls but cautioned that the potential impact of universal vaccination on cervical cancer rates can be realized only if those underserved populations at greatest risk have access ...
Energy drink trends alarm some; no data back safety.(Clinical Rounds)
Feb 01, 2007; ... Energy drinks are all the rage, and the media--along with the millions of people who use the drinks--are buzzing. At the same time, there has been surprisingly little research into the potential health hazards of the caffeine- and sugar-laden drinks that have become a $3 ...
Caution urged on state HPV vaccine mandates.(News)
Feb 01, 2007; ... Despite reservations from some prominent medical organizations, state lawmakers are wasting no time in introducing legislation mandating that all middle school girls be vaccinated with the quadrivalent human papillomavirus vaccine. At press time, legislation mandating ...
Offer all pregnant women down syndrome screen.(News)
Feb 01, 2007; ... A new practice bulletin from the American College of Obstetricians and Gynecologists endorses routinely offering first-trimester screening for fetal chromosomal abnormalities to all pregnant women, not just those over 35 years of age. The bulletin states that first-trimester ...
Agency seeks increased fees from drugmakers.(NEWS FROM THE FDA)
Feb 01, 2007; ... The Food and Drug Administration has proposed greatly increasing the fees its drug division collects from pharmaceutical manufacturers, saying current fees collected under the Prescription Drug User Fee Act have not kept pace with inflation or the agency's growing workload. Most ...
Refrigerated FluMist wins approval; cost still an issue.(News)
Feb 01, 2007; ... A new formulation of intranasal influenza live virus vaccine that can be stored in a standard refrigerator, rather than kept frozen, was approved last month by the Food and Drug Administration. The new formulation of the trivalent vaccine, FluMist, is approved for healthy ...
Ketek's label may be stripped of sinusitis, bronchitis indications.(News)
Feb 01, 2007; ... SILVER SPRING, MD. -- The antibiotic Ketek (telithromycin) is neither safe nor effective for treating acute exacerbation of chronic bronchitis or acute sinusitis, according to a Food and Drug Administration advisory committee that recommended that the agency remove those indications from ...
Talking with patients about CFS.(Letters)(Letter to the editor)
Feb 01, 2007; ... Your article, "CDC Campaign Takes Aim at Chronic Fatigue Syndrome" (Dec. 1, 2006, p. 46), summarized the most effective medical approaches to treatment. I find that a long conversation reviewing the physiologic changes involved in CFS is effective. I have spent much of my ...
Should the extreme elderly be screened for colorectal cancer? Healthy elderly patients benefit from screening.(Point/Counterpoint)
Feb 01, 2007; ... Imagine that a healthy, vigorous woman in her 80s desires screening for colon cancer. She is asymptomatic and has never been screened before. Her request leaves us in a conundrum, since we have few data to guide us. Randomized trials of various modes of screening have generally ...
Should the extreme elderly be screened for colorectal cancer? Risks outweigh benefits in the extreme elderly.(Point/Counterpoint)
Feb 01, 2007; ... Screening colonoscopy is not a wise choice in the extreme elderly, even for a strong, otherwise healthy 88-year-old. Proponents of screening this age group base their argument on one major premise, the apparent yield of screening. Population registries show an exponential rise ...
Fluvastatin XL least likely to cause myalgias.(Cardiovascular Medicine)
Feb 01, 2007; ... CHICAGO -- Fluvastatin XL, either alone or in combination with ezetimibe, is an effective, well-tolerated, and safe option for lowering LDL cholesterol in patients who can't tolerate other statins because of muscle-related side effects, Dr. Evan A. Stein said at the annual scientific ...
In young patients with chest pain, suspect cocaine.(Cardiovascular Medicine)(Disease/Disorder overview)
Feb 01, 2007; ... SAN FRANCISCO -- Consider cocaine use as a cause of chest pain, especially in young patients, Dr. Priscilla Hsue said at a meeting sponsored by the California chapter of the American College of Cardiology. In 2004, 2 million Americans were cocaine users, and cocaine was the ...
Low-carb better than low-fat diet for lipids.(Cardiovascular Medicine)
Feb 01, 2007; ... SAN DIEGO -- People on very-low-carbohydrate diets who consumed three times as much daily saturated fat as people on high-carbohydrate, low-fat diets, lost more weight and had twice the reduction in saturated fat levels compared with the latter, according to a report on a small study at a ...
Lifestyle changes in middle age help stave off disease.(Cardiovascular Medicine)
Feb 01, 2007; ... TUCSON, ARIZ . -- The benefits of adopting healthy lifestyle habits later in life are significant, Dr. Dana King and colleagues reported at the annual meeting of the North American Primary Care Research Group. He presented a secondary analysis of the Atherosclerosis Risk in ...
Chest pain trumps other risk factors if calcium score is low.(Cardiovascular Medicine)
Feb 01, 2007; ... MONTREAL -- Chest pain in patients with low coronary calcium scores may serve as a red flag for the presence of obstructive soft or uncalcified coronary atherosclerosis, Dr. John S. Ho said during a poster presentation at the annual meeting of the American Society of Nuclear Cardiology. ...
Treat atherosclerosis risks in lupus patients: many risk factors were present within 1 year of diagnosis and increased in prevalence over 3 years.(Cardiovascular Medicine)
Feb 01, 2007; ... WASHINGTON -- Awareness of the increased risk of atherosclerosis in patients who have lupus may be rising, but even experts in lupus treatment are not adequately treating patients who have known risk factors for the condition, Dr. Murray B. Urowitz reported at the annual meeting of the ...
Etoricoxib, diclofenac pose similar cardiovascular risks.(Cardiovascular Medicine)
Feb 01, 2007; ... CHICAGO -- Prolonged treatment with the COX-2 inhibitor etoricoxib carried no increased cardiovascular risk, compared with the traditional NSAID didofenac in a pooled analysis of nearly 35,000 arthritis patients, reported Dr. Christopher Cannon at the annual scientific sessions of the ...
Monitoring foot temperature cuts ulceration risk.(Metabolic Disorders)
Feb 01, 2007; ... Patients with diabetic neuropathy who monitor their foot temperature daily can reduce their risk of ulceration more than fourfold, according to an article by Lawrence A. Lavery, D.P.M., of Texas A&M University, College Station, and colleagues. In a physician-blinded trial, 173 ...
Protocol reduces rate of hypoglycemia events.(Metabolic Disorders)
Feb 01, 2007; ... A treatment protocol used at the University of Pittsburgh Medical Center has nearly cut in half the number of severe hypoglycemic events experienced by inpatients with diabetes. "There was a lack of a standardized approach to the treatment of hypoglycemia in the hospital" before ...
High dietary iron is linked to CHD risk in type 2 women.(Metabolic Disorders)
Feb 01, 2007; ... The risk of coronary heart disease among women with type 2 diabetes appears to be elevated for those who consume high levels of heme iron and red meat, according to a large, long-term analysis from the ongoing Nurses' Health Study. "Whether the increased iron intake is causally ...
Celiac disease prevalent in 12% of type 1 children.(Metabolic Disorders)
Feb 01, 2007; ... NEW YORK -- Diagnosis and treatment of symptomatic celiac disease in children with type 1 diabetes can result in significant improvement in growth parameters and symptom relief, according to a study from Denmark. "The data lend support to recommendations of regular screening ...
Waist size linked to kidney disease in diabetics.(Metabolic Disorders)(Clinical report)
Feb 01, 2007; ... Patients with type 1 diabetes and central obesity had a significantly increased risk of developing microalbuminuria in a study of 1,105 patients. Investigators found that each 10-cm (4-inch) increase in waist circumference increased the risk of microalbuminuria by 34%. After ...
Radioiodine overused in low-risk thyroid cancer.(Metabolic Disorders)
Feb 01, 2007; ... VERONA, ITALY -- Radioactive iodine-131 therapy is appropriate for patients with high-risk thyroid cancer, but unjustified in low-risk patients, Dr. Bryan McIver said at a joint meeting of the Italian Association of Clinical Endocrinologists and the American Association of Clinical ...
Consensus a must for managing thyroid nodules.(Metabolic Disorders)
Feb 01, 2007; ... CHICAGO -- As the prevalence of thyroid nodules diagnosed on ultrasound increases, clinicians trying to decide whether to biopsy a particular nodule should consider adding a serum TSH test to their work-up, Dr. R. Brooke Jeffrey Jr. said at the annual meeting of the Radiological Society of ...
Most benign thyroid nodules can be followed.(Metabolic Disorders)(Disease/Disorder overview)
Feb 01, 2007; ... SAN FRANCISCO -- Routine thyroxine therapy for benign thyroid nodules is no longer recommended, Dr. Hossein Gharib said at Perspectives in Women's Health sponsored by Ob.Gyn. News. Thyroxine does not shrink most benign thyroid nodules. In those that do shrink, size increases if ...
Alendronate benefits linger.(Clinical Capsules)(Brief article)
Feb 01, 2007 ... Postmenopausal women who discontinue alendronate after 5 years of treatment may experience a moderate decline in bone mineral density but are not at a significantly higher risk for fracture compared with those who continue alendronate for an additional 5 years, reported Dennis M. Black, ...
Foot ulcers court comorbidity.(Clinical Capsules)(Disease/Disorder overview)(Brief article)
Feb 01, 2007 ... Many diabetic patients with foot ulcers have peripheral arterial disease, infection, and disabling comorbidities, according to a large European study. Of 1,229 consecutive patients presenting with new foot ulcers at 14 hospitals in 10 European countries, only 24% had neither ...
Hb[A.sub.1c] levels predict sepsis outcomes.(Clinical Capsules)
Feb 01, 2007 ... Hemoglobin Ale levels at hospital admission are predictive for hospital mortality and length of stay in diabetic patients with sepsis, reported Dr. Ivan Gornik of Rebro University Hospital in Zagreb, Croatia, and associates. The investigators conducted a prospective, ...
Specific changes mark atypical Kawasaki disease.(Infectious Diseases)(Disease/Disorder overview)
Feb 01, 2007; ... WASHINGTON -- Atypical and incomplete Kawasaki disease may be distinguished from other common childhood febrile illnesses by characteristic changes to the extremities, mucosa, conjunctiva, and blood laboratory values, Dr. Fernanda Falcini reported at a poster session of the annual meeting ...
Lyme borreliosis can rest on clinical findings.(Infectious Diseases)(Brief article)
Feb 01, 2007; ... LAS VEGAS -- Patients who present with localized erythema near the site of a tick bite should not necessarily be referred for laboratory tests, Dr. Jana Hercogova said at a dermatology seminar sponsored by Skin Disease Education Foundation. In fact, a tick bite followed by a ...
Integrase inhibitors show promise in HIV therapy: these agents block reproduction by preventing retroviral DNA from incorporating into host cell DNA.(Infectious Diseases)(Clinical report)
Feb 01, 2007; ... SAN FRANCISCO -- The expected introduction of the integrase inhibitors will usher in the most exciting time in HIV treatment since the advent of highly active antiretroviral therapy, Dr. George Beatty predicted at a meeting on HIV management sponsored by the University of California, San ...
Effect of nonadherence to HIV therapy varies by individual.(Infectious Diseases)
Feb 01, 2007 ... SAN FRANCISCO -- Adherence to highly active antiretroviral therapy remains important, even though treatment may be more forgiving of nonadherence than some have suggested, Dr. Kristen M. Ries said at a meeting on HIV management sponsored by the University of California, San Francisco. ...
Treating recently HIV-infected patients is advised, despite inconclusive data.(Infectious Diseases)
Feb 01, 2007 ... SAN FRANCISCO -- Treating a recently infected HIV patient may provide some benefit, particularly if that treatment begins before or within a few weeks of antibody seroconversion, Dr. Frederick Hecht said at a meeting on HIV management sponsored by the University of California, San ...
Quicker, simpler tests sought for MRSA screening.(Infectious Diseases)
Feb 01, 2007; ... Researchers at the Mayo Clinic and elsewhere are racing to develop rapid-detection tests for Staphylococcus aureus, both to better tailor appropriate antibiotic prescribing and to halt the galloping spread of methicillin-resistant strains of the bacteria. The race for quicker, ...
Ankle-brachial index gauges arterial ulcer risk, outcomes.(Skin Disorders)
Feb 01, 2007; ... OTTAWA -- The ankle-brachial index, which indicates the arterial supply to the legs, can help confirm an arterial wound in suspected cases of arterial leg ulcers, Dr. Rob Miller said at the annual conference of the Canadian Association of Wound Care. Identification of ...
Lab tests, vaccinations key in biologic therapy.(Skin Disorders)
Feb 01, 2007; ... NEW YORK -- Psoriasis patients taking biologic therapies require careful monitoring, including a number of lab tests and vaccinations, Dr. Mark Lebwohl said at a meeting on medical and surgical dermatology sponsored by the Mount Sinai School of Medicine. Seasonal flu vaccines, ...
Methotrexate trumped by adalimumab for psoriasis.(Skin Disorders)
Feb 01, 2007; ... WHISTLER, B.C. -- Adalimumab was significantly more effective against psoriasis than both methotrexate and placebo were in a double-blind, double-dummy, randomized, controlled phase III trial, Dr. Richard Langley reported at a dermatology symposium. The study is the first ...
Consider PHACES syndrome in patients with facial hemangiomas.(Skin Disorders)
Feb 01, 2007; ... WILLIAMSBURG, VA. -- A segmental plaquelike facial hemangioma should be a tip-off to evaluate an infant for PHACES syndrome (posterior fossa malformations, hemangiomas, arterial anomalies, coarctation of the aorta and other cardiac defects, eye abnormalities, sternal defects), Dr. Sharon ...
Research elucidates alcohol's effect on the brain.(Mental Health)
Feb 01, 2007; ... ORLANDO -- Two neurologic systems reinforce alcohol dependence--both dopamine and serotonin pathways--and make it more difficult for people to stop drinking, according to a presentation at a psychopharmacology congress sponsored by the Neuroscience Education Institute. "The ...
Routine AUDIT identifies problem drinkers early.(Mental Health)(alcohol use disorders identification test)(Brief article)
Feb 01, 2007; ... BOSTON -- Screening for alcohol problems at primary care visits and in the emergency room could help in the early identification of heavy drinkers who would otherwise not seek treatment, according to a poster presented at the annual meeting of the American Public Health Association. ...
Girls with ADHD deserve attention.(Expert Commentary)
Feb 01, 2007; ... Too often, girls with attention--deficit hyperactivity disorder are overlooked. As health care professionals, we must not allow this lack of attention to continue. Certainly, boys are diagnosed with ADHD far more often than are girls. Just 10 years ago, the ratio between boys ...
Monitor response to tweak ADHD management.(Mental Health)
Feb 01, 2007; ... ORLANDO -- Start with a long-acting stimulant for treatment of attention-deficit hyperactivity, disorder for most patients, increase the dose before adding a short-acting drug, and monitor response with a rating scale, Dr. Peter S. Jensen advised at a psychopharmacology congress sponsored ...
Methylphenidate steadies ADHD drivers.(Mental Health)(Drug overview)(Brief article)
Feb 01, 2007; ... PARIS -- Methylphenidate really can keep people with attention-deficit hyperactivity disorder on the straight and narrow, according to a study that was conducted in the Netherlands. Dr. Joris C. Verster and his colleagues at the University of Utrecht Institute for Pharmaceutical ...
CDC develops autism education materials.(Mental Health)(Centers for Disease Control and Prevention)
Feb 01, 2007 ... The Centers for Disease Control and Prevention, in conjunction with its "Learn the Signs. Act Early" campaign, has developed a free resource kit for child care providers and educators about child development and autism. It is hoped ...
Figure family structure into BRCA screening.(Women's Health)(Brief article)
Feb 01, 2007; ... SAN ANTONIO -- Consider lowering the threshold for BRCA mutation testing in patients with early-onset breast cancer who have fewer than two first- or second-degree female relatives older than age 45, Dr. Jeffrey N. Weitzel advised at a breast cancer symposium sponsored by the Cancer ...
Breast cancer prognosis tied tightly to genes.(Women's Health)(Disease/Disorder overview)
Feb 01, 2007; ... SAN ANTONIO -- Breast cancer prognosis appears to have a strong and previously unrecognized inherited component, Dr. Mikael Hartman said at a breast cancer symposium sponsored by the Cancer Therapy and Research Center. His study of 2,787 mother-daughter and 831 sister pairs with ...
Suspect ovarian cancer with persistent distention.(Women's Health)
Feb 01, 2007; ... SANTA MONICA, CALIF. -- Persistent abdominal distention, but not transient bloating, is associated with ovarian cancer, and clinicians should listen to their patients carefully to distinguish between the symptoms, according to a poster presentation by Dr. Clare R. Bankhead at the biennial ...
Hysteroscopy OK with endometrial cancer history.(Women's Health)(Brief article)
Feb 01, 2007; ... SANTA MONICA, CALIF. -- While hysteroscopy is the most accurate tool for evaluating abnormal uterine bleeding, the technique can cause the intraperitoneal spread of malignant endometrial cells. This has raised concerns that hysteroscopy might be responsible for a worse prognosis in women ...
Screen pregnant women for depression risk.(Women's Health)
Feb 01, 2007; ... SAN FRANCISCO -- Screen pregnant women to identify those who are at increased risk for postpartum depression, and plan home visits by a nurse with the at-risk group 10-14 days after delivery, Dr. Andrea J. Singer said at Perspectives in Women's Health sponsored by OB.GYN. NEWS. ...
Breast-feeding's benefits outweigh risk of antidepressant exposure.(Women's Health)
Feb 01, 2007; ... SAN FRANCISCO -- All psychotropic medications are excreted into breast milk, but the benefits of breast-feeding generally outweigh the relatively small risks to the baby from antidepressants, Dr. Andrea J. Singer said. The nutritional advantages and the bonding that occurs ...
ACOG's view on SSRIs.(Drugs, Pregnancy, and Lactation)(selective serotonin reuptake inhibitors)(Clinical report)
Feb 01, 2007; ... The multiple recent reports regarding the reproductive safety of the selective serotonin reuptake inhibitors have raised concerns about a spectrum of potentially adverse outcomes associated with SSRI use during pregnancy. But these reports have produced conflicting results and have been ...
Focus on high-yield tests for running injuries.(Musculoskeletal Disorders)
Feb 01, 2007; ... SAN FRANCISCO -- When a patient with a running injury arrives in a busy primary-care office, there's usually not enough time for the provider to do a full orthopedic examination, but several high-yield static assessments can help the provider conduct an efficient exam within the standard ...
Give OTC orthotic soles a test run before going custom.(Musculoskeletal Disorders)
Feb 01, 2007; ... SAN FRANCISCO -- There's no truth in the belief that a person can become dependent on orthotic soles--in fact, orthotics can be very useful in correcting certain foot problems, according to Dr. Anthony Luke, at a conference on sports medicine sponsored by the University of California, San ...
PPI therapy; fracture risk link raises concerns.(Musculoskeletal Disorders)(proton pump inhibitor)
Feb 01, 2007; ... Hip fracture risk was increased with long-term use of proton pump inhibitors in a study published recently in the Journal of the American Medical Association, and the findings have led to concerns and questions among both gastroenterologists and patients who take these frequently ...
Recurrent C. difficile on the rise, no silver bullet.(Digestive Disorders)
Feb 01, 2007; ... LAS VEGAS -- When Clostridium difficile disease recurs, look out. It's likely to recur again and again in a cycle that can go on for "months or years," Dr. Christina Surawicz said at the annual meeting of the American College of Gastroenterology. "Are recurrences ...
'Throw everything' at refractory C. difficile disease.(Digestive Disorders)(clostridium difficile)
Feb 01, 2007; ... LAS VEGAS -- When confronted with severe or refractory Clostridium difficile--associated disease, act fast, act aggressively, and don't be afraid to try unorthodox methods if standard therapies don't work, Dr. Christina Surawicz stressed during a symposium at the annual meeting of the ...
Crohn's perianal fistulas respond to therapy.(Digestive Disorders)(Brief article)
Feb 01, 2007; ... ORLANDO -- About 25% of children newly diagnosed with Crohn's disease will develop perianal fistulas within 2 years, but the majority of these fistulas will resolve in response to medical management alone, Dr. David J. Keljo reported at a poster session at the annual meeting of the North ...
Obesity drugs' benefits may not outweigh risks: the impact on morbidity and mortality is unknown as trial attrition rates were high.(Obesity)
Feb 01, 2007; ... Clinical testing on current weight-loss drugs has been inadequate to determine whether their benefits outweigh the risks of long-term use, according to a literature review by Canadian researchers. The review, by Dr. Raj S. Padwal and Dr. Sumit R. Majumdar of the University of ...
Providers' time, commitment can improve diet adherence.(Obesity)
Feb 01, 2007; ... RENO, NEV. -- Improving patient adherence to a diet program requires an investment of time that must include providing specific weight loss goals and asking patients about their progress at every visit, Lora E. Burke, Ph.D., said at the annual meeting of the American College of Nutrition. ...
Urinary potassium sheds light on quality of one's diet.(Obesity)
Feb 01, 2007; ... RENO, NEV. -- Twenty-four-hour urinary potassium excretion is an effective clinical marker for diet quality and can be used to identify patients with poor diets, Dr. Alexander G. Logan said at the annual meeting of the American College of Nutrition. Physicians can use 24-hour ...
Pseudoephedrine linked to three infant deaths.(Clinical Rounds)(Brief article)
Feb 01, 2007; ... Three infants died in 2005 after ingesting cough or cold medications containing pseudoephedrine, the Centers for Disease Control and Prevention reported. The CDC and the National Association of Medical Examiners (NAME) conducted a joint survey of medical examiners and coroners ...
Let frequency, pain guide restless legs treatment.(Clinical Rounds)
Feb 01, 2007; ... BALTIMORE -- In the decision of which drug to prescribe a patient with restless legs syndrome, the frequency and painfulness of symptoms are crucial to making the correct choice, Dr. Christopher J. Earley said at a neurology meeting sponsored by Johns Hopkins University. "For ...
High-altitude seizure rare but real, study finds.(Clinical Rounds)
Feb 01, 2007; ... SAN DIEGO -- Patients who visit mountain resort towns in Colorado and other moderately high elevation vacation spots in the United States may face a slight but real increased risk of high-altitude seizures, Dr. Edward H. Maa reported during a poster session at the annual meetings of the ...