Family Practice News back issues from September 2007:
Newborn hearing may flag SIDS risk.(News)
Sep 01, 2007; ... Sudden Infant Death Syndrome is associated with hearing abnormalities that are detectable on a standard newborn hearing test, according to a preliminary study that has discovered a specific hearing abnormality in a cohort of infants who later died of the syndrome. [ILLUSTRATION ...
Thiazolidinediones receive black box for heart failure: careful monitoring of patients advised.(News)
Sep 01, 2007; ... The labels of all thiazolidinediones now carry a black box warning about the risk of heart failure, the Food and Drug Administration announced last month. The strengthened warning emphasizes that thiazolidinediones (TZDs) may "cause or exacerbate congestive heart failure in some ...
Medical home model a boon for community centers.(News)(Clinical report)
Sep 01, 2007; ... WASHINGTON -- Community health centers may be the silver lining in an often gloomy forecast for health care in the United States, according to findings from a report that shows a 41% decrease in medical costs for patients seen in community health centers, compared with patients seen ...
Primary care average base recruitment salaries offered in 2006-2007.(VITAL SIGNS)(Table)(Brief article)
Sep 01, 2007 ... <Pre> Primary Care Average Base Recruitment Salaries Offered in 2006-2007 Pediatrics $159,000 Family practice with ob. $159,000 Family practice $161,000 Internal medicine$174,000 Ob.gyn....
Codeine use in nursing mothers risky for infants.(News)(Brief article)
Sep 01, 2007; ... The Food and Drug Administration has advised patients and physicians that some women metabolize codeine so quickly that levels of morphine, a codeine metabolite, in breast milk can threaten the lives of nursing babies. The warning comes after the FDA analyzed a case report that ...
Crohn disease drug approved, with restrictions.(NEWS FROM THE FDA)
Sep 01, 2007; ... GAITHERSBURG, MD. -- A federal advisory panel has recommended that the immune modulator natalizumab be approved to treat moderate to severe Crohn disease, but only under highly restrictive conditions. Because of the serious risks associated with this agent, including progressive ...
CryoCor cryoablation system, Selzentry.(New & Approved)
Sep 01, 2007; ... A cryoablation device approved for the ablation of isthmus-dependent right atrial flutter in patients aged 18 years and older. This is the first cryoablation device approved for atrial flutter. The device is also being studied for use in treating atrial fibrillation. * ...
Average glucose slated to gauge glycemic control.(News)
Sep 01, 2007; ... If all goes as expected, the number of ways in which a diabetes patient's overall glucose control is expressed will soon increase to three but essentially boil down to just one concept: average glucose. New joint guidelines from the American Diabetes Association (ADA), the ...
Cervical cancer screening choices.(Letters)(Letter to the editor)
Sep 01, 2007; ... Dr. Michelle Vichnin's comments about amending the current cervical cancer screening guidelines for her unique population of high-risk urban adolescent girls miss the mark for me, because I believe that any physician can and in fact should, individualize screening choices in a specific ...
Reversing the 'diabesity' epidemic.(Letters)(Letter to the editor)
Sep 01, 2007; ... I prescribe metformin very frequently, and have done so for years, for prediabetics struggling to accomplish weight loss despite decent attempts at exercise and diet ("Oral Glucose Test Advised For 'Prediabetes" Screening," April 1, 2007, p. 1). The addition of metformin enables ...
Should organ donation after cardiac death be promoted and adopted more widely? Yes--it's an ethical and necessary practice.(Point/Counterpoint)
Sep 01, 2007; ... Despite all we have done to increase the number of available organs, over 6,000 people die every year in the United States while on organ waiting lists. If donation after cardiac death (DCD) were pursued as diligently as donation after brain death, the number of organs available ...
Should organ donation after cardiac death be promoted and adopted more widely? No--it's unethical and a dangerous mistake.(Point/Counterpoint)
Sep 01, 2007; ... Organ donation after cardiac death is a big mistake for a host of reasons, not the least of which is that it's driven by the quest to get more organs. This very nature of the practice makes it inherently difficult to prevent conflict between donor and recipient interests. ...
Unstable angina, non-STEMI get new guidelines.(Cardiovascular Medicine)(non-ST-segment-elevation myocardial infarction)
Sep 01, 2007; ... Early invasive and conservative strategies for managing unstable angina or non-ST-segment-elevation myocardial infarction both received endorsements in the first guidelines on the topic from the American College of Cardiology and the American Heart Association since 2002. ...
Value of circadian blood pressure variations confirmed.(Cardiovascular Medicine)
Sep 01, 2007; ... CHICAGO -- Treated hypertensive patients who have either extreme or very slight dips in nighttime blood pressure are at greater cardiovascular risk than are those with moderate dips, according to a study in 1,472 patients. Prior research has shown that people whose blood ...
Statins fail to influence central hemodynamics.(Cardiovascular Medicine)(Clinical report)
Sep 01, 2007; ... CHICAGO -- Statin therapy does not significantly influence central aortic pressures or hemodynamics in patients with treated hypertension, Dr. Bryan Williams reported at the annual meeting of the American Society of Hypertension. He presented data from the lipid-lowering arm of ...
Nightly valsartan is better than daytime dosing.(Cardiovascular Medicine)
Sep 01, 2007; ... CHICAGO -- Bedtime dosing of valsartan is more efficient than morning dosing in controlling blood pressure and improving renal function in hypertensive patients with or without diabetes, Ramon Hermida, Ph.D., said at the annual meeting of the American Society of Hypertension. ...
CT angiography's clinical utility faces hurdles.(Cardiovascular Medicine)(computed tomography)
Sep 01, 2007; ... WASHINGTON -- Although the evaluation of noncalcifled plaques with CT angiography currently is possible, there are still several obstacles to overcome before the technique is dinically useful, said Dr. Stephan Achenbach, a professor of medicine at the University of Erlangen in Germany, at ...
Delay to surgery, gender determine success of carotid surgery.(Cardiovascular Medicine)
Sep 01, 2007; ... BALTIMORE -- Gender and timing are two important determinants of success that are usually ignored when surgically treating carotid artery disease. Such omissions result in subjecting patients to the risks of carotid endarterectomy despite their markedly reduced chances of benefiting from ...
Look out for hyperglycemic hyperosmolar state.(Metabolic Disorders)
Sep 01, 2007; ... CHICAGO -- Physicians who see children must be on the lookout for hyperglycemic hyperosmolar state because the rising tide of pediatric obesity and type 2 diabetes means that this diagnosis is going to occur more often in children, Dr. Arian L. Rosenbloom said at the annual scientific ...
Continuous monitor/pump combo lowers [HbA.sub.1c].(Metabolic Disorders)
Sep 01, 2007; ... CHICAGO -- Findings from a recent study suggest that the combined real-time continuous glucose monitor/insulin pump system reduces glycemic variability and improves glucose control in selected insulin pump users with type 1 diabetes, Dr. Irl B. Hirsch reported at the annual scientific ...
Financial viability eludes diabetes educators.(Metabolic Disorders)
Sep 01, 2007; ... ST. LOUIS -- Diabetes education programs are struggling to achieve financial viability, according to results from a large national survey of diabetes educators. In addition, such providers hail from a diverse range of professional backgrounds and practice in as many different ...
Standardized insulin orders reduce hypoglycemia.(Metabolic Disorders)
Sep 01, 2007; ... DALLAS -- Implementation of standardized subcutaneous insulin order sets and an insulin management algorithm across nearly all services in a 400-bed hospital resulted in significantly improved glycemic control, Dr. Gregory A. Maynard reported at the annual meeting of the Society of ...
Modest weight loss is of little benefit in PCOS.(Metabolic Disorders)(polycystic ovary syndrome)(Clinical report)
Sep 01, 2007; ... Overweight women with polycystic ovary syndrome may need to lose more than 5% of their weight to see improvement in inflammatory markers, reported Lisa J. Moran of the University of Adelaide (Australia) and her colleagues. At the end of an 8-week, prospective study of the effect ...
Many ignore diabetes lifestyle recommendations.(Metabolic Disorders)
Sep 01, 2007; ... CHICAGO -- Few adults with diabetes and prediabetes are adhering to American Diabetes Association nutrition and activity recommendations, and even fewer with undiagnosed diabetes are doing so. After adjustment for age, gender, and race, a logistic regression analysis of 6,446 ...
Patient motivation as crucial as education in managing diabetes.(Metabolic Disorders)
Sep 01, 2007; ... ST. Louis -- Teaching type 2 diabetes patients about how to take care of themselves isn't enough; they need to be motivated to follow through, according to results of a survey of 3,867 patients. Yet discussions with patients remain primarily educational rather than motivational ....
Activity, fitness levels are low in newly diagnosed adult diabetics.(Metabolic Disorders)(Clinical report)
Sep 01, 2007; ... NEW ORLEANS -- Physical activity and fitness levels are low in individuals with newly diagnosed type 2 diabetes, compared with reference populations, Kate. J. Fitzsimons reported in a poster presentation at the annual meeting of the American College of Sports Medicine. Baseline ...
Coverage rates are higher with combo vaccines.(Infectious Diseases)
Sep 01, 2007; ... A study of more than 18,000 infant records in a Medicaid database found that use of combination vaccines significantly improved immunization coverage rates of the vaccines studied in children through age 24 months. This study "is the test in the United States to suggest a ...
Antibiotic prophylaxis for UTI questioned.(Expert Commentary)(urinary tract infections)(Clinical report)
Sep 01, 2007; ... Emerging evidence suggests that we shouldn't be prescribing prophylactic antibiotics for every child with recurrent urinary tract infection, even when vesicoureteral reflux is present. Just as the pendulum has swung over the last decade away from universal use of antibiotics ...
Consider cat-scratch disease in setting with fever, kittens.(Expert Commentary)
Sep 01, 2007; ... MAUI, HAWAII -- "Ask about pets in every febrile patient you see" was one of the take-home messages from Dr. Jay M. Lieberman as he discussed infections you can get from your pets. And in particular, he said, "Consider cat-scratch disease in any patient with fever of unknown ...
Skin diseases get misdiagnosed in primary care.(Skin Disorders)
Sep 01, 2007; ... NEW YORK -- Many primary care physicians are evaluating skin disorders and often relying on general pathologists to make dermatologic diagnoses, which, according to Dr. Clay Cockerell, could be a recipe for disaster. Non-dermatologists referring skin samples to general ...
Leafy vegetables, NSAIDs may prevent recurrent skin cancer.(Skin Disorders)
Sep 01, 2007; ... AMSTERDAM -- Adoption of a diet rich in leafy green vegetables and the regular use of NSAIDs are evidence-based supplementary measures available to patients with prior skin cancer to reduce their risk of future episodes, Dr. Adele C. Green said at the 11th World Congress on Cancers of the ...
Five factors help guide nail streak management.(Skin Disorders)
Sep 01, 2007; ... WASHINGTON -- The technique used to biopsy and treat a nail streak depends on the width of the streak and its location in the nail matrix, Dr. Bertrand Richert said at the annual meeting of the American Academy of Dermatology. If there is no clue to the etiology of a pigmented ...
Weight gain is a strong risk factor for psoriasis.(Skin Disorders)(Clinical report)
Sep 01, 2007; ... Increased adiposity and weight gain are strong risk factors for the development of psoriasis in women, according to a recently published study. As such, weight loss may be a potential target for preventing and managing psoriasis, said Dr. Arathi R. Setty of Massachusetts General ...
Dispensing tops list of ADHD medication errors.(Mental Health)
Sep 01, 2007; ... TORONTO -- Outpatient medication errors in the treatment of pediatric attention-deficit/hyperactivity disorder are numerous, but few of them seem to result in patient harm, Dr. David Bundy said at the annual meeting of the Pediatric Academic Societies. An analysis of a national ...
ADHD drugs may not outlast other therapies.(Mental Health)
Sep 01, 2007; ... Using medication to treat children with attention-deficit / hyperactivity disorder offers no long-term advantage over other treatment methods, according to a follow-up study. Dr. Peter S. Jensen and his colleagues at Columbia University, New York, found that children with ADHD ...
Antidepressant 'poop out' may be placebo effect.(Mental Health)(Brief article)(Clinical report)
Sep 01, 2007; ... SAN DIEGO -- If a patient with depression comes into the office and says that his antidepressant has stopped working, the drug you gave him probably was never working at all, Dr. Mark Zimmerman said at the annual meeting of the American Psychiatric Association. That patient ...
Early intervention needed to deter marijuana use.(Mental Health)
Sep 01, 2007; ... MIAMI -- Intervene to prevent marijuana use in children as young as 8 years, a National Institute on Drug Abuse researcher suggested at the annual conference of the American Society for Addiction Medicine. "Addiction is a developmental disease--it starts in adolescence and ...
Intervene aggressively in gestational diabetes.(Women's Health)(Brief article)
Sep 01, 2007; ... NEW YORK -- Physicians should take an aggressive approach in treating obese women with gestational diabetes because they have a relatively short time in which to make a difference, Dr. Oded Langer advised at the annual meeting of the Diabetes in Pregnancy Study Group of North America. ...
Hot flashes may indicate response to tamoxifen.(Women's Health)(Clinical report)
Sep 01, 2007; ... CHICAGO -- Hot flashes may be an indicator of the efficacy of adjuvant tamoxifen therapy in women who have completed breast cancer treatment, a new study suggests. Data from a large prospective trial of breast cancer survivors on tamoxifen therapy show that women who experienced ...
Bone pain flags worse survival in prostate cancer.(Men's Health)
Sep 01, 2007; ... CHICAGO -- Once bone pain appears in patients with hormone-refractory prostate cancer, it is often too late for docetaxel therapy to have an impact on their survival, according to a poster presentation at the annual meeting of the American Society of Clinical Oncology. For this ...
Stress coaching eases radical prostatectomy fears.(Men's Health)
Sep 01, 2007 ... CHICAGO -- Just 2 hours of teaching men with prostate cancer how to self-manage their stress improves their ability to cope with their fears of undergoing radical prostatectomy. Moreover, the effects of learning how to manage their stress are long-lasting, and could ultimately ...
Quality of life tops list of concerns in prostrate cancer.(Men's Health)(Survey)
Sep 01, 2007 ... CHICAGO -- The major worry of men with prostate cancer is their ability to maintain a good quality of life, according to a poster presented at the annual meeting of the American Society of Clinical Oncology. The finding, from a Web-based survey of 2,128 men with prostate ...
Western diet tied to colon cancer return.(Digestive Disorders)(Clinical report)
Sep 01, 2007; ... Colon cancer patients who eat a typical Western diet seem to have triple the risk of recurrence, compared with those who don't follow a Western diet. After a potentially curative resection of stage III colon cancer and adjuvant chemotherapy, a diet replete with sweets, french ...
FDA: PPIs pose no increased heart risks.(Digestive Disorders)
Sep 01, 2007; ... New data supplied by AstraZeneca, maker of the prescription proton pump inhibitors Prilosec (omeprazole) and Nexium (esomeprazole), do not suggest that either drug increases cardiovascular event risks in patients with severe gastroesophageal reflux disease, according a preliminary ...
Inflammation may drive comorbidities in RA.(Musculoskeletal Disorders)(rheumatoid arthritis)
Sep 01, 2007; ... BALTIMORE -- Inflammation appears to underlie the increased risk for insulin resistance, metabolic syndrome, and cardiovascular morbidity in patients with rheumatoid arthritis, Dr. Joan M. Bathon said at a conference on rheumatic diseases sponsored by the Johns Hopkins University. ...
Functional MRI reveals brain damage in lupus.(Musculoskeletal Disorders)(magnetic resonance imaging)(Brief article)
Sep 01, 2007; ... TORONTO -- Cognitive impairment in patients who have childhood-onset systemic lupus erythematosus can he identified with functional magnetic resonance imaging, reported Svetlana Lvovich, D.O., in a poster presentation at the annual meeting of the Pediatric Academic Societies. ...
Family history, smoking promote cartilage loss.(Musculoskeletal Disorders)(Clinical report)
Sep 01, 2007; ... Smoking seems to contribute to the development of knee cartilage loss and defects in those with a family history of knee osteoarthritis (OA), according to results reported by Dr. Changhai Ding and associates of the University of Tasmania in Australia. In this study, 345 ...
In bronchiolitis, take the evidence-based route.(Pulmonary Medicine)
Sep 01, 2007; ... NEW YORK -- Optimal management of bronchiolitis involves rational use of adrenergic drugs and avoidance of unnecessary tests and treatments, Dr. Howard M. Corneli said at a meeting sponsored by the American College of Emergency Physicians. "We are spending over $700 million ...
FDA review of Alzheimer drugs deemed sluggish.(Clinical Rounds)
Sep 01, 2007; ... Drugs for treating Alzheimer disease are significantly less likely to receive priority review from the Food and Drug Administration than are cancer or HIV drugs, according to a new study that has critics saying the pattern must change as disease-modifying drugs advance in clinical trials. ...
Epileptic women's sexual arousal is diminished.(Clinical Rounds)(Clinical report)
Sep 01, 2007; ... Sexual dysfunction is quite common in women with epilepsy, just as ignoring the problem is quite common among their physicians, experts say. Naturally, said Dr. Romila Mushtaq, an epileptologist at the Medical College of Wisconsin, Milwaukee, the neurologist's first concern in ...
Watch out for recurrent otitis media in children who snore.(Clinical Rounds)
Sep 01, 2007; ... MINNEAPOLIS -- Children with frequent, loud snoring are significantly more likely to develop recurrent otitis media and to require tympanostomy tubes than are children who don't snore, based on data from more than 16,000 children aged 5-7 years. Recurrent otitis media and ...
Adenotonsillectomy helps sleep and breathing, but not behavior.(Clinical Rounds)(Clinical report)
Sep 01, 2007; ... Adenotonsillectomy frequently improves sleep, breathing, and quality of life--but not neurobehavioral outcomes, according to parental reports analyzed by Dr. Evelyn Constantin of Montreal Children's Hospital, and her associates. These effects were seen whether or not the ...
Inherited cancer syndromes.(Genomic Medicine)
Sep 01, 2007; ... Have you ever diagnosed anyone with hereditary nonpolyposis colorectal cancer? Do you have any patients in your practice who are at risk for the syndrome? No? Not sure? For most providers, the answers to those questions should be "yes," and probably for more than one patient. ...
Reversing trend, hospitalizations for stroke dip.(Clinical Rounds)(Report)
Sep 01, 2007; ... BOSTON -- Hospitalization for stroke has declined since the mid-1990s, reversing the trend observed in the previous 10 years, according to findings from two studies relying on different databases and presented in separate posters by Dr. Jing Fang and Dr. H. Christian Schumacher at the ...
'Silent' strokes present broader risks.(Clinical Capsules)(Clinical report)
Sep 01, 2007 ... Persons with symptoms of stroke, but no clinical history of a cerebral infarct, had quality of life scores that were similar to those of individuals who had previously suffered a documented stroke, according to findings from a large retrospective study. The findings suggest ...
Diabetes incidence tops 24 per 100,000.(Clinical Capsules)(Report)(Brief article)
Sep 01, 2007 ... The overall incidence of diabetes in American children and adolescents is 24.3 per 100,000 per year, according to Dr. Dana Dabelea of the University of Colorado, Denver, and associates. Most of the new cases of diabetes in the pediatric population are type 1 disease. Type 2 ...
Cat allergens stalk atopic adults.(Clinical Capsules)(Brief article)(Clinical report)
Sep 01, 2007 ... Increasing exposure to cat allergens in a large study caused greater bronchial responsiveness in atopic adults, even in those who were not allergic to cats. The finding suggests reducing exposure to cats may be beneficial for allergic individuals regardless of their specific ...
Formal programs don't change abstinence rates.(Practice Trends)
Sep 01, 2007; ... Teenagers enrolled in abstinence-only education programs are about as likely to have abstained from sex as are teens in a control group, according to a report evaluating federal abstinence education programs. The study, which was requested by Congress under the Balanced Budget ...
SCHIP's administrative changes could effectively cut coverage.(Practice Trends)(State Children's Health Insurance Program)
Sep 01, 2007; ... The true impact isn't known yet, but an administrative change by the Centers for Medicare and Medicaid Services to rules governing the State Children's Health Insurance Program--made on a Friday night during Congress' August recess--may have the effect of dropping children who currently ...
Publix to offer free antibiotics.(Policy & Practice)(Publix Super Markets)(Brief article)
Sep 01, 2007; ... Publix Super Markets will offer seven oral antibiotics free of charge at its 684 pharmacy locations, the Lakeland, Fla.-based store chain announced. The antibiotics included in the program--amoxicillin, cephalexin, sulfamethoxazole/trimethoprim (SMZ-TMP), ciprofloxacin (excluding Cipro ...
FDA, DoD to share data.(Policy & Practice)(Food and Drug Administration and Department of Defense)(Brief article)
Sep 01, 2007; ... The Department of Defense will share data and expertise with the Food and Drug Administration related to the review and use of FDA-regulated drugs, biologics, and medical devices in an effort to identify potential concerns and recognize benefits of products, the two agencies said. The DoD ...
Bill would improve import safety.(Policy & Practice)(Brief article)
Sep 01, 2007; ... User fees on imported food and drug shipments would fund additional personnel to inspect shipments both at the border and at FDA laboratories under legislation proposed by the chairman of the House Energy and Commerce Committee. Funds from the proposed user fees also would be used to test ...
Leaders back payment reform.(Policy & Practice)(Survey)(Brief article)
Sep 01, 2007; ... The vast majority (95%) of key public officials, analysts, and executives say fundamental health care payment reform is needed, and 75% support Medicare reform that would pay "medical homes" for care coordination, according to the latest Commonwealth Fund Health Care Opinion Leaders ...
GAO finds Medicaid decline.(Policy & Practice)(Government Accountability Office)(Brief article)
Sep 01, 2007; ... A law requiring most U.S. citizens applying for Medicaid coverage to document their citizenship has caused eligible citizens to lose Medicaid coverage, and the law costs far more to administer than it saves, according to two government analyses. The law went into effect on July 1, 2006, ...
R.I. to begin information exchange.(Policy & Practice)(Rhode Island)(Brief article)
Sep 01, 2007; ... Rhode Island is one step closer to a health information system that will allow physicians to access patient health data from a variety of sources. The state has chosen Electronic Data Systems Corp. and its subcontractor, InterSystems Corp., to build and integrate the necessary technology ...