Family Practice News back issues from October 2007:
NYC rewards good patient behavior.(Practice Trends)(New York City)
Oct 01, 2007; ... [ILLUSTRATION OMITTED] NEW YORK -- A new program in New York City that pays low-income families for obtaining preventive medical care and for maintaining health insurance is garnering its share of praise and skepticism among physicians who practice there. Under the ...
Second SERM gets approved to lower breast cancer risk: warning added on stroke, embolism risks.(News)
Oct 01, 2007; ... Raloxifene, first approved for preventing post-menopausal osteoporosis in 1997, has been approved for two new indications: reducing the risk of invasive breast cancer in postmenopausal women with osteoporosis and in postmenopausal women at high risk for invasive breast cancer. ...
Medicare's Top 10 Therapy Classes in 2006.(VITAL SIGNS)(Brief article)
Oct 01, 2007 ... <Pre> Medicare's Top 10 Therapy Classes in 2006 Percentage of all Part D prescriptions Antihypertensives 25.0 Lipid regulators 7.4 Antidepressants5.1 Diabetes drugs, noninsulin 5.0 Analgesics, narcotic ...
Debate persists on benefits of lowering homocysteine.(Cardiovascular Medicine)
Oct 01, 2007; ... VIENNA -- Homocysteine lowering with B vitamins and folate didn't reduce mortality or cardiovascular events in the large randomized Western Norway B-vitamin intervention Trial (WENBIT), Dr. Marta Ebbing reported at the annual congress of the European Society of Cardiology. ...
FDA approves FluMist for children aged 2-5.(News)
Oct 01, 2007; ... The Food and Drug Administration approved the nasal influenza vaccine FluMist for children aged 2-5 years, which could help push up childhood vaccination rates. FluMist manufacturer MedImmune Inc. said that it anticipated shipping the vaccine to physicians and health care ...
New smallpox vaccine approved with educational requirements.(News)
Oct 01, 2007; ... The Food and Drug Administration has approved a new smallpox vaccine, ACAM2000, for active immunization against smallpox in individuals determined to be at high risk for smallpox infection. The vaccine also could be used to immunize populations during a bioterrorist attack. ...
Maker of blood glucose meter issues correction.(News)(Brief article)
Oct 01, 2007; ... Patients who use blood glucose meters manufactured by Abbott Laboratories have been warned by the company to take caution and examine their display screens carefully if they have dropped the meters on a hard surface. According to a statement from Abbott on August 31, if any ...
Reclast.(New & Approved)
Oct 01, 2007; ... Reclast (zoledronic acid, Novartis Pharmaceuticals) A 5-mg formulation of the intravenous bisphosphonate approved for treating postmenopausal osteoporosis, the first osteoporosis treatment administered once a year. Approved earlier this year for Paget disease. ...
Simple preventive care is shown to save lives.(News)
Oct 01, 2007; ... Increasing the use of aspirin, colorectal cancer screening, influenza immunizations, and a few other simple preventive measures would save more than 100,000 lives each year in the United States, according to a new study. The biggest lifesaver identified in the study is aspirin. ...
Clear benefit seen in elderly on antihypertensives.(News)
Oct 01, 2007; ... At large, randomized international trial assessing the benefits of giving blood pressure-lowering medications to hypertensive patients aged 80 and older has been halted early because treatment significantly reduced the incidence of stroke and mortality compared with those who did not ...
Screening for asymptomatic PAD makes sense.(Guest Editorial)(peripheral artery disease)
Oct 01, 2007; ... Results from the German Epidemiogical Trial on Ankle-Brachial Index (getABI), recently presented at the annual congress of the European Society of Cardiology, provide good evidence that there is a real need for primary care physicians to screen asymptomatic patients for peripheral artery ...
Accounts receivable in action.(Letters)(Letter to the editor)
Oct 01, 2007; ... Months ago our 35-person group practice read with interest Dr. Joseph S. Eastern's article ("Slash Accounts Receivable: Stop Extending Credit," Guest Editorial, Dec. 1, 2005, p. 12). He suggested obtaining a credit card "imprint" from all patients and billing them once the ...
Best practices in: chronic constipation in the elderly.
Oct 01, 2007; ... Epidemiology: Chronic constipation (CC) is a common disorder in the United States. Estimates have shown it affects between 2% and 28% of adults. (1) Demographic patterns suggest it is more prevalent in certain populations. Chronic constipation is two to three times more common in women ...
Benefits of low-dose aspirin alone offset costs.(Cardiovascular Medicine)(Brief article)
Oct 01, 2007; ... WASHINGTON -- Low-dose aspirin alone may be the most cost-effective antiplatelet therapy despite the risk of adverse gastrointestinal outcomes, according to an analysis presented at the annual Digestive Disease Week. "In average-risk patients, aspirin alone optimized the ...
Cardiac catheterization must in PAH diagnosis.(Cardiovascular Medicine)(Disease/Disorder overview)
Oct 01, 2007; ... NEW YORK -- Any patient with suspected pulmonary hypertension must have a thorough work-up, including right heart catheterization, before initiating treatment, Dr. Roxana Sulica said at a meeting sponsored by the Pulmonary Hypertension Association and the University of Michigan. ...
Benefit of revascularization in women questioned.(Cardiovascular Medicine)
Oct 01, 2007; ... VIENNA -- Women with non--ST-elevation acute coronary syndrome don't show the same clear benefit as men do in response to a routine invasive management strategy, Dr. Eva Swahn reported at the annual congress of the European Society of Cardiology. In fact, her new meta-analysis ...
Silent heart ischemia appears reversible in type 2 diabetes.(Cardiovascular Medicine)
Oct 01, 2007; ... SAN DIEGO -- Nearly 80% of patients with type 2 diabetes who had silent myocardial ischemia revealed by stress myocardial perfusion imaging had a reversal of exercise-induced myocardial perfusion abnormalities when they were retested 3 years later. The unexpected Finding ...
Team-based diabetes care improves outcomes.(Metabolic Disorders)
Oct 01, 2007; ... A new team-based approach to care as helped physicians and their staffs in the Abington Physician Network achieve goals for blood pressure, cholesterol levels, and hemoglobin Ale levels in their diabetic patients. It's not that physicians in the network are working harder or ...
Insulin regimens for type 2 diabetes compared.(Metabolic Disorders)
Oct 01, 2007; ... CHICAGO -- When advancing a patient with type 2 diabetes to insulin therapy, the choice of whether to use mealtime insulin plus a basal insulin at bedtime or just a mealtime mix of rapid- and longer-acting insulin does not make a difference. However, in a head-to-head trial of ...
Consider early treatment for turner syndrome.(Metabolic Disorders)
Oct 01, 2007; ... Early treatment with growth hormone can correct growth failure in infants and toddlers with Turner syndrome, allowing many of them to achieve normal height within a few years, Dr. Marsha Davenport and her colleagues reported. In their randomized placebo-controlled trial, 93% of ...
BRAF mutation flags aggressive thyroid cancer.(Metabolic Disorders)
Oct 01, 2007; ... COLORADO SPRINGS -- Papillary thyroid cancers positive for the BRAF V600E mutation behave markedly more aggressively than those that aren't, Dr. Electron Kebebew said at the annual meeting of the American Surgical Association. "Future testing for this mutation could help us ...
Can the course of low-risk thyroid cancer be accurately predicted? Scoring schemes can be used to predict the course.(Point/Counterpoint)
Oct 01, 2007; ... Papillary thyroid cancers represent around 80% of all thyroid cancers seen in doctors' offices, and most present when they are small (a median 1.7 cm in diameter) and unlikely to have gross extrathyroid invasion (less than 1.5%). Forty percent of patients will have positive ...
Can the course of low-risk thyroid cancer be accurately predicted? It's difficult to predict the course of low-risk disease.(Point/Counterpoint)
Oct 01, 2007; ... A review of almost 54,000 cases of thyroid cancer treated between 1985 and 1995, showed the 10-year survival rate for cases of papillary thyroid cancer is 93%. But because papillary thyroid cancer makes up such a preponderance of thyroid cancer cases, that 7% mortality rate made up 53% of ...
Steady growth noted in immunization coverage.(Infectious Diseases)
Oct 01, 2007; ... Immunization coverage in 2006 for children aged 19-35 months held steady for most recommended vaccines and grew for several types, but more recent recommendations in coverage for adolescents aged 13-17 years have not yet reached the same levels of success, according to results from the ...
HPV vaccine doesn't clear existing infection.(Infectious Diseases)(Clinical report)
Oct 01, 2007; ... In women who test positive for human papillomavirus DNA, the bivalent HPV-16/18 vaccination does not induce or accelerate clearance of the infection, according to a phase III study report. Human papillomavirus (HPV) vaccination induces cell-mediated immune responses that are ...
Antiretrovirals may inhibit lipid-lowering therapy.(Infectious Diseases)
Oct 01, 2007; ... LOS ANGELES -- HIV-positive patients on antiretroviral therapy who are prescribed lipid-lowering agents do not respond to those drugs as well as other patients do, according to a large retrospective study. The HIV patients were 57% as likely to reach the National Cholesterol ...
MRSA is now ubiquitous, increasingly resistant.(Infectious Diseases)(methicillin-resistant Staphylococcus aureus)
Oct 01, 2007; ... NEW YORK -- Methicillin-resistant Staphylococcus aureus is now the most common cause of serious skin and soft-tissue infections in many communities throughout the United States, Dr. Mark Lebwohl said at the American Academy of Dermatology's annual Academy 2007 meeting. "If ...
A dozen pediatric flu shots may prevent one visit.(Infectious Diseases)
Oct 01, 2007; ... TORONTO -- As few as 12 pediatric influenza immunizations and probably even fewer in each practice could prevent an outpatient visit for influenza later in the season, according to a poster presented at the annual meeting of the Pediatric Academic Societies. "Most physicians ...
Three vaccines at once found safe and effective.(Infectious Diseases)
Oct 01, 2007; ... Coadministering the seven-valent pneumococcal conjugate vaccine and a Haemophilus influenzae type b conjugate vaccine with the pentavalent diphtheria, tetanus, acellular pertussis, hepatitis B, and polio combination vaccine in infants does not compromise the safety and immunogenicity of ...
Periodic fever syndromes are rare, erupt on skin.(Skin Disorders)
Oct 01, 2007; ... CHICAGO -- Many genetically based periodic fever syndromes have skin signs that may help identify the syndromes on the rare occasions when they occur, Dr. Kathryn M. Edwards said at the annual meeting of the Society for Pediatric Dermatology. Although these syndromes, called ...
Tacrolimus prevents flares in atopic dermatitis.(Skin Disorders)
Oct 01, 2007; ... CHICAGO -- Intermittent treatment with tacrolimus ointment kept atopic dermatitis under control with no need for corticosteroids in patients aged 2-15 years whose conditions had stabilized, according to a presentation at the annual meeting of the Society for Pediatric Dermatology. ...
Expert shares challenging cases from Stanford.(Skin Disorders)(Anna L. Bruckner of Stanford (California) University at the meeting of the Pacific Dermatologic Association)(Conference news)
Oct 01, 2007; ... CORONADO, CALIF. -- Making the correct diagnosis and choosing the best therapy are standard goals of practice, but sometimes that's easier said than done. At the annual meeting of the Pacific Dermatologic Association, Dr. Anna L. Bruckner discussed three cases to illustrate that ...
Buprenorphine can save lives.(Guest Editorial)
Oct 01, 2007; ... Young people living in middle class and affluent suburbs are dying in unprecedented numbers because of their addictions to opiates. Most of these deaths are the result of addiction to diverted prescription analgesics, used alone or with alcohol and benzodiazepines. As a ...
Prescription drug abuse increases among teens.(Mental Health)
Oct 01, 2007; ... WASHINGTON -- There's good and bad news from the 2006 National Survey on Drug Use and Health: Overall drug use among adolescents has declined since 2002, but prescription drug misuse among young adults has skyrocketed. In the federally funded annual survey of approximately ...
Tocilizumab is beneficial in moderate to severe RA.(Musculoskeletal Disorders)(rheumatoid arthritis)
Oct 01, 2007; ... BARCELONA -- In a multicenter double-blind study, treatment with the interleukin-6 signaling blocker tocilizumab not only significantly reduced disease activity among patients with rheumatoid arthritis but also improved physical function, fatigue, and quality of life. A total of ...
Long-term steroids in RA may cut function.(Musculoskeletal Disorders)(rheumatoid arthritis)
Oct 01, 2007; ... BARCELONA -- Rheumatoid arthritis patients who use corticosteroids frequently over the long term can maintain a low disease activity state but suffer deterioration of their functional capability, Dr. Eiichi Tanaka reported at a poster session at the annual European Congress of ...
Newer bacterial vaginosis therapies are emerging.(Women's Health)
Oct 01, 2007; ... CHICAGO -- Oral tinidazole, single-dose clindamycin vaginal cream, and lactobacillus-containing products are among the newer therapies for the treatment of bacterial vaginosis, Dr. Paul Nyirjesy said at a conference on vulvovaginal diseases. Many of the therapies have emerged ...
Nondrug options for labor pain rival opioids.(Women's Health)
Oct 01, 2007; ... SAN FRANCISCO -- When it comes to relieving labor pain, there's nothing like an epidural. Beyond that, however, some nonpharmacologic strategies compete well with opioids, the next most common pharmacologic option for treating labor pain, Judith T. Bishop said at a meeting on ...
More safety data on SSRIs.(Drugs Pregnancy, And Lactation)
Oct 01, 2007; ... Over the last 5 years, several studies analyzing the reproductive safety of the selective serotonin reuptake inhibitors (SSRIs), individually and as a group, have been published in the United States and elsewhere. Earlier studies that failed to show an association between first-trimester ...
Rate of obesity rises in 31 states; no drop seen.(Obesity)
Oct 01, 2007; ... Adult obesity is on the rise in 31 states, and no states have experienced a drop in obesity, according to a study from Trust for America's Health. Mississippi topped the list of the fattest states, with the highest adult obesity rates for the third year in a row. More than 30% ...
Overweight, obesity start early in urban youth.(Obesity)
Oct 01, 2007; ... TORONTO -- A critical period for the development of obesity in early childhood appears to be between the ages of 1 and 3 years, according to a study of inner-city youth presented at the annual meeting of the Pediatric Academic Societies. In 1,713 children aged 1-5 years, ...
Consensus formed on eosinophilic esophagitis.(Digestive Disorders)
Oct 01, 2007; ... In the absence of pathologic gastroesophageal reflux disease, young children with esophageal symptoms or feeding problems and older children and adults with dysphagia or esophageal food impaction should be evaluated for eosinophilic esophagitis, particularly if their symptoms are ...
Hypnotherapy beats standard IBS care for kids.(Digestive Disorders)(irritable bowel syndrome)
Oct 01, 2007; ... WASHINGTON -- Children and adolescents with functional abdominal pain or irritable bowel syndrome who were treated with hypnotherapy were cured of their illness in significantly greater numbers than were children given standard medical treatment in a randomized, controlled trial presented ...
Nursing home segregation, disparities detailed.(Geriatic Medicine)
Oct 01, 2007; ... Nursing homes remain segregated in most parts of the United States, providing unequal care that appears to be perpetuated by their growth in segregated residential areas and the practices of not-for-profit facilities, according to a report on survey data from the year 2000. "The ...
Delirium management still elusive, studies needed.(Geriatric Medicine)
Oct 01, 2007; ... LONG BEACH, CALIF. -- So little is known about effective interventions for delirium that efforts to help elderly patients with the condition leave many providers, well, delirious. The goal of treating delirium is not just to control agitation or hallucinations, but to reverse ...
Insomnia treatment in the elderly is complex, unpredictable.(Geriatric Medicine)
Oct 01, 2007; ... MINNEAPOLIS -- Metabolic changes and comorbid conditions are just a few of the challenges involved in treating insomnia in older adults. "The predictability of your giving drug X to patient A and knowing what is going to happen goes way down. That's the bottom line," said Dr ....
Death, MI risk tied to OSA severity.(Pulmonary Medicine)(myocardial infarction)(obstructive sleep apnea)(Brief article)
Oct 01, 2007; ... SAN FRANCISCO -- Obstructive sleep apnea is tied to a 30% increased risk of myocardial infarction or death even after adjustment for many cofactors, Dr. Neomi A. Shah said at the International Conference of the American Thoracic Society. Moreover, the greater the severity of ...
Nocturnal pulse oximetry cuts costs in apnea.(Pulmonary Medicine)
Oct 01, 2007; ... SAN FRANCISCO -- Adiagnostic algorithm employing nocturnal pulse oximetry before referring children to polysomnography can greatly reduce the costs of diagnosing obstructive sleep apnea syndrome, according to a poster presentation by M. Kirstman, Dr. Robert T. Brouillette, and their ...
Eco-awareness can enhance asthma outcomes.(Pulmonary Medicine)
Oct 01, 2007; ... Sometimes, a successful treatment depends on matching the right drug or therapeutic approach with the symptom patterns at hand. But in other cases, it takes a little outside-the-box thinking to get results. With a disorder like asthma, the problem may be as much environmental as ...
Allay parents' concerns about febrile seizure.(Clinical Rounds)
Oct 01, 2007; ... MAUI, HAWAII -- How do you counsel parents after a child has had a generalized tonic-clonic febrile seizure? Address their underlying fears and concerns is what tops Dr. Eileen Vining's list. If they've gone to the emergency department and test results are normal, "the family is ...
Tips for pediatric neurologic exams.(Clinical Rounds)
Oct 01, 2007; ... MAUI, HAWAII -- Be creative and confident in performing pediatric neurologic examinations, urged Dr. Eileen Vining. Obtaining a thorough history is, of course, crucial. "We need to capture all of the information that is available to us," she said at a meeting sponsored by the ...
Prognosis is favorable for many migraineurs.(Clinical Rounds)
Oct 01, 2007; ... CHICAGO -- Migraine appears to have a favorable long-term prognosis in many patients, with more than a third experiencing cessation of headache and the majority of persistent migraineurs reporting symptom improvement over 12 years. "These data probably reflect the natural course ...
Heart evaluation is often critical following stroke.(Clinical Rounds)
Oct 01, 2007; ... CHICAGO -- Up to 20% of strokes begin in the heart, so cardiac imaging should be part of the work-up of many stroke patients, Dr. Gautham Reddy said at the annual meeting of the American Society of Neuroradiology. Electrocardiographically gated multidetector CT can assess the ...
Calcium, vit. D may cut cancer risk.(Clinical Capsules)
Oct 01, 2007 ... High intakes of calcium and vitamin D were associated with lower breast cancer risk in premenopausal women in a prospective study of more than 30,000 women. The decreased risk seems most pronounced with aggressive breast tumors, wrote Jennifer Lin, Ph.D., of Harvard Medical School, Boston, ...
Warfarin okay in elderly with a-fib.(Clinical Capsules)(atrial fibrillation)(Brief article)
Oct 01, 2007 ... In the elderly with atrial fibrillation, warfarin is better than aspirin at preventing strokes and no more likely to cause a major hemorrhage, according to a study of 973 patients aged 75 years or older. Dr. Jonathan Mant, of the University of Birmingham, England, and colleagues ...
Gout treatment patterns vary widely.(Clinical Capsules)(Brief article)
Oct 01, 2007 ... Just 25% of suspected gout patients had arthrocentesis for crystal analysis, although the procedure remains the "gold standard" for diagnosis of the disease, according to Dr. Danielle Petersel and Dr. Naomi Schlesinger of the Robert Wood Johnson Medical School at New Brunswick (N.J.). ...
Monitoring is key in infants born with one kidney.(Clinical Rounds)(Brief article)
Oct 01, 2007; ... MAUI, HAWAII -- In infants born with unilateral renal agenesis, where a single kidney is functioning, it's important to confirm that the good kidney is, in fact, functional, said Dr. Carl M. Grushkin, head of the division of nephrology at Childrens Hospital Los Angeles. About 1 ...
Open access scheduling.(The Office)
Oct 01, 2007; ... In my practice, the open access scheduling system allows a patient to be seen the same day they call for any reason whatsoever. That means if a patient calls at 3 p.m., I'll see that patient that day. Patients obviously love this because they have their needs met quickly and ...
Simplicity is key in cutting wait times.(Practice Trends)
Oct 01, 2007; ... By making some simple changes, Dr. S. Germain Cassiere has dramatically reduced the amount of time patients must wait for lab tests. As in many medical offices, his patients for many years had signed in on a sheet of paper to let the receptionist and technicians know they were ...
Self-referral rule heralds a return to earlier policy.(Practice Trends)
Oct 01, 2007; ... In issuing the third phase of the final regulations implementing the physician self-referral rule, also known as the Stark law, the Center for Medicare and Medicaid Services has returned to a stance it held in the first phase. The Stark law governs whether, how, and when it is ...
UnitedHealthcare agrees to $20 million settlement in claims processing case.(Practice Trends)(Brief article)
Oct 01, 2007; ... The insurance giant UnitedHealthcare could pay up to $20 million to state regulators as part of an agreement to settle allegations that the company violated state laws in its claims processing. Under the settlement, UnitedHealthcare has agreed to pay about $12.2 million up front ...
WHI results still confusing.(Policy & Practice)(Women's Health Initiative)(Brief article)
Oct 01, 2007; ... Just 18% of physicians said they have "no confusion at all" about the results of the Women's Health Initiative study, according to an online survey of more than 400 physicians conducted on behalf of The Hormone Foundation. In addition, only 15% said they believe patients accurately ...
Aventis settles pricing fraud case.(Policy & Practice)
Oct 01, 2007; ... Drugmaker Sanofi-Aventis has agreed to pay more than $190 million to settle allegations of fraudulent drug pricing and marketing against Aventis Pharmaceuticals, one of its predecessor companies. According to the U.S. Department of Justice, Aventis used the difference between the inflated ...
Insurance premium increase slows.(Policy & Practice)(Brief article)
Oct 01, 2007; ... Employer-sponsored health insurance premiums rose on average 6.1% in 2007, reflecting a continuing slowdown in premium increases. The 2007 premium increase is the smallest hike since 1999, according to an employer survey by the Kaiser Family Foundation and the Health Research and ...
Rise in adverse drug event reports.(Policy & Practice)(Brief article)
Oct 01, 2007; ... The number of serious and fatal adverse drug events (ADEs) reported to the Food and Drug Administration more than doubled between 1998 and 2005, according to a report in the Sept. 10 issue of Archives of Internal Medicine. The agency defines a serious adverse event as an event resulting in ...