Family Practice News back issues from February 2008:
The medical home embeds psychiatry.(Mental Health)(Grant Family Medicine)
Feb 01, 2008; ... [ILLUSTRATION OMITTED] Dr. Robert Skully and Ms. Pat Martin are training their residents to meet patients' mental health care needs within the medical home. Under the model at the Grant Family Medicine residency program in Columbus, Ohio, psychiatrist Christopher ...
Added calcium may raise MI risk in older women: physicians clash on need to alter practice.(Cardiovascular Medicine)(Clinical report)
Feb 01, 2008; ... Calcium supplementation significantly increased the risk of a myocardial infarction among healthy, postmenopausal women, compared with those taking placebo in a secondary analysis of an osteoporosis study. Physicians should consider this increased cardiovascular risk against ...
Ezetimibe fails to rein in atherosclerotic advance.(Cardiovascular Medicine)
Feb 01, 2008; ... Results from a controversial study assessing ezetimibe's ability to slow atherosclerotic progression when added to a high-dose statin regimen have cardiologists split on whether the findings signaled a flawed study or a flawed drug. The results were "disappointing, but not ...
Projected aggregate physician and clinical service expenditures in the U.S.(VITAL SIGNS)(Table)(Brief article)
Feb 01, 2008 ... <Pre> Projected Aggregate Physician and Clinical Service Expenditures in the U.S. (in billions of dollars) 2006$447.0 2008 -- 2010 -- 2012 -- 2014 -- 2016$819.9 ...
FDA advises against cold remedies.(News)(Food and Drug Administration)
Feb 01, 2008; ... The Food and Drug Administration has released a public health advisory strongly recommending against the use of over-the-counter cough and cold products in children and infants aged under 2 years, but will not issue recommendations until the spring about the use of these products in ...
PAD is rising among asymptomatic Americans, and in women especially.(News)
Feb 01, 2008; ... ORLANDO -- The prevalence of peripheral artery disease in asymptomatic adults is increasing in the United States, according to data that were collected on more than 5,000 people by the National Health and Nutrition Examination Survey (NHANES) during 1999-2004. The spike in ...
ESA risks in patients with cancer are under review.(NEWS FROM THE FDA)
Feb 01, 2008; ... More evidence associating erythropoiesis-stimulating agents with increased tumor growth and mortality in patients with cancer is being reviewed at the Food and Drug Administration and could result in additional action by the agency. The new data are from two studies, the FDA ...
Natalizumab gets the nod for use in selected Crohn's patients.(NEWS FROM THE FDA)
Feb 01, 2008; ... The Food and Drug Administration's approval of natalizumab for the treatment of moderate to severe Crohn's disease in selected patients includes the requirement that the drug will be administered only through a restricted distribution program, the agency has announced. ...
Derma-Smoothe/FS.(New & Approved)(Hill Dermaceuticals Inc.)(Drug overview)
Feb 01, 2008; ... Derma-Smoothe/FS (fluocinolone acetonide topical body oil, 0.01%, Hill Dermaceuticals Inc.) The Food and Drug Administration approved Derma-Smoothe/FS (fluocinolone acetonide) Topical Oil, 0.01% for treatment of moderate to severe atopic dermatitis in patients who are aged 3 months to 2 ...
Omnaris nasal spray.(New & Approved)(Drug overview)
Feb 01, 2008; ... Omnaris Nasal Spray (ciclesonide nasal spray, Nycomed) The FDA approved Omnaris (ciclesonide) Nasal Spray for treatment of seasonal allergic rhinitis in patients aged 6-11 years. * Recommended Dosage: The recommended 200 mcg per day is delivered as two sprays (50 mcg per spray) ...
Guidelines focus on palliative care at end of life.(News)
Feb 01, 2008; ... Palliative care at the end of life should focus on the assessment and alleviation of symptoms of pain, shortness of breath, and depression, according to new guidelines released by the American College of Physicians. "The ACP's drawing a line in the sand and saying this is ...
Part D boosts drug utilization, drives up nation's health tab.(News)
Feb 01, 2008; ... WASHINGTON -- The nation spent $2 trillion, or $7,000 per person, on health care in 2006. Although that was a small increase from the previous year, America's prescription drug tab increased by 8.5%, fueled largely by the new Medicare Part D drug benefit. Health spending as a ...
Diabetes education needs reevaluation.(Editorial)
Feb 01, 2008; ... With the incidence of diabetes increasing, especially type 2 diabetes in children and adolescents, there is a renewed interest in how to manage diabetes care. It is even more critical because many with diabetes can't achieve metabolic goals that will slow or prevent complications. ...
Challenges of being a single dad.(Letters)(Letter to the editor)
Feb 01, 2008; ... I really have been able to identify almost to the letter with Dr. Michael A. Volz and his experience as a single parent ("Being a Single Dad Is Ongoing Struggle," Letters, Dec. 15, 2007, p. 8). I have three children and have struggled to keep life as smooth as possible for them, ...
Vasopressin antagonists effective for hyponatremia.(Cardiovascular Medicine)(conivaptan and satavaptan)
Feb 01, 2008; ... SAN FRANCISCO -- Satavaptan and conivaptan seem effective in treating dilutional hyponatremia, a frequent consequence of heart failure and of renal failure. Data supporting the efficacy of the vasopressin receptor antagonists for this indication were presented in two posters at ...
Pioglitazone may lower cardiovascular risk in CKD patients.(Cardiovascular Medicine)(Clinical report)
Feb 01, 2008; ... Treatment with pioglitazone might help lower the risk of cardiovascular events in patients with chronic kidney disease, the results of a large study suggest. "CKD, as defined by a glomerular filtration rate of less than 60 mL/min per 1.73 [m.sup.2], is an independent risk factor ...
Coronary calcium flags young men at cardiac risk.(Cardiovascular Medicine)
Feb 01, 2008; ... ORLANDO -- Coronary artery calcium identified young men at relatively high risk for a coronary heart disease event even when their Framingham risk score was low, in a study with more than 1,600 men. The new findings "challenge the notion that a coronary artery calcium [CAC] ...
Continuous glucose monitoring holds potential.(Metabolic Disorders)
Feb 01, 2008; ... COLUMBUS, OHIO -- Real-time continuous glucose monitoring is likely to become the standard of care for the treatment of type 1 diabetes within the next 5-10 years, but for now it's best to reserve the technology for selected patients, Dr. Irl B. Hirsch said at a meeting on diabetes ...
Moderate exercise improves metabolic syndrome in adults.(Metabolic Disorders)
Feb 01, 2008; ... Moderate-intensity exercise that was equivalent to walking about 12 miles over an average of 170 minutes per week significantly improved features of the metabolic syndrome even without dietary modification in a study of 171 overweight adults. Johanna L. Johnson of Duke ...
Men's Osteopenia Dx unlikely to change at 3 years.(Metabolic Disorders)
Feb 01, 2008; ... HONOLULU -- Men diagnosed with osteopenia through dual-energy x-ray absorptiometry are unlikely to have a change in diagnosis at a 3-year follow-up DXA test, according to a study presented in a poster at the annual meeting of the American Society for Bone and Mineral Research. ...
Bazedoxifene nips postmenopausal osteoporosis risk.(Metabolic Disorders)
Feb 01, 2008; ... HONOLULU -- Bazedoxifene is effective in preventing osteoporosis in postmenopausal women, according to the results of a 2-year, phase III, placebo-controlled trial presented at the annual meeting of the American Society for Bone and Mineral Research. Participants were ...
History, low BMD raise long-term fracture risk.(bone mineral density)
Feb 01, 2008; ... Low bone mineral density and a prevalent vertebral fracture were long-term independent predictors of an increased risk of vertebral fractures in women aged 65-99 who were followed for almost 15 years. Previous studies have shown links between low BMD and an increased risk of a ...
Assessment tool helps classify CAP severity.(Infectious Diseases)(community-acquired pneumonia)
Feb 01, 2008; ... CHICAGO -- A simple severity-assessment tool for community-acquired pneumonia accurately identified patients needing intensive respiratory or inotropic support in a multicenter validation study. SMART-COP was developed as part of the Australian Community-Acquired Pneumonia (CAP) ...
Petting zoos, swimming pools bring infectious diarrhea closer to home.(Infectious Diseases)
Feb 01, 2008; ... SAN FRANCISCO -- Go beyond the usual questions about travel to other countries or the keeping of nontraditional pets, when asking parents about potential environmental exposures to diarrhea-causing agents, Dr. Sarah S. Long said at the annual meeting of the American Academy of Pediatrics. ...
Asthmatic children bear the brunt of the influenza burden.(Infectious Diseases)(Clinical report)
Feb 01, 2008; ... The influenza-related hospitalization rates of young children with asthma were four times greater than those of children without asthma, and outpatient visits attributable to influenza were about twice as likely among those with asthma, according to Dr. E. Kathryn Miller and her ...
Chest radiographs may be overused in severe CAP.(Infectious Diseases)(community-acquired pneumonia)
Feb 01, 2008; ... CHICAGO -- Routine follow-up chest radiography may not be appropriate for patients with severe community-acquired pneumonia who clinically respond to initial antibiotic therapy, according to a multicenter study presented at the Interscience Conference on Antimicrobial Agents and ...
Database for RSV.(Infectious Diseases)(respiratory syncytial virus)(Brief article)
Feb 01, 2008 ... A redesigned Web site from the Centers r Disease Control and Prevention now provides data that has been gathered on respiratory syncytial virus (RSV) in the U.S., ...
Approach to C. difficile must change.(Infectious Diseases)(Clostridium)
Feb 01, 2008; ... SAN FRANCISCO -- Community-onset Clostridium difficile infection that is not antibiotic related has emerged as a multinational problem that can be life threatening, said Dr. Sarah S. Long, chief of infectious diseases at St. Christopher's Hospital for Children, Philadelphia. ...
Olive, whey products may help soothe psoriasis.(Skin Disorders)
Feb 01, 2008; ... Two new natural products--one containing olive polyphenols and the other a proprietary combination of whey proteins--can reduce the symptom burden and appearance of mild to moderate psoriasis. Both products were recently introduced in the United States as oral formulations, ...
Practice hosts after-hours psychological services.(Mental Health)
Feb 01, 2008; ... SAN FRANCISCO -- When primary care physicians head home at the end of the day in one New York practice, mental health providers reopen the doors to children and families who need their help. Offering the after-hours office space to mental health providers has helped physicians ...
Self-management tool helps patients navigate depression.(Mental Health)
Feb 01, 2008; ... Family physician Patrice Ranger estimates that she sees about 10 depressed patients a week at the student health services clinic at the Simon Fraser University campus in Burnaby, B.C. That's about 10% of her practice. However, she can help a fair number of those patients by ...
Mental health care gaps recast PCPs as 'reluctant' psychiatrists.(Mental Health)
Feb 01, 2008; ... VANCOUVER, B.C. -- Primary care physicians in community health centers say they are practicing "reluctant psychiatry" because mentally ill patients with chronic diseases often have nowhere else to turn for care, Dr. Carol Darr reported in a poster presentation at the annual meeting of the ...
Histology necessary for endometriosis diagnosis.(Women's Health)(International Pelvic Pain Society)
Feb 01, 2008; ... SAN DIEGO -- When it comes to diagnosing endometriosis, visual inspection is not enough, Dr. Georgine Lamvu said at the annual meeting of the International Pelvic Pain Society. "We need to be more careful to use excisional biopsies during laparoscopies and careful about the ...
Response to hormonal therapy doesn't point to endometriosis.
Feb 01, 2008; ... WASHINGTON -- Response to hormonal therapy does not accurately predict whether a patient has endometriosis, Dr. Todd R. Jenkins reported at the annual meeting of the AAGL. Laparoscopy has long been the standard for diagnosing endometriosis. But a 1999 paper by Dr. Frank W. Ling ...
Prostate cancer therapy breaks deemed risky.(Men's Health)
Feb 01, 2008; ... LOS ANGELES -- For men with low-risk prostate cancer, skipping more than two sessions of radiotherapy beyond their scheduled weekends off can have long-term consequences, investigators found when they reviewed nearly 1,800 patients treated from 1989 to 2004 at a single cancer center. ...
Cialis gets approved for once-daily use.(Men's Health)
Feb 01, 2008; ... The erectile dysfunction drug Cialis (tadalafil) has been approved by the Food and Drug Administration for once-daffy use in 2.5-mg and 5-mg doses, the drug's manufacturer announced. "This low-dose daily treatment option of Cialis may be most appropriate for men with ED who ...
Gastric bypass also cuts cancer, diabetes, heart disease mortality.(Obesity)
Feb 01, 2008; ... Severely obese individuals who opt to have gastric bypass surgery not only reduce their waistlines, they reduce their long-term total mortality as well, Utah researchers have reported. Rates of death from diabetes, coronary artery disease, and cancer were all significantly lower ...
Federal program aims to prevent obesity in girls.(Obesity)
Feb 01, 2008; ... Physicians can now turn to a free federally-developed program that provides the tools to educate parents and caregivers on how to help their young adolescent daughters make small and specific behavior changes to maintain a healthy weight and prevent obesity. The program provides ...
Families lose weight with fat, sugar, carbs intake counseling.(Obesity)
Feb 01, 2008; ... A family dietary program that offered monthly nutritional counseling and online computer support helped parents and children cut their daily intake of fat and sugar. Although the counseling lasted for only 8 months, changes were sustained throughout the 12-month study, wrote ...
Biologics in pipeline for juvenile idiopathic arthritis.(Musculoskeletal Disorders)(Medical condition overview)
Feb 01, 2008; ... BOSTON -- Treatment options for children with juvenile idiopathic arthritis might soon expand, with safety and efficacy now having been demonstrated for two additional biologic agents--even in patients who have failed to respond to methotrexate or another biologic, Dr. Daniel J. Lovell ...
Changes in synovial volume could predict progression of osteoarthritis.(Musculoskeletal Disorders)(Clinical report)
Feb 01, 2008; ... FORT LAUDERDALE, FLA. -- Early screening of synovial fluid volume changes using magnetic resonance imaging could identify patients at risk for progressive knee osteoarthritis, according to interim findings of an ongoing study. Synovial fluid volume decrease on MRI correlated ...
Life expectancy no better in RA patients, despite new therapies.(Musculoskeletal Disorders)(Medical condition overview)
Feb 01, 2008; ... Rheumatoid arthritis patients have not experienced a decline in mortality, despite dramatically increased life expectancy in the general population and newer, more aggressive arthritis treatments. This stagnation is contributing to a widening mortality gap between patients with ...
Early asthma tied to bacteria in neonatal airways.(Pulmonary Medicine)
Feb 01, 2008; ... Infants whose airways are colonized by one or more of three bacterial species are significantly more likely to develop asthma by 5 years of age than are other children. Dr. Hans Bisgaard and his colleagues from the Copenhagen University Hospital found colonization with ...
Inner-city preschoolers with asthma should be evaluated every 3 months.(Pulmonary Medicine)
Feb 01, 2008; ... A study of preschool-age, inner-city children with asthma found marked fluctuations in the degree of asthma control within 3 months, suggesting that frequent evaluations of asthma control in this population may be warranted, investigators reported. "We know asthma is an unstable ...
Elective C-section linked to respiratory morbidity.(Pulmonary Medicine)
Feb 01, 2008; ... Elective cesarian section increases by up to fourfold the risk of respiratory morbidity in babies delivered at 37-39 weeks of gestation, compared with babies delivered vaginally or by emergency C-section at the same gestational age. That finding--from a Danish cohort study of ...
Contrast medium eased small bowel blockages.(Digestive Disorders)
Feb 01, 2008; ... MONTREAL -- FOE patients with adhesive small bowel obstruction, a water-soluble contrast medium produces significantly better outcomes than conservative treatment, according to a study presented at a meeting sponsored by the International Society of Surgery. "Gastrografin ...
Diagnostic criteria devised for adult autoimmune enteropathy.(Digestive Disorders)
Feb 01, 2008; ... Five criteria for diagnosing autoimmune enteropathy are now available thanks to a compilation of 15 patients at the Mayo Clinic, which has more than doubled the number of cases in the published literature. The researchers found that only about half of the patients had histology ...
Mild, acute pancreatitis resolves well with a normal diet.(Digestive Disorders)
Feb 01, 2008; ... PHILADELPHIA -- An early return to a normal diet was not harmful and might even have expedited the hospital discharge of patients with mild, acute pancreatitis in a randomized, prospective study with 62 patients. "Early feeding appears safe and may lead to reduced emotional and ...
Stroke risk after TIA lowest at specialized centers.(Geriatric Medicine)
Feb 01, 2008; ... The risk of a stroke within 7 days of a transient ischemic attack was lowest when patients were treated by specialist stroke services on an emergency basis, according to a systematic review and meta-analysis that included 10,126 TIA patients. The review looked at 18 cohorts in ...
Toolkit helps guide elderly on the Web.(Geriatric Medicine)(Helping Older Adults Search for Health Information Online: A Toolkit for Trainers)(Brief article)
Feb 01, 2008 ... The National Institute on Aging is offering a free curriculum, "Helping Older Adults Search for Health Information Online: A Toolkit for Trainers." Instructors can use this curriculum to teach elderly people how to find health ...
Evidence supports concern over nonfocal TNAs.(Geriatric Medicine)
Feb 01, 2008; ... Adults who suffered transient neurological attacks with nonfocal symptoms were at increased risk of developing major vascular disease and dementia in a study of more than 6,000 adults aged 55 years and older. The findings challenge the perception that nonfocal transient ...
Bipolar, depression symptoms cluster in epilepsy.(Clinical Rounds)
Feb 01, 2008; ... PHILADELPHIA -- Symptoms of bipolar disorder are prevalent among patients with epilepsy, and are highly associated with depressive symptoms in these patients, an analysis of 54 epilepsy patients at a tertiary care center shows. In a poster presented at the annual meeting of the ...
Vitamin E, lutein shave cataract risk.(Clinical Capsules)(Brief article)
Feb 01, 2008 ... Higher intakes of the antioxidants vitamin E and lutein were associated with a 14%-18% lower risk of cataract in the Women's Health Study, according to William G. Christen, Sc.D., of Brigham and Women's Hospital, Boston, and his associates. The results add to existing ...
Smoking raises the odds for AMD.(Clinical Capsules)(age-related macular degeneration)(Brief article)
Feb 01, 2008 ... Smoking might raise the odds of developing age-related macular degeneration by nearly 50% over the long term, and it might also be associated with the cumulative progression of AMD in the Beaver Dam Eye Study, said Dr. Ronald Klein and associates at the University of Wisconsin, Madison. ...
Air quality matter in lung function.(Clinical Capsules)(Brief article)
Feb 01, 2008 ... Improving air quality, particularly by reducing particulate-matter pollution, attenuates the normal age-related decline in lung function in adults, according to Sara H. Downs, Ph.D., of the University of Basel (Switzerland) and associates in the prospective Swiss Cohort Study on Air ...
Clones and the human food chain.(Genomic Medicine)
Feb 01, 2008; ... Primary care providers are asked often about issues that aren't strictly related to diagnoses and treatments, and increasingly, the question of food safety arises (think contaminated spinach and bovine growth hormone). Enter another link in the food chain: cloned animals. ...
States rapidly adopting cystic fibrosis screening in newborns.(Clinical Rounds)
Feb 01, 2008; ... SALT LAKE CITY -- Twenty-nine states required newborn cystic fibrosis screening as of this past summer, and more states are likely to do so soon, Dr. Michael Rock said at the annual meeting of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition. ...
Group to Study the genetics of serious adverse drug events.(Clinical Rounds)
Feb 01, 2008; ... A group of eight of the largest drug manufacturers has formed a consortium to study the genetics of serious adverse drug reactions. The Serious Adverse Events Consortium will work closely with the Food and Drug Administration on the projects that it will undertake. It ...
Expert offers tips for effective opioid prescribing.(Clinical Rounds)
Feb 01, 2008; ... SAN DIEGO -- A good way to ensure a balanced approach to opioid prescribing is to follow the key principles of the Model Policy for the Use of Controlled Substances for the Treatment of Pain, Dr. Edward Michna advised at the annual meeting of the International Pelvic Pain Society. ...
Vitamin D inadequacy might have a role in chronic pain.(Clinical Rounds)
Feb 01, 2008; ... SAN FRANCISCO -- In what may be the first study of the prevalence of vitamin D inadequacy in patients seeking treatment for chronic pain, those who were on opioids used significantly higher doses and had been taking opioids significantly longer if they had vitamin D inadequacy than if they ...
Pain catastrophizing worsens disability from osteoarthritis.(Clinical Rounds)
Feb 01, 2008; ... FORT LAUDERDALE, FLA. -- Pain catastrophizing and pain-related fear are associated with increased disability and worse physical functioning among overweight patients with osteoarthritis, according to a study presented at the World Congress on Osteoarthritis. "In the ...
Medicare payment creates uncertainty for the future.(Practice Trends)
Feb 01, 2008; ... Doubt and low morale are rampant in many primary care practices in light of the uncertainty surrounding Medicare physician payment rates this year. While members of Congress averted a 10% cut in the Medicare physician fee schedule, replacing it instead with a 0.5% increase, that ...
Wealthy, insured patients get free drug samples over poor, uninsured.(Practice Trends)(Brief article)
Feb 01, 2008; ... Poor and uninsured Americans are less likely than wealthy or insured Americans to receive free drug samples, according to a study by physicians from Cambridge Health Alliance and Harvard Medical School. The study found that, in 2003, 12% of Americans received at least one free ...
Low-income seniors helped.(Policy & Practice)(Brief article)
Feb 01, 2008; ... The Centers for Medicare and Medicaid Services has proposed new rules that would allow more low-income Medicare beneficiaries to remain in their current prescription drug plan without having to pay a premium. Each year, CMS recalculates the amount of premium that will be paid by Medicare ...
Coverage improves health.(Policy & Practice)(Brief article)
Feb 01, 2008; ... Uninsured adults 55-64 years old, particularly those with cardiovascular disease or diabetes, saw their health improve significantly once they became eligible for Medicare, a study from Harvard Medical School, Boston, reported. The study looked at more than 5,000 adults who were ...