Family Practice News back issues from May 2008:
Virtual visits free physicians, patients.(Practice Trends)
May 01, 2008; ... [ILLUSTRATION OMITTED] By 10:00 on Saturday morning, Dr. John Bachman has already consulted with a handful of patients: He has prescribed an antibiotic for a urinary tract infection, adjusted the medication of a hypertensive patient, examined one rash, and suggested a course of ...
Top 10 therapeutic classes by U.S. sales in 2007.(VITAL SIGNS)(Statistical table)(Brief article)
May 01, 2008 ... <Pre> VITAL SIGNS Top 10 Therapeutic Classes by U.S. Sales in 2007 (in billions) Lipid regulators $18.4 Proton pump inhibitors $14.1 Antipsychotics $13.1 Antidepresants $11.9 Anticonvulsants ...
Cardiac screening advised before starting ADHD Rx: selective ECG deemed medically indicated.(News)
May 01, 2008; ... Family physicians are likely to receive a deluge of questions from concerned parents regarding new recommendations from the American Heart Association suggesting that a child's risk for adverse cardiac outcomes should be evaluated before initiating pharmacologic treatment of ...
Stakeholders hammer out medical home principles.(Practice Trends)
May 01, 2008; ... WASHINGTON -- A who's who list of physician organizations, advocacy groups, pharmaceutical manufacturers, and employers is throwing its weight behind the idea that the medical home model can cure much of what ails the health care system. "I have been a family physician for 31 ...
Vaccine reduces recurrence, death in patients with HER2 breast cancer.(News)
May 01, 2008; ... SAN DIEGO -- Vaccination with a human epidermal growth factor receptor 2/neu peptide vaccine increased immunogenicity, decreased breast cancer recurrence, and reduced mortality by 50% after a median of 3 years of treatment in node-positive and node-negative breast cancer patients with all ...
Physician burnout takes toll on quality of care.(News)
May 01, 2008; ... PITTSBURGH -- Adverse working conditions are not only associated with stress and burnout for primary care physicians, but also result in diminished quality of care for their patients. The fending, from the third and final phase of the MEMO (Minimizing Error, Maximizing Outcome) ...
'Use it or lose it' strategy confirmed to aid memory.(News)
May 01, 2008; ... CHICAGO -- Older adults with normal cognition who engaged in a mental fitness program for 1 hour a day, 5 days a week, for 8 weeks, demonstrated significant improvements in memory and nonmemory tasks, according to data presented at the annual meeting of the American Academy of Neurology. ...
Rosiglitazone patient guide addresses heart failure, other cardiac concerns.(News)
May 01, 2008; ... A Patient medication guide that explains the risks associated with rosiglitazone (Avandia) will be dispensed to patients with each new prescription, including refills, according to the Food and Drug Administration and GlaxoSmithKline Inc. Rosiglitazone is indicated for the ...
Analysis results may offer rational celecoxib use.(News)
May 01, 2008; ... CHICAGO -- The cardiovascular risk of celecoxib is a function of both dose and dosing schedule, as well as a patient's baseline cardiovascular risk, according to a new National Cancer Institute-sponsored pooled analysis. Individuals at higher baseline cardiovascular risk, ...
Heavy drinking, smoking found to hasten the onset of Alzheimer's.(News)
May 01, 2008; ... CHICAGO -- Heavy drinking and smoking are associated with a significantly earlier age of development of late-onset Alzheimer's disease, according to findings presented at the annual meeting of the American Academy of Neurology. In a retrospective analysis of 686 patients ...
High cholesterol in midlife ups Alzheimer's risk.(News)
May 01, 2008; ... CHICAGO -- High cholesterol levels in midlife are associated with an increased risk of Alzheimer's disease and vascular dementia, data from a large, diverse cohort suggest. The analysis of more than 9,500 individuals showed that those patients with midlife total cholesterol ...
Medical litigation benefits attorneys.(Letters)(Letter to the editor)
May 01, 2008; ... I was outraged to see the opinions of Miles Zaremski, J.D., published in FAMILY PRACTICE NEWS ("Noneconomic Damage Caps," Law & Medicine, April 1, 2008, p. 60). His views on noneconomic damage caps are false and contrary to the best interests of practicing physicians. He poses ...
Should insulin therapy be started earlier in type 2 diabetes patients? Early use of insulin improves [beta]-cell function.(POINT/COUNTERPOINT)
May 01, 2008; ... We should be using insulin earlier in type 2 diabetes. More than 40% of people with type 2 diabetes are not at the hemoglobin Ale goal of less than 7%. More than 50% are not at an [HbA.sub.1c] goal of 6.5% or less. The problem, I believe, is that it's taking far too long to start insulin ...
Should insulin therapy be started earlier in type 2 diabetes patients? Aggressive combination treatment is often enough.(POINT/COUNTERPOINT)
May 01, 2008; ... Is there a compelling reason to add insulin early? Dr. Abrahamson cited a few studies that used intensive insulin therapy for a period of time, with some follow-up. Maybe there is something to that. But is it the insulin or aggressive early therapy in general that gets terrifically tight ...
Moderately large waist measurements matter.(Cardiovascular Medicine)
May 01, 2008; ... COLORADO SPRINGS -- Marginally increased waist circumference is strongly associated with prevalent hypertension in normal-weight and overweight adults, according to data from a large National Institute of Neurological Disorders and Stroke-sponsored study. The finding is likely ...
ACE inhibitor/ARB combination does more harm than good.(Cardiovascular Medicine)(angiotensin-receptor blocker)(angiotensin-converting enzyme)
May 01, 2008 ... CHICAGO -- Telmisartan is as effective as ramipril in reducing vascular events in high-risk patients, but combining the two drugs provides no incremental benefit and increases side effects. That was the key message of ONTARGET (the Ongoing Telmisartan Alone and in Combination ...
Ankle-brachial index adds to Framingham Risk Score.(Cardiovascular Medicine)
May 01, 2008; ... CHICAGO -- The Framingham Risk Score failed to identify a substantial number of people who were at risk for cardiovascular disease events on the basis of their ankle-brachial index, in a review of more than 1,700 asymptomatic people. An ankle-brachial index (ABI) of less than ...
Home defibrillators failed to cut deaths in post-MI patients.(Cardiovascular Medicine)(Myocardial infarction)(Clinical report)
May 01, 2008; ... CHICAGO -- Placing an automated external defibrillator in the homes of patients with a previous anterior-wall MI did not reduce mortality in a large randomized, multicenter trial. The primary end point of death from any cause was not significantly different between patients who ...
Appropriateness of stress echocardiology testing updated.(Cardiovascular Medicine)
May 01, 2008; ... The American College of Cardiology Foundation and key specialty societies have released new appropriateness criteria for the use of stress echocardiography to help physicians keep abreast of rapidly changing imaging technology. The indications in the "2008 Appropriateness ...
Simple steps improve diabetes self management.(Metabolic Disorders)
May 01, 2008; ... SAN FRANCISCO -- Here's what doesn't work when trying to help patients self-manage their diabetes: * Urging them to use more will power. "You need to get serious about your diabetes." * Threatening them with bad outcomes. "Do you want to go blind?" * ...
Financial incentives spur patients to slim down.(Metabolic Disorders)
May 01, 2008; ... Everyone knows that money talks. But when it comes to dieting, can money really motivate overweight patients to shed pounds? Dr. Joseph K. Chemplavil, an endocrinologist in Hampton, Va., thinks it can. He points to his own success in giving patients 51 for each pound they lose. ...
Assess 'global cardiometabolic risk' factors in patients with dyslipidemia.(Metabolic Disorders)
May 01, 2008; ... Lipoprotein management in patients with cardiometabolic risk is the focus of a joint consensus statement from the American Diabetes Association and American College of Cardiology Foundation. The evidence-based statement, written by a seven-member panel, advises assessing global ...
[HbA.sub.1c] may help flag impaired glucose tolerance in children.(Metabolic Disorders)
May 01, 2008; ... PHILADELPHIA -- Testing for hemoglobin [A.sub.1c] could be an effective means of screening children not only for type 2 diabetes but also for impaired glucose tolerance, according to the results of a study of 74 children. "Type 2 diabetes was effectively excluded by hemoglobin ...
Low bone mass frequently gets overtreated.(Metabolic Disorders)
May 01, 2008; ... NEW YORK -- Overtreatment for low bone mass has been all too common in women aged 50-60 years since the introduction of the bisphosphonate drugs and the widespread use of bone scans, according to Dr. Stephen Honig. Routine bone scanning at menopause--very common in this ...
Lower exercise intensity in obese boys.(Clinical Capsules)(Brief article)
May 01, 2008 ... Obese adolescent boys have a limited capacity to metabolize fat by exercising at the recommended moderate intensity level, and might do better with lower-intensity activity, according to Dr. Gautier Zunquin, a sports medicine researcher at the University of the Littoral Opal Coast, ...
Breast-feeding and type 2 diabetes.(Clinical Capsules)(Brief article)
May 01, 2008 ... reast-fed babies may be protected against /developing type 2 diabetes during childhood regardless of ethnicity, according to results from a study adjunct to the ongoing SEARCH for Diabetes in Youth investigation, by Elizabeth J. Mayer-Davis, Ph.D., of the University of South Carolina, ...
Vitamin D cuts risk of type 1 diabetes.(Clinical Capsules)
May 01, 2008 ... Children receiving vitamin D supplementation are significantly less likely to develop type 1 diabetes, according to an analysis of observational studies led by Dr. Christos Zipitis of St. Mary's Hospital for Women and Children, Manchester, England. In four case-control studies ...
Face the facts when dealing with genital herpes: patient education is critical, especially since many who test positive are asymptomatic.(Infectious Diseases)
May 01, 2008; ... BOSTON -- Genital herpes is a recurrent, lifelong viral disease. This is the one thing that patients and providers don't like to say, but there's no way around it, Laura J. Mulcahy said at a conference on contraceptive technology sponsored by Contemporary Forums. Other difficult ...
Universal HIV screening renews disclosure debate.(EXPERT OPINION)
May 01, 2008; ... When a person discloses a positive HIV status to a partner, the disclosure eliminates many of the moral, ethical, and legal considerations inherent in the opposite scenario. Just what is our responsibility as physicians in this regard? Do we have a duty to protect and warn the ...
Gonorrhea often goes undetected in gay men.(Infectious Diseases)
May 01, 2008; ... CHICAGO -- Despite visiting a sexual health clinic for screening tests, up to 35% of sexually active gay men might still have undiagnosed gonorrhea infections, Kristen Mahle said at a conference on STD prevention sponsored by the Centers for Disease Control and Prevention. The ...
Self-collected swabs okay for STDs in men.(Infectious Diseases)(Sexually transmitted diseases)
May 01, 2008; ... CHICAGO -- Patient-collected rectal swabs are just as accurate as provider-collected swabs for diagnosing chlamydia and gonorrhea infections in men, Dr. Christine Wigen reported at a conference on STD prevention sponsored by the Centers for Disease Control and Prevention ...
Eczema center emphasizes research, education.(Skin Disorders)
May 01, 2008; ... Since its debut in April of 2007, the Eczema Center at Rady Children's Hospital in San Diego has received hundreds of e-mails, phone calls, and visits from families in western states and some from the East Coast, many desperate to find relief for their children's eczema. The ...
Tanning industry launches attack against 'melanoma hype'.(Skin Disorders)
May 01, 2008; ... Does tanning increase the risk of melanoma? Not according to the Indoor Tanning Association, which has launched a print and TV advertising campaign in seven major cities claiming there is no compelling scientific evidence linking tanning to melanoma. "Both the sun and tanning beds have ...
Suicidality overlooked in diagnosis of depression.(Mental Health)
May 01, 2008; ... SAN FRANCISCO -- In a randomized trial involving actors portraying patients with major depression, internists and family physicians usually failed to ask these patients about suicidality, even when they correctly made the depression diagnosis, Dr. Mitchell D. Feldman reported at a meeting ...
Seasonal allergies are linked to depression, rise in suicide rates.(Mental Health)
May 01, 2008; ... PHILADELPHIA -- Seasonal allergies might be associated with fatigue and mood disorders, including depression, in certain patients, Dr. Tedor T. Postolache reported at the annual meeting of the American Academy of Allergy, Asthma, and Immunology. These possible associations are ...
Doctor's visit a chance to screen teens for inhalant abuse.(Mental Health)
May 01, 2008 ... BY DENISE NAPOLI Assistant Editor WASHINGTON -- The drugs of choice for children aged 12 and 13 years are inhalants, surpassing pain relievers, marijuana, and any other illegal drug, with 3.4% of 12-year-olds and 4.8% of 13-year-olds using in the past year, according ...
Surgery sans radiation deemed an option in DCIS.(Women's Health)(ductal carcinoma in situ)
May 01, 2008; ... HOLLYWOOD, FLA. -- All women with ductal carcinoma in situ should have the choice of foregoing radiation therapy, according to updated breast cancer guidelines announced at the annual conference of the National Comprehensive Cancer Network. Previously, the guidelines ...
Women's health Web site unveiled.(Women's Health)(http://sis.nlm.nih.gov/out reach/womenshealthoverview.html)(Brief article)
May 01, 2008 ... The National Library of Medicine, a division of the National Institutes of Health, is partnering with the NIH Office of Research on Women's Health to offer a one-stop Web resource with the latest information on significant topics ...
Drugs, pregnancy, and lactation: atypical antipsychotics.(Women's Health)
May 01, 2008; ... Data on the reproductive safety of certain psychotropics, such as selective serotonin reuptake inhibitors and anti-epileptic drugs, have increased in recent years, but information on the attendant risks of fetal exposure to antipsychotics remains sparse. This is particularly ...
Bacterial vaginosis may be risk factor for HSV-2.(Women's Health)(Clinical report)
May 01, 2008; ... CHICAGO -- Women with bacterial vaginosis might face a higher risk of acquiring herpes simplex type 2 infections, said Dr. Emilia Koumans, a public health official with the Centers for Disease Control and Prevention. Her cross-sectional study couldn't assess the temporal ...
Partner history raises risk of BV in gay women.(Women's Health)
May 01, 2008; ... CHICAGO -- The biggest risk factor for bacterial vaginosis among gay or bisexual women is having a sex partner with a history of the infection--an association that increases the chances of bacterial vaginosis by more than 400%, Dr. Jeanne Marrazzo said at a meeting on the prevention of ...
Radiation to target prostate cancer risk.(Men's Health)
May 01, 2008; ... HOLLYWOOD, FLA. -- The use of three-dimensional conformal radiation or intensity-modulated radiation therapy is now mandated in the National Comprehensive Cancer Network's new treatment guidelines for prostate cancer. Specific recommendations for radiation doses to treat low-, ...
Life expectancy must guide prostate cancer treatment.(Men's Health)
May 01, 2008; ... [ILLUSTRATION OMITTED] HOLLYWOOD, FLA. -- Updated National Comprehensive Cancer Network guidelines stress expectant management--surveillance only with no other treatment--for low- and intermediate-risk prostate cancer. "We think it is more prudent to take into account ...
Pyriformis syndrome frequently overdiagnosed: what's often labeled pyriformis syndrome is more likely proximal radicular pain or referred pain.(Musculoskeletal Disorders)
May 01, 2008; ... SNOWMASS, COLO. -- Pyriformis syndrome as a cause of low back pain is greatly overdiagnosed, Dr. Zacharia Isaac asserted at a symposium sponsored by the American College of Rheumatology. "First of all, true pyriformis syndrome involves an entrapment of the sciatic nerve as it ...
Maneuvers, not imaging, can help confirm sacroiliac joint syndrome.(Musculoskeletal Disorders)
May 01, 2008; ... SNOWMASS, COLO. -- Reserve an anesthetic block to diagnose sacroiliac joint syndrome for those patients having at least three positive pain-provoking tests on physical examination, Dr. Zacharia Isaac urged at a symposium sponsored by the American College of Rheumatology. "At ...
Risk factors are identified for ovarian failure in SLE.(Musculoskeletal Disorders)
May 01, 2008; ... Higher disease activity, treatment with cyclophosphamide, an older age, and a certain ethnic background were each linked with a significantly increased risk for developing premature gonadal failure in a study of 316 women with systemic lupus erythematosus. Disease activity and ...
Genetics is top of the list of risk factors for RA.(Musculoskeletal Disorders)
May 01, 2008; ... SNOWMASS, COLO. -- Of the many putative risk factors for rheumatoid arthritis investigated to date, only three--genetics, smoking, and reproductive factors-are supported by strong and persuasive evidence, Dr. Sherine E. Gabriel said at a symposium sponsored by the American College of ...
Update on diagnosing, managing celiac disease: short stature and dental enamel defects are added to the existing list of extraintestinal symptoms.(Digestive Disorders)(Disease/Disorder overview)
May 01, 2008; ... MIAMI -- Ataxia, peripheral neuropathy; and epilepsy are among the extraintestinal manifestations of celiac disease when it presents in a child over age 15 months. The bowel symptoms of diarrhea, nausea, and abdominal pain are more common in younger children. Other ...
Colorectal cancer screening rises, but disparities persist.(Digestive Disorders)
May 01, 2008; ... The use of sigmoidoscopy or colonoscopy to screen for colorectal cancer has increased in recent years, according to Dr. D.A. Joseph and his associates at the Centers for Disease Control and Prevention. "Although this increase is encouraging, disparities persist in colorectal ...
Colonoscopy greatly underused in high-risk African Americans.(Digestive Disorders)
May 01, 2008; ... African Americans who had multiple first-degree relatives with colon cancer were much less likely to undergo the recommended screening colonoscopy than their white counterparts, according to the findings of a large cohort study. "Physicians and other health care providers need ...
With specialist shortage, obese kids turn to PCPs: the data suggest that geographic differences in endocrinologist supply may be driving variation.(Obesity)(primary care physicians)
May 01, 2008; ... The distribution of children with diabetes and obesity does not parallel that of pediatric endocrinologists in the United States, largely because of geographic disparities in the supply of these specialists, according to Dr. Joyce M. Lee and colleagues at the University of Michigan, Ann ...
Responsiveness to external, internal cues tied to obesity.(Obesity)
May 01, 2008; ... BALTIMORE -- Children with greater body mass indexes appear to be more responsive to external food cues and less responsive to internal satiety signals, according to a study involving almost 11,000 children. The findings, which were presented at the annual meeting of the ...
Short sleep duration in infancy may predict childhood adiposity.(Obesity)
May 01, 2008; ... Sleep duration of less than 12 hours per day during infancy may predict childhood overweight, researchers reported. In a prospective study of 915 mother-child pairs, sleep curtailment at age 6 months to 2 years doubled the odds that, at age 3 years, a child would show increased ...
Adenotonsillectomy may not resolve sleep apnea.(Pulmonary Medicine)(Clinical report)
May 01, 2008; ... FORT LAUDERDALE, FLA. -- Although adenotonsillectomy remains the first-line treatment for children with obstructive sleep apnea syndrome, only about 25%-30% will experience complete resolution of symptoms, according to a prospective study. Another 25% or so of children will ...
Preemie asthma tied to mom's chorioamnionitis.(Pulmonary Medicine)
May 01, 2008; ... PHILADELPHIA -- Children born prematurely to mothers who developed chorioamnionitis during pregnancy were about fourfold more likely to develop asthma and wheezing during the first 2 years of life, compared with term infants born to mothers without chorioamnionitis, based on data collected ...
Oral drug for cystic fibrosis shows promise in early trials.(Pulmonary Medicine)(Clinical report)
May 01, 2008; ... A drug for fixing a crucial defective protein in cystic fibrosis improved patients' lung function and sweat chloride levels, according to early results from a small randomized study. The investigational oral drug, VX-770, is still in phase II trials. But preliminary findings in ...
Genetic marker may flag risk of asthma, poor lung function.(Pulmonary Medicine)
May 01, 2008; ... A protein linked to inflammation and tissue remodeling is a significant biomarker for asthma and poor lung function, and a variation in that protein's genetic code is also associated with asthma risk and bronchial hyperresponsiveness. A single-nucleotide polymorphism (SNP) was ...
Treat pain to improve cognition in older adults.(Geriatric Medicine)(Disease/Disorder overview)
May 01, 2008; ... ORLANDO -- Pain is a comorbid condition too often overlooked in the setting of geriatric psychiatry, despite the potential for better mental health outcomes when it is treated, Dr. Jordan E Karp said at the annual meeting of the American Association for Geriatric Psychiatry. "I ...
Many elderly, particularly in nursing homes, lack vitamin D.(Geriatric Medicine)
May 01, 2008; ... SALT LAKE CITY -- Even among nursing home residents receiving substantial vitamin D supplements, half or more show deficiencies in the nutrient, according to two separate posters presented at the annual symposium of the American Medical Directors Association. Researchers who ...
TPA fails in women with metabolic syndrome: the effect may be caused by defective endogenous fibrinolysis, a hallmark of metabolic syndrome.(Clinical Rounds)(Clinical report)
May 01, 2008; ... NEW ORLEANS -- The detrimental effect of metabolic syndrome on recanalization after intravenous thrombolytic treatment of acute ischemic stroke appears to be more pronounced in women than in men, according to the results of a prospective study. Among patients with metabolic ...
Insulin resistance is linked to stroke risk in nondiabetics.(Clinical Rounds)(Clinical report)
May 01, 2008; ... NEW ORLEANS -- Insulin resistance independently predicted the risk of ischemic stroke and vascular disease in nondiabetic participants in the Northern Manhattan Study, a community-based, prospective cohort of 3,298 people. The results of the study, which had a mean follow-up of ...
MRI method may oust liver biopsy for sickle cell.(Clinical Rounds)
May 01, 2008; ... ATLANTA -- Children with sickle cell disease, [beta]-thalassemia, and other hematologic diseases may no longer need to undergo potentially painful and risky biopsies to assess the amount of iron accumulating in their liver as a result of therapeutic blood transfusions--at least at one ...
Frequency of migraine with aura may be tied to cardiovascular risk.(Clinical Rounds)
May 01, 2008; ... CHICAGO -- Migraine frequency seems to be an indicator of increased risk of cardiovascular disease in migraineurs with aura, according to findings from a large cohort analysis presented April 17 at the annual meeting of the American Academy of Neurology. The study, which used ...
More mild cognitive impairment seen in men.(Clinical Rounds)
May 01, 2008; ... CHICAGO -- Men have more mild cognitive impairment than women do, yet there is no gender difference in the prevalence of dementia, according to the results of one of the first studies to measure mild cognitive impairment prospectively in a population-based setting. [ILLUSTRATION ...
Migraine and apnea may be linked in kids.(Clinical Rounds)
May 01, 2008; ... CHICAGO -- Sleep apnea was observed in more than half of children with migraine in a study presented at the annual meeting of the American Academy of Neurology. Evaluation by polysomnography revealed sleep apnea in 56% of children with migraine, compared with 30% of those with ...