Family Practice News back issues from August 2008:
Medical homes to test fee per patient.(Practice Trends)
Aug 01, 2008; ... [ILLUSTRATION OMITTED] Imagine being able to spend all the time you need to with the 20-year-old patient who is overweight and smokes. While a sore throat may have prompted the visit, given the time, you might be able to successfully convince him to make a few lifestyle changes ....
Top 10 most expensive diagnoses.(VITAL SIGNS)(Table)(Brief article)
Aug 01, 2008 ... <Pre> Top 10 Most Expensive Diagnoses (in millions of dollars) Aggregate hospital costsCoronary atherosclerosis ...
Sleep apnea raised all-cause mortality in a 14-year study: the hazard ratio for dying reached 6.24.(News)
Aug 01, 2008; ... BALTIMORE -- Moderate to severe sleep apnea significantly increased the risk of all-cause mortality, according to 14 years of follow-up data from a large community sample. "Sleep apnea is a disease of public health significance," said Nathaniel Marshall, Ph.D., of the University ...
Feds use carrot approach to promote e-prescribing.(News)
Aug 01, 2008; ... Federal officials are urging physicians to begin electronic prescribing as soon as possible now that Congress has authorized bonus payments for the successful use of the technology. Under the recently enacted Medicare Improvements for Patients and Providers Act (H.R. 6331)--the ...
FDA reforms communication about approvals.(News)
Aug 01, 2008; ... The Food and Drug Administration will no longer issue "approvable" or "not approvable" letters when a drug application is not approved, but will instead issue a "complete response" letter at the end of the review period, the agency announced last month. The change goes into ...
Assay for HER2 status in breast cancer approved.(News)(SPOT-Light by Invitrogen Corp.)(Brief article)
Aug 01, 2008; ... The Food and Drug Administration has approved a novel assay for assessing HER2 (human epidermal growth factor receptor 2) status in breast cancer patients being considered for treatment with trastuzumab. The SPOT-Light test, manufactured by Invitrogen Corp., uses chromogenic in ...
New diabetes drugs must meet heart health tests: the recommendations were intended for new drugs, and suggestions for existing drugs weren't as specific.(News)
Aug 01, 2008; ... SILVER SPRING, MD. -- At a meeting earlier this month, a Food and Drug Administration advisory panel agreed in a 14-2 vote that developers of new drugs or biologics for type 2 diabetes should be required to conduct a long-term study evaluating cardiovascular safety or should provide ...
FDA panels reject suicidality warning for antiepileptic drugs.(News)
Aug 01, 2008; ... BELTSVILLE, MD. -- A boxed warning about an increased suicidality risk with the use of antiepileptic drugs should not be added to the labels of drugs in this class, but patients prescribed these drugs should receive information about this risk with every prescription, according to the ...
Tendinitis warning is added to fluoroquinolones.(News)
Aug 01, 2008; ... The Food and Drug Administration has announced that manufacturers of fluoroquinolone drugs will be required to add a boxed warning to the label and provide a medication guide for patients explaining the increased risk of tendinitis and tendon rupture in patients taking the drugs. ...
AMA apology for racial inequity is just a starting point, experts say.(News)(American Medical Association)
Aug 01, 2008; ... African American physicians are looking for action to back up the words of apology recently tendered by the American Medical Association for more than a century of racial inequity and bias. In accepting the AMA's apology, the National Medical Association (NMA), which represents ...
Joint commission rules target infection control.(News)
Aug 01, 2008; ... The Joint Commission has issued new requirements for hospitals in a bid to prevent infections from multidrug-resistant organisms, central line-associated bloodstream infections, and surgical site infections. The requirements, which are part of the 2009 National Patient Safety ...
Washington-based hospital is ahead of the curve in cutting central-line infections.(News)
Aug 01, 2008 ... The physicians, nurses, and other clinical staffers at Tacoma (Wash.) General Hospital aren't sweating the new Joint Commission on Accreditation of Healthcare Organizations" requirements on central line-associated bloodstream infections that are scheduled to be phased in throughout 2009. ...
Implications of diabetes diagnosis.(Letters)(Letter to the editor)
Aug 01, 2008; ... I take issue with Dr. Rhoda Cobin's claim that there were "few arguments against" the recent recommendation that women with polycystic ovary syndrome be screened for diabetes ("Glucose Tolerance Tests Urged for All With PCOS," Jan. 15, 2008, p. 16). Perhaps Dr. Cobin should ...
Should hospitals be required to screen patients for infections at the time of admission? Screening holds the key to prevention.(Point/Counterpoint)
Aug 01, 2008; ... In 2007, 2.4% of all hospitalized patients had methicillin-resistant Stahylococcus aureus health care infections, according to a survey of U.S. hospitals. That means at least 880,000 patients a year are infected by one superbug. Action is needed. These infections can be largely ...
Should hospitals be required to screen patients for infections at the time of admission? More data are needed.(Point/Counterpoint)
Aug 01, 2008; ... Hospitals have a long track record of preventing health care-associated infections. Still, no one knows better than the caring professionals who work in hospitals that we have to do more to protect patients from infection. There are three things we will need if we are to succeed ...
In atrial fib, quality of life shifts for spouses, too.(Cardiovascular Medicine)(atrial fibrillation)
Aug 01, 2008; ... SAN FRANCISCO -- Atrial fibrillation affects the quality of life of both patients and their spouses in equal measure, a survey of 264 patients and 94 spouses suggests. "When you're educating patients about atrial fibrillation, it's important to educate the spouses as well," Dr ....
Postmenopausal women on statins are less prone to AF.(Cardiovascular Medicine)(atrial fibrillation)
Aug 01, 2008; ... SAN FRANCISCO -- Postmenopausal women with coronary heart disease were less likely to develop atrial fibrillation if they were taking statins, a secondary analysis of data on 2,673 patients found. The prevalence of atrial fibrillation was 65% lower, and the incidence was 55% ...
Data support assessing heart health in children with NAFLD.(Cardiovascular Medicine)
Aug 01, 2008; ... Overweight or obese children who have nonalcoholic fatty liver disease appear to be at high risk of developing cardiovascular disease, according to study findings. This subset of overweight children also appears to have a high incidence of metabolic syndrome and to be at risk ...
ABI undervalued in assessing cardiovascular risk.(Cardiovascular Medicine)
Aug 01, 2008; ... The ankle-brachial index, a measurement that is commonly used by vascular specialists but not by other providers, adds such important information to cardiovascular risk assessment that it could now be incorporated into that process routinely, according to investigators who performed a ...
Repeat measurements unveil masked hypertension.(Cardiovascular Medicine)
Aug 01, 2008; ... NEW ORLEANS -- "Masked hypertension," which is thought to affect about one in eight individuals, can be identified through repeated office blood pressure measurements in persons who show discrepancy between office and home blood pressure levels, according to Italian investigators. ...
Note forearm bone density in prostate Ca patients.(Metabolic Disorders)
Aug 01, 2008; ... SAN FRANCISCO -- Checking bone mineral density in the forearm as well as the spine and hip in 181 men taking androgen deprivation therapy identified more patients with bone loss than did using densitometry on the spine and hip alone, according to data from a recent study. ...
Watch for risks to bone health in continuous androgen deprivation.(Metabolic Disorders)
Aug 01, 2008; ... CHICAGO -- Six or more months of continuous androgen deprivation therapy was associated with significantly increased risk of fragility fractures and type 2 diabetes in an observational study of nearly 20,000 men aged 66 years and older with prostate cancer, reported investigators at the ...
Atorvastatin tied to fewer cardiac events in diabetics.(Metabolic Disorders)
Aug 01, 2008; ... SAN FRANCISCO -- All statins may not be created equal as far as diabetes patients are concerned, according to a recent study. In patients with diabetes initiating statin therapy for the first time, those who took atorvastatin experienced 12% fewer cardiovascular events than ...
Type 2 diabetes overtakes type 1 in Hispanic girls.(Metabolic Disorders)
Aug 01, 2008; ... SAN FRANCISCO -- From age 15 years onward, Hispanic females in the United States are significantly more likely to be diagnosed with incident type 2 diabetes than type 1 diabetes, according to an analysis of data from the Search for Diabetes in Youth study. In addition, at ages ...
Glucose monitoring in type 2 diabetics is often inadequate.(Metabolic Disorders)
Aug 01, 2008; ... SAN FRANCISCO -- Only about 40% of patients who were newly prescribed oral antidiabetes drugs received a fasting plasma glucose test, according to findings in a recent study. In addition, only about half of patients received any hemoglobin [A.sub.1c] monitoring during the period ...
Hyperglycemia postpartum may flag metabolic syndrome risk.(Metabolic Disorders)
Aug 01, 2008; ... Gestational impaired glucose tolerance, defined by a single abnormal value at 1 hour during the oral glucose tolerance test, is associated with many of the same adverse outcomes as gestational diabetes mellitus, including postpartum glycemia, insulin resistance, and [beta]-cell ...
Data reassure on pregnancy outcomes in diabetes.(Metabolic Disorders)
Aug 01, 2008; ... SAN FRANCISCO -- Pregnancy outcomes for women with diabetes who maintain excellent glucose control during their pregnancy are very good, and are similar to those seen in the general population, according to the results of a retrospective study. The study, conducted by the ...
Pneumococcal vaccine schedule questions persist.(Infectious Diseases)
Aug 01, 2008; ... ATLANTA -- Recommendations regarding use of the 23-valent pneumococcal polysaccharide vaccine in high-risk children aged 24-59 months who previously received the 7-valent pneumococcal conjugate vaccine remain to be finalized after discussion of the issues by the Advisory Committee on ...
Patches, food among new vaccine delivery methods.(Expert Commentary)
Aug 01, 2008; ... New vaccines in the pipeline offer needleless alternatives that will help alleviate the human pincushion problem as well as facilitate immunization in the developing world. Transdermal patches, oral administration via food or drink, and new intranasal vaccines are three exciting ...
HPV vaccine approval for older women delayed.(Infectious Diseases)(human papillomavirus)
Aug 01, 2008; ... The expanded approval of the currently marketed human papillomavirus vaccine to women aged 27-45 years is being held up, at least until the manufacturer addresses some outstanding issues. In a statement issued in late June the manufacturer of Gardasil, Merck & Co., announced ...
Reimbursement woes loom over HPV vaccinations.(Infectious Diseases)
Aug 01, 2008; ... NEW ORLEANS -- Getting reimbursed is the top concern for physicians who offer the human papillomavirus vaccine, according to a survey by researchers at Brigham and Women's Hospital, Boston. Using a Web-based tool, Brigham resident Dr. Emily M. Ko and colleagues surveyed 1,488 ...
Acceptance of sunless tanning products is rising.(Skin Disorders)
Aug 01, 2008; ... KYOTO, JAPAN -- The use of sunless tanning products by American women is on the rise, with the most cited reason by users being the topical products safety as an alternative to sunbathing and tanning beds. This is a most welcome trend. Increased public acceptance of sunless ...
Mounting evidence points to psoriasis as an independent risk factor for CVD.(Skin Disorders)
Aug 01, 2008; ... MONTREAL -- Psoriasis is an independent risk factor for increased cardiovascular morbidity and mortality, according to a growing number of studies and new guidelines from the American Academy of Dermatology. Based on this evidence, it is important to screen and regularly monitor ...
Plaque psoriasis tied to arterial stiffness.(Skin Disorders)
Aug 01, 2008; ... KYOTO, JAPAN -- Severe chronic plaque psoriasis is associated with increased arterial stiffness independent of conventional cardiovascular risk factors, reported Dr. Giampiero Girolomoni. This arterial stiffness, a reflection of endothelial dysfunction, is expressed in a greater ...
Ask new mothers about corporal punishment.(Mental Health)
Aug 01, 2008; ... HONOLULU -- Corporal punishment was being used by 1 in 7 mothers to discipline their 11-month-olds in a prospective study of 1,378 mothers. Dr. Esther K. Chung, primary investigator, said the findings suggest that physicians may want to consider addressing the issues of spanking ...
Mental ills, pregnancy studied.(Mental Health)
Aug 01, 2008; ... Pregnancy does not raise the risk of developing any of the most prevalent mental disorders, with the notable exception of postpartum depression, according to the findings of a survey. Pregnant and postpartum women are widely considered to be vulnerable to psychiatric disorders, ...
Prevalence of ADHD is up among older children.(Mental Health)
Aug 01, 2008; ... The percentage of adolescents being diagnosed with attention-deficit/hyperactivity disorder is on the rise, but prevalence rates remain constant among younger children, a new study shows. In children aged 12-17 years, the prevalence of attention-deficit/hyperactivity disorder ...
Use of SSRIs, SNRIs is tied to upper GI bleeding.(Mental Health)(use of selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors elevate risk of gastrointestinal hemorrhage)
Aug 01, 2008; ... Antidepressants that block action on the serotonin reuptake mechanism seem to raise the risk of upper gastrointestinal bleeding to the same degree that antiplatelet drugs do, according to data from a case-control study involving over 11,000 subjects. Both selective serotonin ...
Eating disorder classifications of adolescents shift over time.(Mental Health)
Aug 01, 2008; ... SEATTLE -- Sizable proportions of adolescents progress along a spectrum of eating-disordered behavior over time, highlighting the importance of early detection and intervention, Diann M. Ackard, Ph.D., said at an international conference sponsored by the Academy for Eating Disorders. ...
Asthma drugs, anorectal atresia may be related.(Women's Health)
Aug 01, 2008; ... MONTEREY, CALIF. -- Women who take anti-inflammatories for asthma during the first trimester of pregnancy have an elevated risk of giving birth to an infant with anorectal atresia, according to results of a multicenter, case-control study of more than 7,000 women. ...
Screen, intervene to help pregnant substance abusers.(Women's Health)
Aug 01, 2008; ... CHICAGO -- Careful screening for substance abuse in pregnant women and recognizing that intervention can make a difference for these patients and their offspring are two important ways to improve obstetric outcomes. Physicians might also examine the attitudes and biases they ...
FDA to revise risk categories.(Drugs, Pregnancy, And Lactation)(United States Food and Drug Administration)
Aug 01, 2008; ... The Food and Drug Administration has proposed revisions to the longstanding system of pregnancy category labeling for all medications. The current system has classified the reproductive safety of medications across five risk categories--A, B, C, D and X--usually based on available data ...
MRI increases mastectomy in early breast cancer.(Women's Health)(magnetic resonance imaging)
Aug 01, 2008; ... Preoperative magnetic resonance imaging may be a factor in the rising rate of mastectomy in women with early-stage breast cancer, a study suggests. Investigators reviewed 5,596 stage 0-II breast cancers in 5,463 women who underwent surgery for the malignancy between 1997 and ...
Leptin, ghrelin levels eyed in amenorrheic athletes.(Women's Health)
Aug 01, 2008; ... SAN FRANCISCO -- Athletic teenage girls who are amenorrheic have higher ghrelin and lower leptin levels than do athletic girls who are eumenorrheic or girls who are nonathletic, according to a small study. The findings could help tease out which girls are more likely to stop ...
Citalopram seems effective in the reduction of hot flashes in trial.(Women's Health)
Aug 01, 2008; ... CHICAGO -- Citalopram may be an effective option for reducing hot flashes, having performed twice as well as placebo in a randomized, placebo-controlled phase Ill trial conducted by the North Central Cancer Treatment Group. "Hot flash relief can be obtained with as little as 10 ...
More young men have stage IV prostate cancer.(Men's Health)
Aug 01, 2008; ... CHICAGO -- Advanced prostate cancer is being diagnosed increasingly in younger men aged 60 years or less in the United States, despite the widespread availability of prostate-specific antigen testing, according to epidemiologic evidence spanning 15 years from the Surveillance, ...
Even low-grade prostate cancers need follow-up.(Men's Health)(Brief article)
Aug 01, 2008; ... ORLANDO -- Metastasis occurs after surgical removal of low-grade prostate cancer in some men, suggesting that close follow-up is warranted. Although there is an overall 30% recurrence rate a decade after prostatectomy, a man with a Gleason score of 6 or less generally has a ...
Natalizumab cuts hospitalization rates in Crohn's.(Digestive Disorders)(Crohn's disease)
Aug 01, 2008; ... SAN DIEGO -- Treatment with natalizumab significantly reduced the rates of overall hospitalization and disease-specific hospitalization for adults with Crohn's disease, according to data from 1,373 adults presented at the annual Digestive Disease Week. Hospitalization is one of ...
Methotrexate failed to boost infliximab's benefit in Crohn's.(Digestive Disorders)(Crohn's disease)
Aug 01, 2008; ... SAN DIEGO -- Adding methotrexate to infliximab was not superior to infliximab alone in Crohn's disease, according to a presentation at Digestive Disease Week. Both drugs are effective on their own, but it was not known whether a combination approach would be more effective, said ...
Older age is a strong predictor of early mortality after GI bleeding.(Digestive Disorders)(gastrointestinal hemorrhage)
Aug 01, 2008; ... SAN DIEGO -- Older age was the strongest predictor of early mortality in adults with gastrointestinal bleeding after investigators controlled for medications and comorbidities, according to data from more than 1,000 adults treated at a single medical center. More clinicians have ...
Risk factors predict acetaminophen hepatotoxicity.(Digestive Disorders)
Aug 01, 2008; ... Patients hospitalized for acetaminophen overdose had a 4.5% rate of acetaminophen-induced hepatotoxicity in a population-based study, according to Dr. Robert P Myers and his associates. In a multivariate analysis of residents of Calgary and southern Alberta (Canada) during ...
Indeterminate liver failure is often due to acetaminophen.(Digestive Disorders)
Aug 01, 2008; ... SAN DIEGO -- As many as 18%-20% of cases of indeterminate acute liver failure may be the result of unrecognized acetaminophen toxicity, according to a presentation at the annual Digestive Disease Week. The etiology is unknown in about 15% of cases of acute liver failure (ALF), ...
Metformin improves weight loss, satiety in kids.(Obesity)
Aug 01, 2008; ... SAN FRANCISCO -- Metformin is associated with modest weight loss and some improvements in signs of metabolic syndrome in obese children with severe hyperinsulinemia, a government-sponsored randomized controlled trial has concluded. But because this is the first such study in ...
Study shows favorable gastric banding outcomes in teen cohort.(Obesity)
Aug 01, 2008; ... SAN FRANCISCO -- Teens who underwent laparoscopic gastric banding surgery had improvements in hemoglobin [A.sub.1c], triglyceride, and C-reactive protein measures, according to 6-month follow-up results for 14 patients. The Lap-Band, made by Inamed Inc., a division of Allergan ...
Mediterranean, low-carb diets found as effective as AHA diet.(Obesity)(American Heart Association)
Aug 01, 2008; ... Both the Mediterranean diet and the low-carbohydrate (Atkins) diet proved to be as safe and effective for inducing weight loss in moderately obese subjects as was the American Heart Association's low-fat, restricted-calorie diet, according to a report. In a 2-year randomized ...
MRSA infections are seen in patients on anti-TNF therapy.(Musculoskeletal Disorders)
Aug 01, 2008; ... PARIS -- Methicillin-resistant Staphylococcus aureus infections have been reported for the first time in patients with rheumatoid arthritis being treated with tumor necrosis factor inhibitors. In a poster presented at the annual European Congress of Rheumatology, Dr. Jack ...
High coffee intake kicks up the risk of developing rheumatoid arthritis.(Musculoskeletal Disorders)
Aug 01, 2008; ... PARIS -- Heavy coffee drinking was associated with progression of undifferentiated arthritis to rheumatoid arthritis in an analysis of data from a Norwegian early arthritis clinic. The study included 280 patients aged 18-75 years with arthritis of at least one joint. The mean ...
In older adults, running is not linked to knee OA.(Musculoskeletal Disorders)(osteoarthritis)
Aug 01, 2008; ... Long-distance running among older adults has no effect on the development of radiographic osteoarthritis, according a small, prospective study comparing a population of runners with community-matched controls. The study looked at 45 runners and 53 controls who were at least 50 ...
Urate levels may be normal in gout.(Musculoskeletal Disorders)(Brief article)
Aug 01, 2008; ... PARIS -- Serum urate levels are often normal during acute gouty arthritis attacks, according to Dr. Naomi Schlesinger. In a study of 339 patients, 29% of individuals on chronicallopurinol had a true-normal serum urate level, defined as 6 rag/dL or less. Among patients not on the ...
Osteoarthritis knee pain eased by duloxetine.(Musculoskeletal Disorders)
Aug 01, 2008; ... PARIS -- Duloxetine once daily at 60 a 120 mg significantly improved knee osteoarthritis pain starting in week 1 of a 13 week placebo-controlled double-blind trial. Results of this positive study served as the partial basis for a recent supplemental New Drug Application to the ...
Education key to preventing female athlete triad.(Sports Medicine)
Aug 01, 2008; ... SEATTLE -- Education and the collaborative efforts of a team of professionals are important for preventing the female athlete triad, according to Sharon H. Thompson, Ed.D. The definition of the female athlete triad has been expanded recently, said Dr. Thompson, professor of ...
Ergogenic agents offer few benefits and plenty of risks.(Sports Medicine)
Aug 01, 2008; ... VANCOUVER, B.C. -- When it comes to improving performance in young athletes, the tried and true approaches--such as a balanced diet and adequate training--trump the energy drinks, supplements, and drugs. Although anabolic androgenic steroids increase muscle strength, they have ...
Celecoxib reduced lung lesion biomarker levels.(Pulmonary Medicine)(Clinical report)
Aug 01, 2008; ... CHICAGO -- Short-term treatment with high-dose celecoxib reduced expression levels for a biomarker associated with pre-cancerous lung lesions in a chemoprevention study of about 200 current and former smokers, according to data presented at the annual meeting of the American Society of ...
Look beyond asthma in assessing absenteeism.(Pulmonary Medicine)
Aug 01, 2008; ... HONOLULU -- Insight into what's happening at home may help to explain behavior problems and school absenteeism in children with asthma, according to studies presented at the annual meeting of the Pediatric Academic Societies. Researchers from the University of Rochester (N.Y.) ...
Dopaminergics appear to impair impulse control.(Clinical Rounds)
Aug 01, 2008; ... CHICAGO -- Evidence continues to mount that dopaminergic therapy increases the odds of impulse control disorders in patients with Parkinson's disease. Dopamine agonist (DA)-treated patients had two- to threefold elevated odds of having a current impulse control disorder (ICD), ...