Family Practice News back issues from October 2008:
AAFP: transform practice to survive.(News)(American Academy of Family Physicians)
Oct 01, 2008; ... [ILLUSTRATION OMITTED] SAN DIEGO -- Two themes dominated the annual Congress of Delegates of the American Academy of Family Physicians: the risk of the specialty sinking from financial burdens, and a potential lifeboat called the patient-centered medical home. In the ...
Antidepressants show promise for fibromyalgia: tolerability may limit usefulness for some.(News)
Oct 01, 2008; ... BARCELONA -- Milnacipran, an antidepressant that equally inhibits both norepinephrine and serotonin uptake, and trazodone, an antidepressant with sedative properties, both appear to relieve pain and improve sleep and overall quality of life for fibromyalgia patients. Although ...
Experts continue debate on ezetimibe cancer concerns.(News)
Oct 01, 2008; ... MUNICH -- Many experts have been reassured that the signal of a cancer risk that was reported last July for treatment with the lipid-lowering drug ezetimibe was likely the result of chance and was not real, but other cardiologists cautioned that their concerns will linger until additional ...
A high ankle-brachial index also spells trouble.(News)
Oct 01, 2008; ... MUNICH -- Just when a low ankle-brachial index is gaining traction in clinical practice as a useful predictor of cardiovascular events, new evidence indicates a high ankle-brachial index also confers significant risk. Historically, high ankle-brachial index (ABI) values were ...
Medical home demo seeks coordinating centers.(News)(Brief article)
Oct 01, 2008; ... The Commonwealth Fund is gearing up to turn 50 safety net clinics into models of the patient-centered medical home. The demonstration project, called the Safety Net Medical Home Initiative, will run for 5 years with the goal of creating an implementation plan that can be ...
Temptation of tobacco money for Tar Wars ignites debate.(News)
Oct 01, 2008 ... AAFP delegates debated long and hard about whether to make a onetime exception to academy policy and seek tobacco industry money to fund its antismoking Tar Wars program. In a year of belt-tightening, the academy decided it no longer could afford the $115,000 annual budget of ...
Data back benefits of early glucose control.(News)
Oct 01, 2008; ... ROME -- Sustained improvements in diabetes-related end points were achieved with early rather than delayed use of intensive glucose control in patients with newly diagnosed type 2 diabetes, according to results from a landmark diabetes study follow-up. Particular benefits were ...
No free ride on health care.(Letter to the editor)
Oct 01, 2008; ... Miles J. Zaremski continues the misleading "for or against" discussion in his column, "'Has the Time Come for Universal Coverage?" (Law & Medicine, Aug. 1, 2008, p. 48). FAMILY PRACTICE NEWS, the AAFP, and similar organizations need to educate the media, politicians, and the ...
Obama: preserve what works; improve what doesn't.(Election 2008: Physicians' Perspectives)(Barack Obama)
Oct 01, 2008; ... As doctors, you know well what ails Our health care system. Are there any among us who have not cared for a patient without health insurance? Who hasn't noticed that the cost of care has risen so high that many can no longer afford the care we provide? Who doesn't sometimes feel that we ...
McCain: control costs; ensure access.(Election 2008: Physicians' Perspectives)
Oct 01, 2008; ... For the past several months I have closely followed the health care policies of Sen. John McCain (R-Ariz). I am impressed how the senator places the individual--patient and physician--at the center of this policy. The McCain plan is not simply about insurance or government programs. It is ...
Complex coronary disease poses trade-offs.(Cardiovascular Medicine)
Oct 01, 2008; ... MUNICH -- Will patients who need coronary revascularization rather face a small increased risk of a stroke or a larger risk for a repeat procedure within a few months? That is the decision facing patients with complex coronary disease, based on results from the largest and most ...
Diabetic patients may fare as well from stents as from CABG.(Cardiovascular Medicine)(Clinical report)
Oct 01, 2008; ... MUNICH -- Patients with diabetes who received coronary stents fared just as well as similar patients who underwent coronary bypass surgery in a randomized study. The results seemed to disprove the conventional wisdom that percutaneous coronary intervention (PCI) is not a good ...
Heart failure is no longer deadlier than most cancers.(Cardiovascular Medicine)
Oct 01, 2008; ... MUNICH -- Five-year survival of patients with heart failure has been dire, worse than for many cancers. But therapeutic advances in the last 2 decades mean that today, for the first time, that's no longer true, according to a large Swedish study. "Heart failure has become less ...
Metformin reduced heart failure morbidly, mortality.(Cardiovascular Medicine)
Oct 01, 2008; ... MUNICH -- Metformin-treated diabetic patients with heart failure had strikingly lower morbidity and mortality than did those on oral sulfonylureas, in a long-term observational study. "Our data suggest metformin is probably safe--and potentially effective--in congestive heart ...
Inflammatory marker may flag higher cardiac mortality risk.(Cardiovascular Medicine)(Clinical report)
Oct 01, 2008; ... TORONTO -- An elevated serum level of a novel inflammatory marker, YKL-40, was linked with a significantly increased risk for all-cause death and cardiovascular death in a study of more than 4,000 patients with a history of myocardial infarctions or angina. "This is the first ...
A 1% rise in [HbA.sub.1c] bumps up cardio risk by 11%.(Metabolic Disorders)
Oct 01, 2008; ... ROME -- For every 1% rise in baseline hemoglobin [A.sub.1c] the risk that a patient with type 2 diabetes would later develop coronary heart disease increased by 11% in a large observational study. Furthermore, there was a 25% decreased risk of cardiovascular disease (CVD) in ...
Telmisartan failed to improve cardiac event rates.(Metabolic Disorders)(Brief article)
Oct 01, 2008; ... MUNICH -- The disappointing performance of the angiotensin receptor blocker telmisartan for prevention of cardiovascular events and new-onset diabetes in the nearly 6,000-patient TRANSCEND trial leaves the ACE inhihitors securely ensconced as agents of choice, cardiologists agreed at the ...
Pioglitazone cut ischemic cardiac event rate by 17%.(Metabolic Disorders)
Oct 01, 2008; ... MUNICH -- Treating type 2 diabetic patients with the insulin-sensitizing drug pioglitazone conferred a highly significant 17% reduction in ischemic cardiovascular events, according to a large meta-analysis. The relative risk reduction was comparable among patients at relatively ...
Fitness sharply cut death in high-BMI diabetics.(Metabolic Disorders)(body mass index)
Oct 01, 2008; ... MUNICH -- Middle-aged men with type 2 diabetes can reduce their long-term mortality risk by roughly 14% for each 1-MET increase they achieve in peak exercise capacity through improved physical fitness, according to a large epidemiologic study. The findings provide a persuasive ...
Online record access failed to impact outcomes.(Metabolic Disorders)
Oct 01, 2008; ... Primary care physicians are more likely to adjust medications for patients with diabetes who are given interactive, online access to their personal health records before an appointment, compared with a control group, according to a randomized trial. However, clinical outcomes at 1 ...
Most cancer patients don't get flu shots.(Infectious Diseases)
Oct 01, 2008; ... STOCKHOLM -- Vaccination coverage for very severe manifestations of influenza remains low in patients with cancer, even though they are at high risk. Just 34% of 112 consecutive cancer patients receiving treatment at the Hopital Cochin, Paris, also received flu shots in 2008. Of ...
Immunization rates continue to increase.(Infectious Diseases)
Oct 01, 2008; ... More than three-quarters of the nation's young children have been immunized with the full series of childhood vaccines recommended by the Centers for Disease Control and Prevention. Data from the 2007 National Immunization Survey showed that all but one vaccine in the ...
Lab tests catch infection risk in febrile infants.(Infectious Diseases)
Oct 01, 2008; ... HONOLULU -- A few simple, inexpensive laboratory tests conducted in the outpatient setting could have identified which febrile infants were likely to have serious bacterial infections and should have been considered for hospital admission, according to the results of a retrospective study ...
Infections in athletes demand close attention.(Skin Disorders)
Oct 01, 2008; ... VANCOUVER, B.C. -- Managing skin infections in young athletes can be more challenging than in the general pediatric population, because close physical contact and use of shared equipment can lead to rapid spread of infections and outbreaks. In addition, some athletes with skin ...
Triamcinolone 10 mg is best for psoriatic nails.(Skin Disorders)(Brief article)
Oct 01, 2008; ... CHICAGO -- Triamcinolone acetonide 10 mg/mL is the best dose for psoriatic fingernails dystrophy, according to a randomized, dose-comparison study. The 90 psoriatic fingernails included in the study were divided into three groups of 30 and treated with an intramatrix injection ...
Molecular imaging helps in detection of breast cancer.(Women's Health)
Oct 01, 2008; ... A novel imaging technique seems to e better than standard mammogaphy at detecting breast cancer in high-risk women with dense breast tissue, according to findings from a study involving 940 women. Molecular breast imaging detected three times as many cancers as mammography did ...
Antirejection drugs.(Drugs, Pregnancy And Lactation)
Oct 01, 2008; ... Stopping a medication during pregnancy because of potential risks to the fetus is not an option for women who have had an organ transplant, because they risk losing the transplanted organ. Despite considerable concerns about the reproductive safety of cyclosporine, by far the most commonly ...
Illicit drug use dips in youth, spikes in boomers.(Mental Health)
Oct 01, 2008; ... WASHINGTON -- The rate of illicit drug use in adolescents and young adults stayed relatively steady in 2007, showing mild decreases in use for many drugs. But drug use continues to be carried into older age by baby boomers, especially those aged 55-59 years, which more than ...
Cognitive-behavioral therapy backed for PTSD in children.(Mental Health)(posttraumatic stress disorder )
Oct 01, 2008; ... Only cognitive-behavioral therapy, of all the major interventions being used to reduce psychological harm in children and adolescents who have witnessed or been victims of trauma or violence, has strong evidence to show it is effective, according to a review. Evidence was scant ...
Trends in teen sexual risk behavior veer from positive.(Mental Health)
Oct 01, 2008; ... MEXICO CITY -- Some of the favorable trends in sexual risk behaviors achieved among U.S. adolescents in recent decades appear to be stalling, particularly in certain subgroups, according to a study reported at the International AIDS Conference. "The purpose of this study was to ...
Hepatic encephalopathy can impair driving.(Digestive Disorders)
Oct 01, 2008; ... Patients with minimal hepatic encephalopathy typically rate themselves as good drivers, but they have significantly worse performance and more accidents on a driving simulator. The poor driving skills of these patients were corroborated by friends and family members in a study, ...
No difference in high-def endoscopy comparison.(Digestive Disorders)
Oct 01, 2008; ... A new high-definition, wide-angle videoendoscope did not detect significantly more colorectal adenomas or polyps, compared with a conventional colonoscope in a randomized study. The study's researchers noted that although it seemed logical that a higher resolution endoscope ...
Physical activity offset effect of "obesity genes".(Obesity)
Oct 01, 2008; ... Two gene variants were found to confer risk for obesity, but that risk was offset by an intensely physical lifestyle in a study of an Amish community. The findings suggest that in people genetically predisposed to obesity, high levels of physical activity can blunt that ...
Drug, lifestyle combo promotes weight loss.(Obesity)
Oct 01, 2008; ... Pramlintide treatment combined wwith lifestyle intervention resulted in sustained weight loss at 12 months in a single-blind, placebo-controlled extension study. Pramlintide (Symlin) is an injectable synthetic analogue of human amylin, a peptide hormone that is naturally ...
Apnea risk in bronchiolitis may be exaggerated.(Pulmonary Medicine)
Oct 01, 2008; ... DENVER -- Apnea risk may be lower than previously believed in otherwise normal infants with bronchiolitis. Early studies included many children with serious comorbid conditions that may have compounded their apnea risk, a systematic review of studies concluded. Hospitalization ...
Steroids might stem resistance to [[beta].sub.2] agonists.(Pulmonary Medicine)(Brief article)
Oct 01, 2008; ... Steroids may prevent or reverse the desensitization occurring with prolonged exposure to short-acting [[beta].sub.2]-adrenergic receptor agonists in treating chronic obstructive pulmonary disease and asthma. Phillip R. Cooper, Ph.D., and Dr. Reynold A. Panettieri Jr. incubated ...
Pediatric SLE's course varies by ethnicity, age.(Musculoskeletal Disorders)(systemic lupus erythematosus)
Oct 01, 2008; ... DESTIN, FLA. -- Ethnicity appears to play an important role in the incidence and clinical manifestations of pediatric systemic lupus erythematosus, data from a recent study suggest. Findings from the study of 87 white and 154 nonwhite children showed that more than 60% of ...
Combo prevents progression of early rheumatoid arthritis.(Musculoskeletal Disorders)
Oct 01, 2008; ... PARIS -- The addition of infliximab to intensive combination disease-modifying therapy in early rheumatoid arthritis resulted in higher rates of remission and no radiographic progression at 2 years in a placebo-controlled trial of 100 patients. Combination therapy with ...
Factors may predict response to less aggressive RA therapy.(Musculoskeletal Disorders)(rheumatoid arthritis )
Oct 01, 2008; ... PARIS -- Factors that predict which patients with rheumatoid arthritis will achieve and maintain stable remission following treatment with traditional disease-modifying drugs include low body mass index, low erythrocyte sedimentation rate levels, and absence of anti-cyclic citrullinated ...
Red blood cell measure linked to stroke death.(Clinical Rounds)
Oct 01, 2008; ... NEW ORLEANS -- Red blood cell distribution width appears to be a significant predictor of stroke mortality, according to data from the third National Health and Nutrition Examination Survey. An analysis of data from 480 participants in NHANES III who had a stroke and who were ...
Look for four signs of serious disease in microhematuria.(Clinical Rounds)
Oct 01, 2008; ... STANFORD, CALIF. -- Asymptomatic microscopic hematuria is usually benign in children but should prompt an assessment for the big four signs of serious underlying renal disease--asymptomatic microhematuria and recurrent or persistent gross hematuria, significant fixed (nonorthostatic) ...
Pregabalin deemed safe add-on for refractory seizures.(Clinical Rounds)
Oct 01, 2008; ... MADRID -- Pregabalin is an effective add-on therapy for refractory partial seizures in adults aged 50 years and older, according to a post hoc analysis that included 335 patients. The analysis extracted data on patients aged 50 years and older who were enrolled in any of six ...
Insulin may curb plaques in Alzheimer's patients.(Clinical Rounds)
Oct 01, 2008; ... CHICAGO -- A postmortem analysis of subjects with Alzheimer's disease and diabetes found up to 80% fewer amyloid beta plaques in the brains of those who took both insulin and oral diabetic medication while alive. Although epidemiologic studies confirm a significantly increased ...
Antihistamine may play a role in Alzheimer's.(Clinical Rounds)
Oct 01, 2008; ... CHICAGO -- An off-the-market antihistamine, previously shown to slow cognitive decline over 1 year in Alzheimer's patients, continued to preserve cognition and memory in a 6-month open-label extension trial. The drug, dimebon, also stabilized cognition in patients who started ...
Brain stimulation trumps drugs for parkinson's.(Clinical Rounds)
Oct 01, 2008; ... CHICAGO -- Preliminary data suggest that deep brain stimulation may be superior to medical therapy in Parkinson's disease, and that stimulating specific targets may lead to different outcomes. Complete data on 230 of 255 patients with idiopathic Parkinson's disease showed that ...
CMS proposes to switch to ICD-10 codes by 2011.(Practice Trends)(Centers for Medicare and Medicaid Services )
Oct 01, 2008; ... Officials at the Centers for Medicare and Medicaid Services plan to replace the ICD-9-CM diagnosis and procedure code set with a significantly expanded set of codes--the ICD-10--by Oct. 1, 2011. But physician groups are calling the agency's plan rushed and unworkable and want ...
Media influences tobacco use.(Policy & Practice)(Brief article)
Oct 01, 2008; ... Media communications--including movies, advertising, and news--play a key role in shaping tobacco use, according to a lengthy report from the National Cancer Institute. It noted that cigarettes are among the most heavily marketed products in the United States, and that most of the ...
Tobacco control support drops.(Policy & Practice)(Brief article)
Oct 01, 2008; ... Budgets for tobacco control programs in most states are either staying level or declining, despite increases in payments from the 1997 Tobacco Master Settlement Agreement, designed to compensate states for some of the cost of smoking-related illnesses, the American Lung Association ...
'Free' Rx samples expensive.(Policy & Practice)(Brief article)
Oct 01, 2008; ... Free drug samples provided to physicians by pharmaceutical companies actually could cost uninsured patients more in the long run, because those patients are prescribed brand-name drugs rather than generics, according to a study done by researchers at Wake Forest University Baptist Medical ...
Grants to doctors in hurricanes.(Policy & Practice)(AMA Foundation's Health Care Recovery Fund )(Brief article)
Oct 01, 2008; ... The AMA Foundation's Health Care Recovery Fund will provide grants of up to $2,500 to physicians in places that have been declared disaster areas by the Federal Emergency Management Agency, and the foundation currently is accepting donations to help physicians who have been ...
Tools' usefulness limited.(Policy & Practice)(Brief article)
Oct 01, 2008; ... Although health plans are developing tools to help consumers compare price and quality information across hospitals and physicians, the tools" pervasiveness and usefulness are limited, according to a study by the Center for Studying Health System Change. The information provided as part of ...
Many reach 'doughnut hole'.(Policy & Practice)(Brief article)
Oct 01, 2008; ... One in four Medicare Part D enrollees who filled prescriptions in 2007 reached the gap in coverage known as the "doughnut hole," and most remained in the doughnut hole for the rest of the year, according to an analysis from the Kaiser Family Foundation. The analysis suggested that about ...
Good Samaritan acts.(Law & Medicine)
Oct 01, 2008; ... Question: During a flight from Los Angeles to Newark, a passenger developed acute chest pain and diaphoresis. A flight attendant put out an emergency call, but Dr. Brown, a general internist nearing retirement, failed to respond because he was concerned about potential litigation ....
CMS steps up oversight of the Joint Commission.(Practice Trends)(Centers for Medicare and Medicaid Services)(Brief article)
Oct 01, 2008; ... The Joint Commission on the Accreditation of Healthcare Organizations, which provides the standard in hospital accreditation in the United States, will soon be subjected to greater federal oversight. Congress recently eliminated the Joint Commission's "unique deeming authority" ...
Newborn Screening.(GENOMIC MEDICINE)
Oct 01, 2008; ... Technological advances in recent years have made it possible for newborn infants in the United States to be screened for more than two dozen conditions. The first genetic screen for newborns was a simple, reliable test for phenylketonuria (PKU), an inherited neurodevelopmental ...
Pain relievers.(Practice Trends)(Cartoon)
Oct 01, 2008 ... "It's not perfect, but it's the only peer review ...
Whoa, that's heavy, man.(Indications)(Brief article)
Oct 01, 2008; ... When 29 young men in Leipzig, Germany, last year presented with possible poisoning symptoms--stomach cramps, nausea, anemia, and fatigue--public health doctors and officials were puzzled. But there were quite a few clues: The patients were all young (aged 16-33 years), students or ...
Fleshy facebook photos.(Indications)(patient's flesh posted by a nurse on her Facebook account)(Brief article)
Oct 01, 2008; ... And speaking of unscrupulous dealings, a nurse at a hospital in Stockholm may lose her job because she posted images to her Facebook page from a couple of surgeries-brain and spinal--on which she assisted. In one shot (via her cell phone, natch, since cameras are normally banned from the ...
Auricular therapy eases chronic pain.(Clinical Rounds)
Oct 15, 2008; ... [ILLUSTRATION OMITTED] In 2005, family physician Robert Bonakdar was searching through PubMed in preparation for a lecture he was about to deliver to physicians on the nonpharmacologic treatment of chronic pain. He came across two randomized controlled trials that ...
Direct patient care hours similar among family medicine work settings, 2007.(VITAL SIGNS)(Statistical table)(Brief article)
Oct 15, 2008 ... <Pre> Direct Patient Care Hours Similar Among Family Medicine Work Settings, 2007 Mean clinical hours per week Family practice: sports medicine (n = 26) 38.2 Family practice: urgent care (n = 96) 38.1 Family practice with ob. (n = 632) 37.0 ...
Mental health care parity signed into law; starts in 2009: health plans can decide what to cover.(News)
Oct 15, 2008; ... After a 12-year fight led by mental health advocates, patients, families, clinicians, and a handful of members of Congress, some 113 million Americans will soon have equality of coverage between their benefits for physical health care and mental or behavioral health care. The ...
Even subclinical thyroid dysfunction ups mortality.(Metabolic Disorders)(Clinical report)
Oct 15, 2008; ... CHICAGO -- Subclinical hyperthyroidism significantly increases the risks of both cardiovascular and all-cause mortality, according to a prospective Brazilian cohort study. Subclinical hypothyroidism was similarly an independent risk factor for all-cause mortality in the study ....
Kudos to family doctor Regina M. Benjamin.(News)(Brief article)
Oct 15, 2008; ... Dr. Regina M. Benjamin received "the call" last month. The once-in-a-lifetime kind from the John D. and Catherine T. MacArthur Foundation, which awarded the family physician and 24 other individuals $500,000 each in "no strings attached" support. The awards, paid over the next 5 years, are ...
Pediatric OTC cough, cold drugs await standards.(NEWS FROM THE FDA)(over-the-counter)
Oct 15, 2008; ... BELTSVILLE, MD. -- The use of over-the-counter cough and cold products in children continued to be questioned by pediatricians and consumer advocates at a Food and Drug Administration public hearing on this issue-the latest step in the agency's time-consuming process of revising the ...
FDA warns five ADHD medication manufacturers on false label claims.(News)(Food and Drug Administration, attention-deficit/hyperactivity disorder)
Oct 15, 2008; ... The Food and Drug Administration has warned five manufacturers of drugs for attention-deficit /hyperactivity disorder against using what it terms "false or misleading" promotional materials that overstate the drugs' .efficacy and downplay risks. The warnings, contained in ...