Family Practice News back issues from November 2008:
Sexual dysfunction postsurgery ignored.(Women's Health)
Nov 01, 2008; ... [ILLUSTRATION OMITTED] GOTEBORG, SWEDEN -- Almost every woman treated for a gynecologic cancer has sexual problems during or after therapy, yet providers and investigators rarely address those consequences. Sexual dysfunction is "the silent issue," Dr. Karin Bergmark ...
Little financial reward from PQRI.(VITAL SIGNS)(Brief article)
Nov 01, 2008 ... <Pre> VITAL SIGNS Little Financial Reward From PQRI How has your practice's involvement in the 2007 and/or 2008 PQRI program affected total physician compensation? Don't know 9.8% Increased 11.7% No change 72.7% Reduced ...
Type 2 algorithm backs aggressive approach to care: an [HbA.sub.1c] of 7% or greater is a call to act.(News)
Nov 01, 2008; ... A newly revised type 2 diabetes treatment algorithm released jointly by the American Diabetes Association and the European Association for the Study of Diabetes aims to clarify therapeutic options and to assure physicians that an aggressive treatment approach may be warranted in select ...
Evidence-backed exercise goals set for adults, kids.(Obesity)
Nov 01, 2008; ... Adults who engage in at least 2.5 hours of moderate-intensity aerobic exercise each week and children who are physically active for I hour a day can realize "substantial" health benefits, according to guidelines from the U.S. Department of Health and Human Services. There is ...
Ongoing drug safety investigations posted online.(News)
Nov 01, 2008; ... The Food and Drug Administration has posted on its Web site the first quarterly report of drugs identified as having "potential safety issues" that are under evaluation, to keep health care professionals and the public informed about latest drug safety information available, according to ...
FDA set to clarify food allergen label wording.(News)
Nov 01, 2008; ... COLLEGE PARK, MD. -- Efforts to improve the confusing, inconsistent, and often misleading statements on food packages that indicate a food allergen may be present in the product are underway at the Food and Drug Administration. Manufacturers of food products that contain a major ...
U.S. hospitals score a mediocre 'C' for palliative care services.(News)
Nov 01, 2008; ... Hospitals are rapidly adding palliative care services, but their availability is widely disparate, according to a report that gave a grade of "C" to the state of palliative care services in the nation's hospitals. Overall, 53% of U.S. hospitals with 50 or more beds reported ...
Paying for advanced medical imaging.(Guest Editorial)
Nov 01, 2008; ... Advances in imaging technology can promote earlier, safer, and more precise detection of disease. More than 80 million medical imaging tests are performed annually in the United States at a cost of more than $100 billion. About 15% of that testing, at a cost of $15 billion per year, is ...
Chain drugstores and cigarette sales.(Letter to the editor)
Nov 01, 2008; ... The recent graphic feature on the front page listed chain drugstores as the top source for prescription drugs ("Top 10 Channels for Prescription Drug Distribution in 2007," Vital Signs, June 1, 2008, p. 1). It is particularly ironic that these establishments also are a top ...
Liability may delay vaccine adoption.(Letter to the editor)
Nov 01, 2008; ... A front page article says that physicians may choose to delay adoption of combination vaccines because doctors are reimbursed based on the number of vaccines they administer, and that reducing the number of shots will reduce profits ("New Combo Vaccines Could Complicate Practice," July 15, ...
Uninsured buy luxuries, nut health care.(Letter to the editor)
Nov 01, 2008; ... I must respectfully disagree with Dr. Steffie Woolhandler and her opposition to consumer-directed health care ("Do High-Deductible Plans Coupled With HSAs Promote Underinsurance?" Point/Counterpoint, July 15, 2008, p. 12). She attempts to prove that universal single-payer ...
Ivabradine cuts coronary events in those with high resting heart rate.(Cardiovascular Medicine)(Antiangina agents)
Nov 01, 2008; ... MUNICH -- The antianginal drug ivabradine reduced acute myocardial infarctions and need for coronary revascularization in patients with coronary artery disease, left ventricular dysfunction, and a resting heart rate of 70 beats per minute or more in the 11,000-patient BEAUTIFUL trial. ...
Groups address GI effects of antiplatelets, NSAIDs.(Cardiovascular Medicine)(gastrointestinal, non-steroidal anti-inflammatory drugs)
Nov 01, 2008; ... Identifying and treating the potentially life-threatening problem of gastrointestinal complications in patients who use the combination of antiplatelet therapy and NSAIDs are the focus of a new scientific statement by the American College of Cardiology Foundation, the American College of ...
STAT registry: acute severe hypertension is poorly managed.(Cardiovascular Medicine)(Studying the Treatment of Acute Hypertension)
Nov 01, 2008; ... MUNICH -- Acute severe hypertension is a common, suboptimally treated condition with a high recurrence rate and surprisingly high morbidity and mortality. These are the principal lessons of the just-completed large national Studying the Treatment of Acute Hypertension (STAT) ...
Cardiomyopathy common in breast cancer patients taking trastuzumab.(Cardiovascular Medicine)
Nov 01, 2008; ... MUNICH -- Roughly one in four breast cancer patients will develop trastuzumab-mediated cardiomyopathy when the monoclonal antibody is used with adjuvant chemotherapy in real-world settings. In the clinical trial setting, 5%-10% of women treated with trastuzumab (Herceptin) in ...
Coronary impact of smoking is worse in women.(Cardiovascular Medicine)(Brief article)
Nov 01, 2008; ... MUNICH -- Women who smoke tend to have their first acute MI considerably earlier in life than do male smokers. This observation in a case-control study suggests smoking increases the risk of cardiovascular disease to a relatively greater degree in women than in men, Dr. Morten ...
Guidelines suggest doubling kids' daily vitamin D dosage.(Metabolic Disorders)
Nov 01, 2008; ... BOSTON -- All children should get at least 400 IU of vitamin D daily, either through dietary intake or supplementation, beginning within days of birth and continuing through adolescence. New guidelines from the American Academy of Pediatrics double its 2003 vitamin D intake ...
Greater loss of bone density seen in men with diabetes.(Metabolic Disorders)
Nov 01, 2008; ... MONTREAL -- Loss of bone mineral density over time appears to be more severe in older men with type 2 diabetes than in older men without diabetes, even though men with diabetes have higher average bone mineral density at baseline. Data from 4 years of follow-up from a ...
Benefits outweigh lasofoxifene's risks in select women.(Metabolic Disorders)
Nov 01, 2008; ... ROCKVILLE, MD. -- The majority of a federal advisory panel agreed that the benefits of treatment with lasofoxifene, a selective estrogen receptor modulator, would likely outweigh the risks in some postmenopausal women with osteoporosis. The Food and Drug Administration's ...
Long-term outlook improving for type 1 patients.(Metabolic Disorders)(Clinical report)
Nov 01, 2008; ... ROME -- The long-term outlook for patients with type 1 diabetes today is improving substantially and is projected to improve further now that intensive therapy is used more widely. That conclusion is based on an analysis of epidemiologic data from two major studies involving ...
Intensive lifestyle intervention delivers a bonanza of benefits.(Metabolic Disorders)
Nov 01, 2008; ... MUNICH -- Obese type 2 diabetes patients with metabolic syndrome saw dramatic improvements in cardiac function and multiple cardiovascular risk factors after only 3 weeks in a German pilot study of an intensive lifestyle modification program including aerobic exercise and a low glycemic ...
Avoid delayed hypoglycemia in type 1 athletes.(Metabolic Disorders)
Nov 01, 2008; ... KEYSTONE, COLO. -- Delayed-onset hypoglycemia can become a concern in patients with type I diabetes after high-intensity or prolonged exercise, according to diabetes counselor Gary Scheiner, who spoke at a conference on the management of diabetes in youth. The effect is "due to ...
Early insulin trumps oral therapy in type 2.(Metabolic Disorders)
Nov 01, 2008; ... Early, aggressive insulin therapy is probably the optima] treatment for patients with newly diagnosed type 2 diabetes who present with severe hyperglycemia, because it provides better short-term glycemic control and [beta]-cell recovery than a regimen of oral antidiabetes drugs, a study ...
Study shows spike in prevalence of food allergies.(Skin Disorders)(Clinical report)
Nov 01, 2008; ... CHICAGO -- The prevalence of reported food allergies has risen 24% in children under age 5 years and 19% in children aged 5-17 years during the past decade, according to a study by the National Center for Health Statistics. The study, based on statistics for 1997-2007, provides ...
Makeup allergens are the source of most lip cheilitis.(Skin Disorders)(Brief article)
Nov 01, 2008; ... SAN FRANCISCO -- Fragrances, lip balm, and nickel are the allergens most responsible for allergic contact cheilitis, which is more prevalent in women. The data come from a subset of 10,061 patients with allergic contact dermatitis who were treated and underwent patch testing ...
New psoriasis treatments boast ease, convenience.(Skin Disorders)
Nov 01, 2008; ... CHICAGO -- A topical coal-tar solution that doesn't smell, a user-friendly hydrogel patch, and supraerythemogenic phototherapy were among the innovative approaches to psoriasis discussed at the American Academy of Dermatology Academy's 2008 meeting. The NeoStrata Co. has ...
Black box on efalizumab's label warns of infection risk.(Skin Disorders)
Nov 01, 2008; ... The label of the immunomodulator efalizumab will soon have a black box warning describing the potential risks of progressive multifocal leukoencephalopathy and other life-threatening infections, because of postmarketing reports of these serious infections, the Food and Drug Administration ...
Cardiac issues go unrecognized in many patients with psoriasis.(Skin Disorders)
Nov 01, 2008; ... PARIS -- Patients with moderate to severe psoriasis are at increased risk for cardiovascular disorders and diabetes, which often go undiagnosed, according to an analysis of three clinical trials. "There was a substantial number of psoriasis patients with previously undiagnosed ...
Let's reexamine the treatment of URIs.(Expert Commentary)(upper respiratory infection)
Nov 01, 2008; ... The data from three studies should prompt us to reexamine our approach to the management of upper respiratory infections in children. Guidelines from the American Academy of Pediatrics recommend antimicrobial treatment for children with upper respiratory symptoms lasting longer ...
One in four teen girls got at least one HPV vaccine dose.(Infectious Diseases)
Nov 01, 2008; ... A Survey providing the first estimates for human papillomavirus vaccination found that 25% of girls aged 13-17 had received at least one dose of the vaccine, according to the Centers for Disease Control and Prevention. "This was very good for a first-year measurement for a new ...
Experts offer hot tips for helping smokers quit.(Mental Health)
Nov 01, 2008; ... SAN DIEGO -- When it comes to helping patients quit smoking, most primary care physicians could stand to improve their communication and persuasion skills. A 2007 survey of more than 3,000 physicians conducted by the Association of American Medical Colleges found that 84% asked ...
Antipsychotics raise need for health checks.(Mental Health)(Clinical report)
Nov 01, 2008; ... BARCELONA -- More than 20% of patients taking antipsychotic medications for schizophrenia were at risk for diabetes, more than 30% had undiagnosed hyperlipidemia, and more than 50% had undiagnosed hypertension, a large European epidemiologic study has found. The findings drive ...
Preeclampsia may put adult offspring at risk of stroke.(Women's Health)
Nov 01, 2008; ... WASHINGTON -- A maternal history of preeclampsia may identify adults who are at increased risk for stroke. Adults whose mothers had severe preeclampsia were almost twice as likely to have strokes, compared with adults whose mothers didn't have preeclampsia, based on data from ...
Hypertension in pregnancy ups risk for later HT, stroke.
Nov 01, 2008; ... WASHINGTON -- Women who had hypertension during pregnancy are at increased risk for hypertension and stroke after 40 years of age. Follow-up data from more than 4,000 women suggest providers should ask patients about a history of hypertension in pregnancy and note the increased ...
Pulmonary hypertension and SSRIs.(Drugs Pregnancy And Lactation)(selective serotonin reuptake inhibitors)
Nov 01, 2008; ... Over the last several years, the reproductive safety of selective serotonin reuptake inhibitors (SSRIs) has been the focus of continual interest and concern, with data from several studies informing the question of relative risks of fetal exposure to these medicines. Two recent analyses ...
Hands-on approach helps assess shoulder pain.(Musculoskeletal Disorders)
Nov 01, 2008; ... SAN DIEGO -- When patients present to primary care clinics complaining of shoulder pain, the injury usually stems from secondary impingement, which results from mechanical dysfunction such as structural glenohumeral laxity or insufficiency of the shoulder's stabilizing muscles. ...
Most NSAID responders do so within two weeks.(Musculoskeletal Disorders)(non-steroidal anti-inflammatory drug)(Brief article)
Nov 01, 2008; ... PARIS -- The overwhelming majority of osteoarthritis patients who will respond favorably to a given cyclooxygenase-2-selective NSAID will do so within the first 2 weeks, a pooled analysis of two placebo-controlled clinical trials has shown. Thus, the 2-week mark is a reasonable ...
Large study links rhinitis to adult-onset asthma.(Pulmonary Medicine)
Nov 01, 2008; ... Rhinitis was a strong predictor of adult-onset asthma, according to findings from an 8-year population-based study in Europe. In the European Community Respiratory Health Survey, data from 6,461 participants showed that allergic rhinitis was associated with an increased risk of ...
Taking the stairs at work is a leg up for a healthier heart.(Obesity)
Nov 01, 2008; ... MUNICH -- "No thanks, I'll take the stairs instead," was the catch-phrase at the University Hospital, Geneva, last year as physicians and nurses in the Geneva stair study eschewed elevators for foot power. The study was set up to test a population-based strategy for increasing ...
Merck drops taranabant, cites psychiatric side effect profile.(Obesity)
Nov 01, 2008; ... Pharmaceutical manufacturer Merck & Co. has stopped developing taranabant, a weight-loss drug, because of concerns over psychiatric side effects, the company announced last month. "Available phase III data showed that both efficacy and adverse events were dose related, with ...
GERD guidelines deem surgery a last resort.(Digestive Disorders)
Nov 01, 2008; ... Medical therapy with antisecretory drugs should be the first-line treatment for gastroesophageal reflux disease, with antireflux surgery offered only to those whose symptoms are not controlled by medication or who can't tolerate the drugs, according to a new management guideline released ...
Barrett's guidelines tweak screening justification.(Digestive Disorders)
Nov 01, 2008; ... ORLANDO -- Strategies for screening and treatment approaches for Barrett's esophagus, which were addressed in clinical practice guidelines released by the American College of Gastroenterology earlier this year, continued to trigger discussion during the college's annual meeting. ...
Call to action targets deep vein thrombosis.(Clinical Rounds)(acting Surgeon General Steven K. Galson's statement)
Nov 01, 2008; ... WASHINGTON -- Despite progress that has been made in preventing deep vein thrombosis and pulmonary embolism, the persistently high incidence of these conditions has prompted a Call to Action statement by Acting Surgeon General Steven K. Galson. Among hospitalized spinal cord ...
Deaths raise ESA safety concerns in stroke study.(Clinical Rounds)(Clinical report)
Nov 01, 2008; ... A greater mortality rate in patients treated with epoetin alfa in a German study evaluating the drug's potential neuroprotective effects in stroke patients is the subject of an ongoing Food and Drug Administration safety review. A statement on the FDA's Web site said it had been ...
Framingham score IDs risk with raloxifene.(Clinical Rounds)(cerebrovascular event risk)(Brief article)
Nov 01, 2008; ... ORLANDO -- The Framingham stroke risk score can predict a high-risk postmenopausal woman's likelihood of a future cerebrovascular event with raloxifene use, according to an analysis of data from the Raloxifene Use for the Heart study. Investigators in 26 countries enrolled ...
Imaging preauthorization advised under Medicare.(Practice Trends)
Nov 01, 2008; ... The Government Accountability Office is urging Congress to require Medicare to adopt prior authorization procedures for outpatient imaging services, saying that the federal health program's current approach has allowed costs to balloon. According to the GAO, from 2000 to 2006, ...
Mass. Medicaid waiver extended.(POLICY & PRACTICE)(Massachusetts)(Brief article)
Nov 01, 2008; ... The Centers for Medicare and Medicaid Services has granted Massachusetts a 3-year, $21.2 billion Medicaid waiver that will allow the state to continue to expand access to care through its health reform law. The agreement represents a $4.3 billion increase over the current waiver and fully ...
Cephalon pays $425 million.(POLICY & PRACTICE)(inappropriate drug marketing for off-label use)(Brief article)
Nov 01, 2008; ... Cephalon Inc. has agreed to pay more than $425 million to settle claims that it inappropriately marketed three drugs for off-label uses, according to the U.S. Justice Department. The settlement will resolve civil and criminal complaints alleging that the company marketed Gabitril ...
Consumers like flat Rx pricing.(POLICY & PRACTICE)(Brief article)
Nov 01, 2008; ... Pharmacy customers who take advantage of flat-rate generic prescription drug prices have higher levels of satisfaction than those who don't, according to the second annual J.D. Power and Associates National Pharmacy Study. Nearly one-fourth of pharmacy customers participate in a $4 generic ...
Nationwide RAC launched.(POLICY & PRACTICE)(recovery audit contractor program)(Brief article)
Nov 01, 2008; ... CMS has launched its national recovery audit contractor program as part of its "aggressive new steps to find and prevent waste, fraud and abuse in Medicare." The new RACs, which will be paid on a contingency fee basis, soon will begin to contact providers about the program, CMS said. The ...
Many drug studies unpublished.(POLICY & PRACTICE)(Brief article)
Nov 01, 2008; ... Studies on new prescription drugs are less likely to be published if they conclude that the medication is ineffective, researchers reported in the journal PLoS Medicine. The researchers found that only 43% of all clinical trials submitted to the Food and Drug Administration to support drug ...
Florida files Vioxx suit.(POLICY & PRACTICE)
Nov 01, 2008; ... Florida Attorney General Bill McCollum has sued Merck & Co. on behalf of state agencies he said were damaged by "the company's allegedly deceptive marketing and promotion" of Vioxx. The lawsuit follows a 3-year investigation of Merck's promotional practices of Vioxx (rofecoxib) and alleges ...
Many practices are not prepared for disasters.(Practice Trends)
Nov 01, 2008; ... SAN DIEGO -- About a third of medical practices have no emergency medical preparedness plan to deal with disasters such as hurricanes and terrorist attacks, results from a national survey showed. More than 60% have not had disaster drills in their practice in the last 12 months ...
Geisinger uses medical home model to trim inpatient costs.(Practice Trends)(Geisinger Health System)
Nov 01, 2008; ... WASHINGTON -- Geisinger Health System has used a medical home model to slash inpatient costs in a demonstration program that it is now expanding to more of its practice sites, Dr. Glenn Steele Jr., CEO, said at a press briefing. The pilot was conducted at Geisinger's practice ...
Medical error reports tend to lowball costs.(Practice Trends)
Nov 01, 2008; ... Medical error studies that focus only on inpatient stays and do not take into account hospital readmissions and other patient care may underestimate costs by up to 30%, according to an analysis of millions of health insurance claims. William E. Encinosa, Ph.D., and Fred J ....
Penicillin allergy; negligence, and standard of care.(Law & Medicine)
Nov 01, 2008; ... Question: A 56-year-old man was admitted to the hospital with pneumonia. He had told the triage nurse on initial presentation he was allergic to penicillin, but the hospitalist subsequently administered ampicinin. Shortly after receiving the first dose, the patient developed progressive ...
Breaking the code.(Genomic Medicine)
Nov 01, 2008; ... In a recent lecture, Dr. Harold E. Varmus, Nobel laureate, former head of the National Institutes of Health, and president of Memorial Sloan-Kettering Cancer Center, suggested that we should temper our expectations about the near-term prospects for Finding "a" cure for cancer. Why would a ...
AAFP eyes greater role in setting CPT values.(Practice Trends)(American Academy of Family Physicians, Current Procedural Terminology)
Nov 01, 2008; ... Over the next year, officials at the American Academy of Family Physicians will weigh the best strategy for getting their voices heard when it comes to setting the values that determine Medicare payments. Traditionally, organized medicine has come together through a body called ...
When the (only a) moment is right.(Indications)(premature ejaculation)(Brief article)
Nov 01, 2008; ... Despite long being popularly perceived as a major concern for men, premature ejaculation did not have an evidence-based definition until earlier this year, when the International Society for Sexual Medicine (ISSM) presented the conclusion of a panel of world-class sexual health experts. To ...
From the big brother research dept.(Indications)(electroencephalography)(Brief article)
Nov 01, 2008; ... A couple of West Coast firms are adapting brain-scanning technology to gain insight into how people react to advertisements, computer games, and even presidential candidates. The companies use EEG sensors to correlate brain activity with physiological cues such as ...
From the that '70s lifesaver dept.(Indications)(Brief article)
Nov 01, 2008; ... The Bee Gees still rule. Yes, their iconic 1977 disco smash "Stayin' Alive" has been shown to help heart patients do just that, according to research presented at the American College of Emergency Physicians annual meeting. A study presented at the ACEP Scientific Assembly found that ...
E-prescribing tied to Medicare bonus.(News)
Nov 15, 2008; ... BOSTON -- "E-prescribing saves lives, it saves money, and it's time we implement it," according to Health and Human Services Secretary Mike Leavitt. Streamlining the bloated health care system "is an economic imperative for our country. We have to get down to making the system ...
CDC: immunize smokers against pneumococcus: habit accounts for 50% disease burden.(Infectious Diseases)
Nov 15, 2008; ... ATLANTA -- Cigarette smoking in adults aged 19-64 years should be considered an indication for 23-valent pneumococcal polysaccharide vaccination, the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention decided at its fall meeting. ...
MRSA-related sinusitis spikes, cultures warranted.(News)(methicillin-resistant Staphylococcus aureus )
Nov 15, 2008; ... WASHINGTON -- A steep increase in the proportion of sinusitis cases caused by methicillin-resistant Staphylococcus aureus should drive health care providers to broaden the use of cultures in areas where the prevalence of MRSA is high, a new study suggests. In a study comparing ...
Medicare rule could mean 5.1% more.(News)
Nov 15, 2008; ... physicians will have the potential to gain as much as a 5.1% increase in their Medicare payments next year, according to a final rule issued by the Centers for Medicare and Medicaid Services. The projected pay raise is a combination of the 1.1% payment increase mandated by ...