Family Practice News back issues from March 2009:
Big Apple targets diabetes outcomes.(NEWS)
Mar 01, 2009; ... [ILLUSTRATION OMITTED] New York City's diabetes prevalence and control numbers paint a dismal picture, but public health officials hope that the now 3-year-old hemoglobin [A.sub.1c] registry will help brighten the future for the city's nearly 700,000 adult residents living with ...
Stimulus law to target health IT, primary care: $17 billion available for EHR incentives.(NEWS)(electronic health records)
Mar 01, 2009; ... The newly enacted economic stimulus law will infuse tens of billions of dollars into the health care sector, providing incentives for using health information technology, increasing funds for primary care training, and launching initiatives in comparative effectiveness research. ...
Guidelines address use of opioids for chronic pain.(NEWS)
Mar 01, 2009; ... Newly released guidelines on opioid treatment of chronic noncancer pain address the dramatic increase in the use of opioids for this indication and provide evidence-based recommendations geared toward both specialists and primary care physicians. The guidelines, released by the ...
NYC's diabetes "not so nice" numbers.(NEWS)(The New York City Health and Nutrition Examination Survey)
Mar 01, 2009 ... The NYC HANES data revealed some telling facts about New York City's diabetic population. Diabetes prevalence in NYC HANES increased with age. from 3% among those aged 20-39 years to 28% among adults aged 60 years and older, but did not differ significantly by sex, race / ...
Multivitamin use questioned in postmenopausal women.(NEWS)
Mar 01, 2009; ... The use of multivitamins does not alter risk for several common cancers, cardiovascular disease, or death in postmenopausal women, according to a recent study. Data on 161,808 women participating in the Women's Health Initiative "provide convincing evidence that multivitamin use ...
Vitamin supplement use mismatched to need.(NEWS)
Mar 01, 2009; ... Vitamin and mineral supplements are used mostly by children and adolescents who don't need them, while those at greatest risk for deficiencies use supplements the least, according to a report. Analysis of data from the 1994-2004 National Health and Nutrition Examination Survey ...
Febuxostat becomes first gout drug approved in decades.(NEWS)
Mar 01, 2009; ... For the first time since 1964, the Food and Drug Administration has approved a drug for treating patients with gout. Last month, the FDA approved febuxostat for the long-term management of chronic hyperuricemia in patients with gout. Approval was based on data from three ...
FDA to require risk strategy for some opioids.(NEWS)(Food and Drug Administration)
Mar 01, 2009; ... A risk-management plan will be required to address the ongoing problems of inappropriate prescribing, misuse, abuse, and accidental overdoses of certain opioid medications, the Food and Drug Administration recently announced. The agency announced that letters had been sent to 16 ...
Doping 101.(EXPERT COMMENTARY)(Essay)
Mar 01, 2009; ... The recent admission by base-ball superstar Alex Rodriguez that he used banned drugs earlier in his career is only one chapter in the ongoing saga of performance-enhancing products in sports, as athletes seek an edge and regulators try to keep the playing field level with high-tech drug ...
Hyperthyroidism in kids presents as cardiac, behavioral symptoms.(CARDIOVASCULAR MEDICINE)
Mar 01, 2009; ... Cardiac symptoms in a child should raise a high index of suspicion of hyperthyroidism, based on the results of a single-center study that also found prominent behavioral and mood issues in many children with the diagnosis. Hyperthyroidism was diagnosed in more than half the ...
Companies to study plavix's inconsistency.(CARDIOVASCULAR MEDICINE)
Mar 01, 2009; ... The Food and Drug Administration said that Sanofi-Aventis and Bristol-Myers Squibb Co. have agreed to conduct studies to better characterize the effectiveness of clopidogrel (Plavix) in patients with certain genetic factors. The two manufacturers also have said they will lead clinical ...
Aldosterone blockers viewed as key drugs in obese patients.(CARDIOVASCULAR MEDICINE)
Mar 01, 2009; ... NEW YORK -- Two aldosterone receptor blocking drugs--spironolactone and eplerenone--have almost overnight become important, second-line antihypertensive drugs for obese patients. "Aldosterone receptor blockers were never on the list [of major antihypertensive drug choices], and ...
Heredity strongly influences insulin clearance.(METABOLIC DISORDERS)
Mar 01, 2009; ... Insulin clearance is a highly heritable trait that has now been tracked to specific regions of two chromosomes, a finding that may have important implications for risk assessment in diabetes, polycystic ovary syndrome, and the metabolic syndrome. Although it has been "virtually ...
Use of glitazone associated with diabetic macular edema.(METABOLIC DISORDERS)
Mar 01, 2009; ... Glitazone use was associated with an increased risk of diabetic macular edema even after accounting for confounding factors, according to the results of a large, prospective cohort study. Insulin use and meglitinide use also resulted in statistically significant increases in the ...
Diabetes, prediabetes top 40% among U.S. adults.(METABOLIC DISORDERS)
Mar 01, 2009; ... More than 40% of American adults aged 20 years and older have hyperglycemic conditions, according to review of data from the 2005-2006 National Health and Nutrition Examination Survey. In this study, Catherine Cowie, Ph.D., of the National Institutes of Health and her colleagues ...
A. baumannii infections emerge in vets, families.(INFECTIOUS DISEASES)(acinetobacter baumannii infections in veterans)
Mar 01, 2009; ... SINT MAARTEN, NETHERLANDS ANTILLES -- Be on the lookout for Acinetobacter baumannii infections among wounded military personnel returning to the United States, an expert warned. "This is a major problem with our soldiers returning from Iraq and Afghanistan," according to Dr ....
RSV burden much worse than previously recognized.(INFECTIOUS DISEASES)(respiratory syncytial virus)
Mar 01, 2009; ... An estimated 2 million children under age 5 years require medical attention for respiratory syncytial virus each year, a "much larger burden than previously recognized," according to an analysis of surveillance data on more than 5,000 children. Recent data from the Centers for ...
Non-AIDS-Defining cancer rates still high in HIV infected.(INFECTIOUS DISEASES)
Mar 01, 2009; ... MONTREAL -- Although the rates of AIDS-defining cancers have declined significantly among people with HIV infection since the advent of antiretroviral therapy, the rates of non-AIDS-defining cancers--particularly those associated with an underlying infectious pathogen--continue to be ...
Doxycycline, metronidazole effective for rosacea.(SKIN DISORDERS)
Mar 01, 2009; ... SINT MAARTEN, NETHERLANDS ANTILLES -- A combination of doxycycline and metronidazole cleared more inflammatory rosacea lesions and worked faster than metronidazole alone in a randomized controlled trial. This combination should be considered a first-line treatment for rosacea, ...
Minimize side effects from treatment of acne, rosacea.(SKIN DISORDERS)
Mar 01, 2009; ... When treating rosacea and acne, pay close attention to the potential for adverse effects ranging from skin irritation to drug resistance, according to Dr. Joseph F. Fowler Jr. Irritation is especially common in rosacea patients, and there can be significant adverse effects from ...
Each beach vacation raises risk of small nevi in kids.(SKIN DISORDERS)
Mar 01, 2009; ... Each beach vacation from birth to age 6 by white Colorado children was associated with a 5% increase in small nevi when the children were examined at age 7, but not with large nevi development. In addition, the total estimated UV dose received on waterside vacations and the ...
Postnatal depression headed off by nurses, peers.(MENTAL HEALTH)
Mar 01, 2009; ... Two forms of postnatal intervention--one with trained nurses or midwives, and another with a peer--significantly reduced the likelihood of postnatal depression, according to the findings of two studies. The studies "add to the growing evidence that postnatal depression can be ...
Prepregancy obesity linked to postpartum depression.(MENTAL HEALTH)
Mar 01, 2009; ... SAN DIEGO -- Prepregnancy obesity is an independent risk factor for postpartum depression, a large analysis demonstrates. "While I advocate that we should screen all women for depression, I think there are subsets of women whose risk is so high that we should either be ...
Holistic steps advised for respiratory health.(PULMONARY MEDICINE)
Mar 01, 2009; ... SAN DIEGO -- Taking an integrative holistic medical approach to treating respiratory disease requires addressing the patient's environment, immune system balance, and emotional health. At a meeting sponsored by the Scripps Center for Integrative Medicine and the American Board ...
Probiotic use cut GI infections in preschoolers.(DIGESTIVE DISORDERS)
Mar 01, 2009; ... Preschool-aged children taking a multispecies probiotic showed a significant reduction in gastrointestinal infection, both over the short and long term, according to a Taiwanese study. Although single-strain probiotics did not have such an effect on gastrointestinal diseases, ...
Planned c-section found risky in low-risk women.(WOMEN'S HEALTH)(cesarean delivery)
Mar 01, 2009; ... SAN DIEGO -- Planned primary cesarean delivery was associated with increased morbidity, compared with vaginal delivery, among low-risk primiparous women at term, results from a large population-based study showed. Clinicians have debated the role of planned primary cesarean ...
Birth events unexpectedly common in cerebral palsy.(WOMEN'S HEALTH)
Mar 01, 2009; ... SAN DIEGO -- The development of cerebral palsy is associated with adverse intrapartum events in about 27% of term infants and 38% of preterm infants with the condition, according to findings from a large, retrospective population-based cohort analysis. Previous studies have ...
SSRIs and PPHN revisited.(DRUGS, PREGNANCY & LACTATION)(selective serotonin reuptake inhibitor, persistent pulmonary hypertension of the newborn)
Mar 01, 2009; ... The risks associated with selective serotonin reuptake inhibitor use in pregnancy have been addressed in previous columns because of the accumulating data suggesting that depression during pregnancy is common and that many pregnant women use SSRIs. A recent study indicated that as many as ...
Bone health advice in cancer updated.(WOMEN'S HEALTH)
Mar 01, 2009; ... SAN ANTONIO -- Current American Society of Clinical Oncology guidelines for the maintenance of bone health in breast cancer patients are outdated and do not sufficiently protect against fractures, a prominent European expert asserted at the San Antonio Breast Cancer Symposium. ...
IVF appears to increase risk of ovarian cancer.(WOMEN'S HEALTH)
Mar 01, 2009; ... SAN ANTONIO -- Ovarian stimulation for in vitro fertilization was linked to an increased risk of ovarian cancer 15 years later in a large cohort study that followed thousands of women in the Netherlands. Compared with controls who had fertility problems but did not undergo in ...
Prior breast ca warrants MRI screen.(WOMEN'S HEALTH)(magnetic resonance imaging)
Mar 01, 2009; ... CHICAGO -- Screening by breast magnetic resonance imaging is warranted in women with a personal history of breast cancer, data from a retrospective study of 144 women suggest. A review of 1,699 breast MRI studies performed at Memorial Sloan-Kettering Cancer Center in New York ...
Liver enzymes elevated with two RA biologics.(MUSCULOSKELETAL DISORDERS)
Mar 01, 2009; ... SAN FRANCISCO -- Patients being treated for rheumatoid arthritis with infliximab or adahmuma--but not etanercept--were more likely to have elevated levels of liver enzymes, compared with patients on nonbiologic disease-modifying antirheumatic drugs, analyses of data on 6,861 patients ...
Modified running technique reduced injuries.(SPORTS MEDICINE)(ChiRunning)
Mar 01, 2009; ... RIO GRANDE, P.R. -- Injury rates among recreational runners were significantly reduced after they adopted a running technique called ChiRunning, according to results of a survey of 2,500 runners. Previous research has suggested that injuries among runners increase with age, but ...
Mild septal deformation may be safe in athletes with LVH.(SPORTS MEDICINE)(left ventricular hypertrophy)
Mar 01, 2009; ... Endurance athletes with left ventricular hypertrophy had deformation values within normal limits, based on echocardiographic findings from 182 adults who participated in a study. Because hypertrophic cardiomyopathy (HCM) is a leading cause of sudden cardiac death in athletes, ...
Ankle replacement may not preclude sports participation.(SPORTS MEDICINE)
Mar 01, 2009; ... Most patients who undergo a total ankle arthroplasty are able to resume their sports activities at presurgical levels, an observational study has found. Of the 101 patients surveyed, 62% were active in sports before surgery and 66% after surgery; these patients participated in ...
Sedatives used in ICU may impair brain function.(CLINICAL ROUNDS)(intensive care unit)
Mar 01, 2009; ... NASHVILLE, TENN. -- Cognitive outcomes are significantly better in mechanically ventilated patients who are allowed a daily trial of spontaneous awakening and breathing, a finding that has led researchers to conclude that the sedatives used to induce coma in intensive care patients may ...
CAP guides may adversely affect antibiotic use.(CLINICAL ROUNDS)
Mar 01, 2009; ... Hospitals' responsibility to report compliance with guidelines on community-acquired pneumonia to the Centers for Medicare and Medicaid Services may influence many emergency physicians to prescribe antibiotics to patients they do not believe have pneumonia, according to the results of a ...
A family history call to action: genomic medicine.(GENOMIC MEDICINE)
Mar 01, 2009; ... One of my big pet peeves with electronic health record systems has been the lack of attention to family history capabilities. Most provide only a text box for data collection, and although a few systems collect structured data, in most cases that data cannot be moved from system to system ...
Medicare coverage of CT colonography is unlikely.(PRACTICE TRENDS)(computed tomography)
Mar 01, 2009; ... The Centers for Medicare and Medicaid Services has proposed to refuse coverage of computed tomography colonography for colorectel cancer screening. "The evidence is inadequate to conclude that CT colonography (CTC) is an appropriate colorectal cancer screening test," the agency ...
CMS limits bariatric surgery coverage for type 2 diabetes.(PRACTICE TRENDS)
Mar 01, 2009; ... The Centers for Medicare and Medicaid Services has made it official: Medicare beneficiaries with type 2 diabetes and a body mass index less than 35 kg/[m.sup.2] will not receive coverage for bariatric surgery. The announcement finalizes a proposed decision memo issued by CMS ...
Court shields billing records.(POLICY & PRACTICE)(Brief article)
Mar 01, 2009; ... An appeals court has ruled against the release of Medicare billing records, which was sought by the group Consumers" Checkbook so that it could grade physicians on quality. The nonprofit had filed a Freedom of Information Act request for all 2004 Medicare claims from physicians in several ...
IOM report: HIPAA is inadequate.(POLICY & PRACTICE)
Mar 01, 2009; ... The government's main health-privacy rule doesn't adequately protect people's health information, yet it hinders important health research, a report from the Institute of Medicine concluded. The privacy rule, stemming from the Health Insurance Portability and Accountability Act (HIPAA), is ...
Many people go without drugs.(POLICY & PRACTICE)(Brief article)
Mar 01, 2009; ... More children and working-age adults are failing to take needed prescription medications because of cost concerns, according to a national study by the Center for Studying Health System Change. In 2007, 1 in 7 Americans under age 65 years reported not filling a prescription in the previous ...
FDA on 'high-risk' list.(POLICY & PRACTICE)(Food and Drug Administration)(Brief article)
Mar 01, 2009; ... The Food and Drug Administration faces significant challenges that compromise its ability to protect Americans from unsafe and ineffective products, the Government Accountability Office said in adding the FDA to its biennial "high-risk" list. The GAO gives that label to government ...
Poll: affordability is tops.(POLICY & PRACTICE)(Brief article)
Mar 01, 2009; ... Making health insurance more affordable trumps improving quality and expanding coverage among the public's priorities for health care reform, according to a new poll. The survey from the Kaiser Family Foundation and the Harvard School of Public Health found that most people believe that ...
Humana supports ID cards.(POLICY & PRACTICE)(Brief article)
Mar 01, 2009; ... Humane has become the first health insurer to publicly support the Medical Group Management Association's drive to get standardized, machine-readable insurance cards into people's wallets by next January. "'Our goal is to continue working with MGMA and the industry to eliminate waste, ...
National children's study recruitment underway.
Mar 01, 2009; ... Researchers in North Carolina and New York are beginning to recruit volunteers as part of a huge federal study that will examine the effects of genes and environment on children's development. The researchers plan to track 100,000 women through pregnancy and then follow their ...
Thinking about golf.(INDICATIONS)
Mar 01, 2009; ... Thinking About Golf "Dude, where's my cart?" "It's in the guest bedroom, sir, exactly where you left it." "Right! That was one hetluva round." "Really sir, and does one crash into the house after a good round or a bad one?" "It was totally ...
HPV vaccine shows efficacy in males.(INFECTIOUS DISEASES)(human papillomavirus)
Mar 15, 2009; ... [ILLUSTRATION OMITTED] ATLANTA -- The human papillomavirus vaccine was efficacious in preventing persistent infections and genital warts caused by HPV strains 6, 11, 16, and 18 in a Merck-sponsored study of 4,065 males aged 16-26 years. The findings were presented by ...
FDA urged to step up regulation of supplements: adverse events are largely underreported.(NEWS)
Mar 15, 2009; ... The days when the dietary supplements industry is allowed to regulate itself may be numbered following release of a federal report addressing growing concerns about dietary supplement industry. The report, issued this month by the Government Accountability Office, calls on the ...
Guidelines tout prostate cancer chemoprevention.(CLINICAL ROUNDS)
Mar 15, 2009; ... Healthy men with a prostate-specific antigen score of 3.0 or lower should consider taking a 5-alpha reductase inhibitor to prevent prostate cancer, according to newly released clinical practice guidelines. The guidelines, issued by the American Urological Association and the ...
Dietary guidelines address eating behaviors: the recommendations identify the range of possible influences on contemporary eating patterns.(NEWS)
Mar 15, 2009; ... The American Heart Association and several other health-advocacy groups have had healthy-diet recommendations on the table for several years while obesity raged on. Now the AHA has released a plan on how America can make better diets part of everyone's everyday life. The AHA's ...
Stronger warning on dyskinesia risk required on metoclopramide.(NEWS FROM THE FDA)
Mar 15, 2009; ... A boxed warning about an increased risk of tardive dyskinesia associated with the chronic use of metoclopramide will be added to the drug's label, according to the Food and Drug Administration. In a written statement issued last month, the FDA announced that manufacturers of ...
Check serum bicarbonate before zonisamide therapy.(NEWS FROM THE FDA)(Brief article)
Mar 15, 2009; ... Serum bicarbonate levels should be checked in patients before initiating treatment with the antiepileptic drug zonisamide because of an association between the drug and metabolic acidosis, according to an alert issued by the Food and Drug Administration last month. Serum ...
Primary care docs balk at herpes vaccine costs.(NEWS)
Mar 15, 2009; ... ATLANTA -- About half of family physicians and internists currently stock and administer the herpes zoster vaccine in their offices, but most administer it to very few of their eligible patients, citing cost and reimbursement hurdles as major barriers. Those findings come from a ...
Initiative offers coverage for obesity prevention.(NEWS)
Mar 15, 2009; ... Nearly a million children would gain health insurance coverage for weight-management counseling under an obesity prevention initiative spearheaded by former President Bill Clinton. As part of the initiative, a group of health insurers and employers have agreed to pay for at ...
Analysts predict big jump in health care share of GDP.(NEWS)
Mar 15, 2009; ... WASHINGTON -- Even as the economic downturn causes private health spending to slow, public sector health spending is rising, according to a federal analysis. An estimated 3.4 million people may lose private health insurance coverage in 2009 and another 2.6 million may lose ...
President's budget earmarks $634 billion for health reform.(NEWS)
Mar 15, 2009; ... President Barack Obama has made health care a top priority in his first budget proposal by setting aside $634 billion over the next decade to begin reforming the health care system and expanding coverage to all Americans. The proposed "reserve fund" for health care would get ...
Let's admit what isn't working.(COMMENTARY)(Kaiser Family Foundation)
Mar 15, 2009; ... If there's one statistic that says it all about the impact of this recession on health care, it's this one: More than half of Americans (53%) report that they have had to cut back on health care in the past 12 months because of cost concerns, according to survey findings from the Kaiser ...
United's medical home gamble.(COMMENTARY)(UnitedHealth Group Inc.)
Mar 15, 2009; ... UnitedHealth Group's proposal for a "medical home" program in Florida sounded like a reasonable idea. It's hard to argue with developing performance measures and improving quality for patients. United's proposal also addressed one thing I am always concerned about: low pay for ...
Dyslipidemia in kids predicts carotid thickening.(CARDIOVASCULAR MEDICINE)
Mar 15, 2009; ... Adolescents with dyslipidemia--especially those who were overweight or obese--were more likely than were adolescents with normal lipid levels to have increased carotid artery intima-media thickness by young adulthood, a study of 1,711 people found. The study also found the ...
Opinion-based ACC/AHA recommendations raise concern.(CARDIOVASCULAR MEDICINE)(American College of Cardiology, American Heart Association)
Mar 15, 2009; ... Nearly half of the current clinical practice recommendations issued by the American College of Cardiology and the American Heart Association are based on expert opinion, case studies, or standards of care, and hence are not evidence based. This may or may not be a problem, but ...
Hep A vaccine advised for adoptee contacts.(INFECTIOUS DISEASES)(hepatitis A vaccination)
Mar 15, 2009; ... ATLANTA -- Hepatitis A vaccination should be given to all previously unvaccinated nontraveling individuals who will be in close personal contact with an internationally adopted child, the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention voted ...
Influenza A appears resistant to oseltamivir.(INFECTIOUS DISEASES)
Mar 15, 2009; ... The dominant strain of influenza A during the current flu season is nearly completely resistant to oseltamivir because of a mutation that leaves its virulence intact, according to two studies that upset long-held ideas about oseltamivir-resistant influenza A (H1N1) viruses. ...
Outreach boosts quality of rural diabetes care.(METABOLIC DISORDERS)
Mar 15, 2009; ... NEW YORK -- A concerted effort to bring diabetes educators to rural primary care practices in the Pittsburgh area led to substantial improvements in the quality of patient care. In one practice, for example, use of critical monitoring tools rose significantly after a diabetes ...